Inattentive ADHD

Inattentive ADHD can often get overlooked. After all, it’s much easier to spot someone who is physically on the move and restless (hyperactive-impulsive) than to spot the person quietly reading and daydreaming.

Predominantly inattentive ADHD used to be known as ADD. While the official name has changed, the symptoms are the same!

The Diagnostic and Statistical Manual of Mental Disorders (DSM) identifies nine symptoms of inattentive ADHD. You can learn how they are used in the diagnostic process here.

In addition to the nine official symptoms, there are unofficial or soft symptoms of inattentive ADHD. Knowing all the subtle ways ADHD may appear in your life can give a huge sense of relief and help you know why you are the way you are.

It’s surprising all the ways that attention regulation difficulties can show up in your life.

Here are 26 Signs of Inattentive ADHD.

1. You find it hard to focus, although you are physically still.

2. Your mind drifts off during conversations. You might have trained yourself to ‘look’ like you are listening so people don’t think you are rude, or your eyes might drift to the nearest window.

3. People close to you complain that you forget things they shared with you.

4. Attention to detailed tasks is especially challenging.

5. You find it difficult to follow verbal or written instructions.

6. Your physical environment is disorganized even though you try/aspire to be organized.

7. You often lose important items like keys, wallets and passports, which is inconvenient and expensive as well as stressful.

8. You are frequently late for work or meeting friends and sometimes miss appointments completely.

9. You find it hard to complete a task from beginning to end. Even if it’s fun for you, motivation seems to dwindle half way through.

10. Finishing a task becomes extra hard if the task is boring or stressful.

11. It is much harder for you to pay attention in boring lectures or meetings than it is for your non-ADHD peers.

12. You don’t feel motivated to ‘do’ things. You might be called a couch potato or have people say you lack drive, which can feel hurtful.

13. Tasks seem to take you longer than other people.

14. You’re generally cautious and avoid taking risks.

15. People often describe you as a day dreamer.

16. You might rush through a task to get it over with, and later find you missed parts or made mistakes.

17. You are prone to procrastination.

18. You find it hard to block out noise.

19. You feel extra resistance to starting tasks that involve mental effort.

20. You experience fatigue or feel sluggish more than other people.

21. You are sensitive to noise, textures of clothes, etc.

22. You heard the phrase ‘Could try harder’ a lot at school (even if you were trying+++).

23. Breaking big projects down into smaller steps doesn’t come naturally to you and feels a confusing prospect.

24 You make what appear to be careless errors despite your best intentions.

25. You would describe yourself as shy.

26. You under-estimate your own abilities. How you see yourself is very different from the capable and smart person other people see you as.

Here are some other interesting facts about Inattentive ADHD.

Anxiety and Inattentive ADHD

Anxiety is common among inattentive ADHDers. A person with inattentive ADHD can seem restless, in a way similar to how someone with hyperactivity might seem. However, the underlying reasons are different. The restlessness in a person with inattentive ADHD could be due to anxiety, while restlessness in a person with hyperactivity could be due to impatience and impulsivity.

SCT and ADHD

Some people with inattentive ADHD display signs of ‘sluggish cognitive tempo’ (SCT). It is a condition different from ADHD; however there are overlaps.

People with SCT think and process information at a slower speed. Symptoms include brain fog, daydreaming, lethargy and moving slowly, all of which sound familiar to inattentive ADHDers. We tend to think quick equals smart, but ‘sluggishness’ is in no way a reflection of intelligence.

Dr. Russell Barkley, who is a prolific researcher in the field of ADHD, advocates changing the name from ‘sluggish cognitive tempo’ (SCT) to ‘concentration deficit disorder’ (CDD) which sounds less offensive.

Inattentive women

More girls and women have inattentive ADHD, compared to their male counterparts.

Historically, ADHD was considered to be something that energetic little boys had and outgrew. This misunderstanding of ADHD meant the ADHD of girls and women with ADHD, and particularly inattentive ADHD, went undetected. Luckily, more is known about ADHD and inattentive ADHD so that it can be recognized and accurately diagnosed.

Mistaken diagnosis

Inattentive ADHD can be mistakenly diagnosed as anxiety or depression because the symptoms can appear similar. To confuse matters, both anxiety and depression frequently co-exist with ADHD. If you suspect you have ADHD but it hasn’t been diagnosed yet, be persistent and find health professionals who are knowledgeable about ADHD in adults.

Can you have Inattentive and Hyperactive Impulsive ADHD?

Yes! It’s possible to have both Inattentive and Hyperactive Impulsive ADHD. This is called Attention-Deficit/Hyperactivity Disorder, Combined Presentation, or Combined Type. It’s the most common type of ADHD and the most researched. Inattentive ADHD is the second most common.

