Do adults with ADHD get hyperactive?

Attention-Deficit/Hyperactivity Disorder (ADHD) is a condition commonly associated with children, but it also affects adults. In adults, ADHD can present itself in different subtypes, with varying levels of hyperactivity and inattention. However, the hyperactive subtype of ADHD is quite rare among adults. This is illustrated by a visual abstract which shows that only 7% of adults with ADHD fall into the hyperactive/impulsive only category, compared to 62% with the combined subtype and 31% with the inattentive only subtype.

Adults who seem to exhibit hyperactive behaviors might actually be diagnosed with Combined ADHD, a more common subtype. The notion of ADHD-HI (Hyperactive/Impulsive) being a distinct adult condition is increasingly challenged. Studies reveal that ADHD-HI is more prevalent in younger children and tends to evolve as they grow older. In fact, none of the 691 adults in a study met the strict criteria for ADHD-HI, leading to the suggestion that this subtype might be extremely rare or possibly non-existent in adults.

In adults, the diagnosis of hyperactive ADHD, also known as ADHD-HI, might not always be accurate. Research indicates that the attention deficit in adults clinically diagnosed with ADHD-HI does not significantly differ from those diagnosed with other subtypes. Interestingly, the inattention mean for the ADHD-HI group was slightly above that for the ADHD-Inattentive group, which contradicts the expectation of a lack of inattentive symptoms in ADHD-HI. This points towards a potential misdiagnosis in adults who are believed to have the hyperactive subtype.

Despite the rarity and potential misdiagnosis of the hyperactive subtype of ADHD in adults, hyperactive symptoms are commonfor many adults with ADHD. They manifest in the combined subtype, where those with ADHD have inattention and hyperactivity/impulsivity symptoms. These symptoms can significantly impact their daily lives, often requiring constant movement or mental stimulation.

For adults with ADHD, hyperactivity can manifest in various forms, often subtler than in children. Adults might experience a constant need for movement, such as tapping, shaking a leg, or playing with objects. This need for movement can extend to frequent breaks for stretching or walking. Besides physical hyperactivity, adults with ADHD often seek constant mental stimulation, engaging in conversations, listening to podcasts, or interacting on social platforms. These behaviors, including micro-movements like foot tapping or skin picking, are part of the adult ADHD experience, representing the less recognized aspects of hyperactivity in adults.