What is ADD or ADHD, AD/HD and AD(H)D? (And what’s up with all the initials?)

What is ADD or ADHD, AD/HD and AD(H)D? (And what’s up with all the initials?)

ADD stands for Attention Deficit Disorder and ADHD stands for Attention Deficit/Hyperactivity Disorder. It has also been called “Minimal Brain Dysfunction” and “Hyperkinesis” or “Hyperkinetic Disorder.” The name has changed over the years based on how doctors (specifically the American Psychiatric Association) label the condition in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). They are working on publishing the most recent version which will be called the DSM-V.

The most recent “label” is AD/HD or Attention Deficit/Hyperactivity Disorder. However, not all individuals with AD/HD have symptoms of hyperactivity so they will be diagnosed as AD/HD minus (meaning minus the “H”.) Some people have even begun abbreviating it as AD(H)D. Confusing… and annoying. Throughout the rest of my blog, I’ll be using the ADD abbreviation because it’s the most common and well-known version, plus it’s faster and my ADD symptoms include a lack of tolerance for bureaucratic baloney.

Now that we’ve cleared all that up, what the heck does it actually mean? To fully understand ADD, you have to first understand what attention is and what is isn’t. Do not make the mistake of thinking that ADD is all about short attention spans – while that can be part of it, it’s a small part of the disorder and certainly doesn’t come close to drawing a complete picture. The process of paying “active” attention to something involves several steps:

1. Arousal: Actively engaging your attention in the appropriate direction.
2. Competitive Selection: Filtering out competing stimulus (distractions).
3. Maintenance: Sustaining your attention on in the desired direction over time.
4. Disengaging: Ceasing to pay attention to one thing in order to transition to another.
5. Re-engaging: Actively engaging your attention in the next desired direction.

The process of “paying attention” can break down at ANY or ALL of the above steps. A given individual can have issues with any combination of the steps and their ability to manage the process can change from day to day, although most people will struggle repeatedly with the areas of primary difficulty for them.

What this all means is that a child may be able to sustain their attention just fine at home where it’s quiet, but have trouble filtering noise and activity at school (step 2). They may be able to maintain their attention just fine when playing a highly stimulating video game but be unable to remain interested in a math assignment (step 3). An adult with ADD may not have trouble with steps 1-3 at all, but may find it extremely difficult to disengage themselves from work, the Internet or the book they’re engrossed in (step 4) and may “hyper-focus” or “over-focus” on that task or topic to a destructive degree. Once an individual with ADD finally does wrench themselves away from the object of their fascination, they may be so worn out by the experience that they have trouble re-engaging (step 5)… or, they may avoid activities that require a lot of mental effort and engage themselves in less demanding activities without realizing that they are doing so (step 1).

The moral of the blog is, don’t assume that just because your child focuses just fine on video games or sports that they don’t have ADD. On the same token, don’t presume that just because your spouse can focus on whatever they choose to that you should overlook the fact that they have issues with procrastination, over-committing, follow-through or being constantly on the go. If you suspect that you, your child or another family member has ADD you should look into the symptoms and see a health professional. I’ll be adding a “Links” page soon with resources to assist you in both of those endeavors.

One Response to What is ADD or ADHD, AD/HD and AD(H)D? (And what’s up with all the initials?)

  • Mike

    In my fifties, I’m completely new to the whole subject of ADD. Looking (Oh God, yet again!!)for information that would FINALLY help me to overcome my chronic procrastination (and thankfully finding it, I believe) I also came across references to “ADD”. Following these up, some ADD characteristics (notably hyperfocus, difficulty getting started, extreme difficulty “disengaging”, problematic relation to time and simply not noticing things)that uncannily chimed with my personal experience from childhood onwards. I’ve no idea whether I really have ADD or just similar behavior re. procrastination. I’ll get it checked professionally.

    My comment is that your description of ADD in terms of the “paying attention” process is wonderful! I’ve not seen ADD described like this anywhere else (yet). I now understand why there is such a wide range situational/behavioral differences between ADD individuals.

    Great resource, thank you!

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