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Comments

  1. I think sluggish cognitive Tempo is a great name for the ultimate diagnosis, because that is exactly how it feels.

  2. Ed says:

    Hi Jacqui

    The article on Inattentive ADD was on the mark. I would like to share my experience as I have followed your newsletter for some time.

    I read Amen’s book (before he appeared on PBS, I like to brag) some years ago ostensibly (and actually) looking into our young son’s symptoms. But I was not in denial…I saw my lifelong ADD vividly described.

    It was only 7 months ago I took the plunge and visited the Amen clinic in NYC. As I am risk averse it was a little scary…but I ended up loving the whole thing.

    The Dr’s IADD take on the SPECT scan was no surprise but the visual confrontation was powerful. The overactivity of the thalamus at rest… quenched under stress…is the opposite of normal. One compelling reason for the visit ——the push over the cliff so to speak—was years of 3-4 hours of sleep on average per 24h. This is just not sustainable after decades. I felt my memory fading and faced the fact that my iron determination applied to all things but myself.

    It was my place to give and give and take up the slack for everybody and keep it all going. I had learned some important and positive lessons in believing in myself. The tendency of others … family especially and somewhat at work … had been to bully me because I was easily bullied and depend on me because I am ultra-reliable and, believe it or not, can do some things almost nobody else can, even though my handwriting is remains illegible, plus numerous other inadequacies. For those I have been forever stereotyped.

    I could not do this on my own. I needed help.

    I already had a pretty good diet and had started a gym membership when I visited the clinic. I was on the runway. The visit left no room for rationalization or excuses and provided the proper structure for supplements, better tuned diet, less caffeine (I really try) and interval training several times a week. I take medication, but it is a mild stimulant with no liver toxicity issues. I don’t feel anything when I take it, but I’m sticking with the program. It’s about total compliance. I can skip the medication a few days per week anyway. I’m pretty good.

    After 7 months of personal trainers and total 16 months gym membership, at age 67 I’m running 2-3 miles 4 times a week plus modest weight training. I have HM and watch it, but have no issues. 58 bps at rest. I’m up to 5-6 hours a night sleep and working on it. Still working as engineer in hi tech job, doing well.

    I don’t know if the astronomical cost of lifelong ADD can ever be fully recouped. My less than robust self esteem and tendency toward social isolation are somewhat improved, but the needle has not moved too far. It takes time.

    I’ve taken some good points from your newsletter. Just reading that a good breakfast is more than just a good idea helps me remember to do it. Brain health is serious business! The clinic gave me marching orders too. Some brands of canned salmon are excellent and I love it in the morning.

    That’s about it. I’m glad to be alive. The self-destructive thoughts…however stupid and fraudulent…are a drawback and it is progress to have them fade.

    Best regards

    Ed

  3. I was diagnosed ADHDi aged 36
    Understanding the diagnoses and having therapy to get to grips with my behaviour /character drives has helped. Medication has not.
    Interesting term ‘shut down’ someone uses over ‘melt down’. Truly descriptive for ADHDi – I experience this maybe 7-8 times a year. For a few weeks I turn into a zombie. No care for self or my surroundings. Then something triggers me out (I never know what this is, just time maybe) and I’m driven to make up for lost time all of a sudden. Horrible game of catch up and learned my whole life cannot rely on myself to do anything consistently.

  4. Taylor says:

    So I haven’t been diagnosed with inattentive adhd, but am wondering if I should get checked. I don’t meet all of the symptoms, as I keep an hourly/daily schedule and regularly clean my room. But the reasons I do these things is because if I don’t, my life would be a complete mess. I NEED to do these things or I *will* fail in college. What I do have issues with is remembering the things I read/learn in class, focusing when I’m reading/writing a paper/doing a longer task, paying attention to details, etc. I have a really hard time remembering the things that people tell me when I’m just casually talking or listening to a list of things they need, which affects my friendships. No matter how hard I try to pay attention to my friends or stick with a group conversation, I always end up thinking about something else (usually related to what they said), and then come back to the convo realizing my thoughts kind of trailed off. If I don’t write down literally everything that I have to do within the week and write down instructions as people are telling me them, there is a 98% chance I will forget about it. I think that through the years (I’m 22 now), I’ve sort of naturally adapted to my deficiencies, which is why I like to keep a clean room and a written schedule. I’m wondering if there’s a possibility I might have the innattentive kind of ADHD. I definitely don’t have the hyperactive part. If anything, I am very frequently tired, sometimes overstimulated, and just want to be by myself. People sometimes think I’m sad when in reality, I just don’t have the energy to make the facial expressions you make when you’re happy/interested in something. I don’t know. I think I’m just rambling at this point. But I’d like to get some other opinions before I take the time/money to get checked, and I don’t want to make a big deal out of something that may not be what I think it is.

  5. Dave says:

    I seem to be combined-type, although I think the hyperactivity isn’t apparent to most people. Only those who know me well. I’m pretty good at hiding it in public. Which why, I think, people often don’t believe me when I say I have ADHD. They’re expecting the hyper-active bouncy type.

    The hyperactivity is there. It’s just building under the surface. As manifest by my numerous injuries, near death experiences, near engagements, major changes, etc.

    So while some people see me as solid and reliable, others see me as flaky and inconsistent. Typically the latter were once the former, and are, at times, quite vocal in their disappointment. I think I’d prefer it went the opposite direction. I think those that have known me for a long time have a more complex view of me, and are beginning to accept the role ADHD plays in all that.

    My public face isn’t so much an act, as a reflection of the person I’d like to see myself as, and I believe the people close to me realize that. At least I hope they do 🙂

    • Kyla Fitzpatrick says:

      This response echoes my feelings and my situation perfectly. Thanks for posting.

  6. Just a quick thank you for the article. I appreciate the info and I appreciate the comments as well. I am feeling lost with all my symptoms and knowing others are tackling thier lives and gaining control gives me hope.

  7. Walter says:

    I was diagnosed with the full monty ADHDhi and have been through several medications trying to find the right one. I am currently on Vyvanse and it does a great job for the impulsive side, but I still fall asleep anytime I am in a meeting, class, or even some conversations. I am currently on 30mg but will be going to 40mg on my next visit to the doctor. What is frustrating was he moved me to 50mg and it was just too much so he moved me back to the 30mg. Now I have to change the dose again and see how it works.

    I am 44 and have been dealing with this since I was a kid. I made it through college and have a successful career, but it seems like it has gotten worse since I hit forty. I have spent the last two years being a lab rat for constant testing to make sure it’s not other conditions causing me to think this way, but they haven’t found anything yet. I am scheduled for another round of testing tomorrow morning but I doubt they find anything this time either.

    Has anyone else noticed their condition getting worse in any way in their adulthood? I would love to know if it’s just me!!

    • Amber says:

      Hi Walter,

      You mention you have a successful career. Has your position in that career risen considerably over the past few years? Do you have more/different types of responsibilities now that you hadn’t before? I know I had a lot more symptoms manifest when I had to do more managerial and paperwork.

      How about kids? I know I’m experiencing more things now that my eldest is starting school and I have his schedule to maintain as well.

      Ugh life!

      • Patti says:

        I’ve experienced this too. I’ll be 45 this year and haven’t been officially diagnosed with ADDi yet (waiting for appt with specialist my GP referred me to). I have been diagnosed with depression for ~15 yrs about ~5 yrs ago anxiety the last year or two has been horrible. My counsellor suggested it may be ADDi and I should be tested. A couple years ago I moved into a mgt role and I’m starting to wonder if maybe why this is coming out now. When I look at the symptoms I think I’ve experienced these most of my life but just recently I can’t seem to be successful in life any more.

    • Melissa B says:

      Hi Walter,
      I actually did not figure out that I had ADHD until I was in my late 30’s! I had the benefit of a structured and calm home so my condition was not obvious when I was a kid. Looking back I figure that it started getting bad right around my late 20’s but back then I was just told that I was spacey and being selfish because I couldn’t remember things that people told me and those same people could not get my attention when I was focused on something. It didn’t all come to a head until I was living on my own after my separation and had to try and get myself motivated to take care of my home without someone else reminding me all of the time.

      I have read, in many places, that at least for women it can actually seem to get worse too when they go through menopause as the change in the hormones can also affect the neurotransmitters and cause symptoms to become a bit more pronounced.

      You are not alone! 🙂

      Melissa

      • Lilian says:

        Oh, no, Melissa! I hadn’t heard it might get worse when one goes through menopause! That is coming soon for me, as I’m nearly 47. 🙁 Jacqui, is this suspected?

        Walter, I wasn’t officially diagnosed until 44-5, but I still think I may be worse now than earlier. Sigh…

  8. Polly says:

    I have not been diagnosed with inattentive ADHD, but am 98% sure I have it. I meet virtually all the criteria. Executive function skills are tough for me: organizing, prioritizing, time management, focusing, remembering, keeping track of things, I’m easily distracted, love to start things, but difficult to complete them because I’ve moved on to other things, etc…

    I’m wondering if meds will help me. I’m 48 years old. All of my life I have dealt with these issues and it’s very discouraging. Most of these tasks are simple for many people. I would love to feel a part of this group. In what way do the meds work when it’s the right drug/dosage for the individual? Help with focus? Concentration? I would love to hear some positive stories. I have heard plenty of the negative side effects, would like to hear the good ones as well.

  9. Jenni says:

    This is an excellent article. My son has ADDi and is now going to University. I’m so very proud of him. As a Mum of an ADD adult, it really is still about keeping him on task, reminding without nagging, and helping to instill organisation in daily life…I had numbered lists with pictures of what to do in the morning/afternoon laminated and put in toilet, bathroom, bedroom and on fridge door. That was when he was young. Nowadays it’s writing appts/activities in the household diary, uni schedules on the fridge and household rules for grown ups. Having a good support network is so important too. Kokoda Kids helped my son so much.
    To all of the adults with ADDi out there, I’m proud of you! Daydreams, love and hugs!

    • Hi Jenni!
      Congratulations to you and your son! Getting to university when you have ADD is a huge achievement.
      The laminated pictured checklist sound fabulous!

  10. Michelle says:

    I’ve been finding acouple stray articles that suggest non-stimulants might be better for inattentive type adhd.

    • Sheila says:

      I take a (very) low dose of Strattera and have found I can focus much better (with some coaching on time management etc.). I was never precribed stimulants, I have never asked why but it could be because I am prone to insomnia and also can become anxious, so they may be counter-productive. I was on a higher dose of the Strattera but didn’t like the side effects. I said I was going to give it up altogether – but reducing it right down keeps most of the benefits without many negatives (feeling sick being a major one).

    • Tgparker2 says:

      My husband was only diagnosed at age 47 with ADHD, predominantly of the inattentive type. He was started on Vivance, then one stimulant after another. His weight went from a nicely carried 170lbs down to skin and bones 120lbs. For almost a year now he has been taking a non stimulant Stratera 40mg. His weight started climbing back up to his healthy 170.
      We are currently seeking therapy for aids that will help his memory challenges along with music, the Mozart effect. Inattentive types have melt-downs too, their called “shut-downs”. It’s like turning off the power. It’s not something that can be helped with stimulants. People have to learn where the power switch is and not turn it off. Completely opposite of the hyperactive type. My husband grew up with a parent and two siblings with ADD. It boils my blood that he was just passed over. I thank God I have him in my life. He was my rock through stage 3 cancer, retired from the Navy and has never met a single soul he wouldn’t reach out to help in whatever way he can.
      Sorry for the little rant, but there is a HUGE need for more research and availability of information on this type.

  11. Elizabeth says:

    I am 39 and have struggled with extreme inattentive ADD for my entire life. Wondering your thoughts on the best meds for inattentive types. It seems like all meds are created for hyper types. Adderall makes me very anxious & gives me terrible insomnia.

    • Ann Sparks says:

      I’m 55 y/o and just was diagnosed with Inattentive ADHD a couple of months ago. I had struggled in school and college, ever since 6th grade, particularly with lengthy reading assignments, feeling frazzled when pushed for productivity, and organization/clutter. Amazingly enough, I obtained my Master’s Degree in Nursing 5 years ago, but have had struggles holding a job.

      Adderall XR gave me side effects which were intolerable, even when treated with anxiety medications. Just last week, I was switched to Concerta (Long-Acting Ritalin) and there’s essentially no side effects with the Concerta. I’m still at a modest dose of 36mg. I have moderate anxiety (have had all of my life), so I am still talking the anxiety medication too. But I plan on omitting the anxiety medication within a few days.

      I am already feeling better in regards to my self-esteem and confidence, which I can attribute to the medication for ADHD. In fact, I have a great interest in becoming a Psychiatric Nurse Practitioner and have decided to go back to school for one more year! I’ve worked in a Pediatric Psychiatric Hospital and both the CEO and my collaborative psychiatrist told me, “You have a gift for psychiatry; you’ve found your niche.”

      Yes, I’ve heard from one person with Inattentive ADHD that med helped 100% — another said that meds helped his symptoms about 80-90%.
      LONG story, short, I knew that I MIGHT not find success is the first medication attempted. I am one to persevere, and CONCERTA is working much better, with much fewer side effects. If for some reason CONCERTA doesn’t work when I stop the anxiety medication, there is always FOCALIN or non-narcotic STRATTERA to try.

      By the way, make sure your thyroid is tested too, by getting a TSH, FT4 – hypothyroidism can cause symptoms of ADHD too.

  12. Becky says:

    My son has ADHD and he fits your 15 items and I am going nuts trying to help him and he is 21 years old.

    • vaibhav says:

      Dont worry your son is not alone, even I am going through same pattern. Though i am on my medication and therapy still nothing seems to work out and it is so frustrating that it killing my will to live. I am not doing anything about it

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