Episode 4 – The different types of ADHD

There are three different types of ADHD — inattentive, hyperactive/impulsive and combined type. But what do those classifications actually mean and how do we see those symptoms play out in our day-to-day lives?

Journalist and mental health advocate Lindsay Guentzel dives into those questions with Dr. Gayle Jensen-Savoie, the division chief of psychology for ADHD Online, to help paint a better picture of what ADHD looks like out of the textbooks and in real life. 

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Lindsay Guentzel (00:00):

I’m going to date myself here, but many years ago, okay, decades ago, there was an infomercial on TV for Hair Club for Men, a hair restoration company. If you didn’t have hair on your head and you were a man and you wanted some, this was the place to call. And in it, the company’s president, a man with a full head of hair stood next to a photo of himself without any hair and said, “I’m not only the Hair Club president, I am also a client.”

Lindsay Guentzel (00:32):

I thought of that yesterday, Monday, the day this podcast is supposed to come out when it wasn’t done. Why wasn’t it done? I mean, where would you like me to begin? Could it be the volunteer coaching gig I took on a couple of months ago that morphed into me tie dying 48 pairs of athletic socks? My idea, of course. Or maybe it’s the two kittens I came home with after going on Next Door to sell our old patio furniture. I still have the patio furniture and the kittens who I guess will hang out at our house until I find them their forever home. You may hear them running around right now. Or maybe it’s that I am a terrible judge of how long things are actually going to take me.

Lindsay Guentzel (01:17):

So what made me think of that old Hair Club for Men commercial? I’m not pretending to be someone who has her ADHD figured out. I’m learning right along with you. There are a lot of places on the internet where you can find someone who has it altogether, or at least is very good at pretending. I am not that person and this podcast is not that place. This is a place for growth and mess ups and forgiveness and do you want to know how I know that? Because I have spent my entire life afraid of dropping the ball. Because the times it has happened, I didn’t like the reaction. And when I went to my team at ADHD Online yesterday morning and said, “Episode four, isn’t done.” all I was greeted with was support and encouragement and people asking me how they could help. Send me cat food. Seriously. If there was ever a time to let a ball drop, it was now because it showed me what I have waiting behind me. I hope you enjoy this episode. Thank you for being here.

Lindsay Guentzel (02:26):

This is episode four of Free Focus with Lindsay Guentzel and this episode examines the three different types of ADHD, inattentive, hyperactive- impulsive, and combined type. In 1987, the Revised Third Edition of the DSM, that’s the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders started using the name attention deficit hyperactivity disorder, which was a transition away from ADD. Prior to that revision, the APA had been using the diagnosis attention deficit disorder with, or without hyperactivity. Then in 1994, the fourth edition of the DSM went even more in depth and added the three different types of ADHD that we reference today. The current DSM five refers to them more as presentations acknowledging they can change during the course of a person’s life.

Lindsay Guentzel (03:18):

My name is Lindsay Guentzel and I’m a television and radio host, producer, writer and mental health advocate living and working in the Twin Cities, that’s Minneapolis and St. Paul, for those that are unfamiliar. For the last few months, I’ve been working with the team at ADHD Online to not only create this podcast, but to make sure we are establishing a solid base of information to build up from. The first three episodes went all over the place. We started by establishing what is ADHD in episode one, by speaking to Dr. Gail Jensen [inaudible 00:03:49]. She’s the Division Chief of Psychology for ADHD Online, and I’ll actually speak to her again today.

Lindsay Guentzel (03:55):

And then in episode two, I shared my own ADHD journey. Well, parts of it anyway, because it’s a very long story. My older sister, Kate shared some of her observations, both from my time as her rambunctious baby sister, to now as the more scatterbrained adult who lives less than two miles down the street.

Lindsay Guentzel (04:14):

And then in episode three, I pondered the question, can you build the perfect podcast for an ADHD brain. The answer, unlikely, but [inaudible 00:04:24] ADHD online and I, we are committed to giving it a shot week after week. ADHD Online is a telemedicine healthcare company that specializes in diagnosing and treating ADHD through convenient and affordable assessments and personalized treatment plans, typically, in just seven days. I wasn’t diagnosed through ADHD online, in fact, I didn’t even know what they offer was an option for me when I started my own process, I am grateful for my hyper focus and impulsivity that pushed me to call my primary care provider’s office, but it still took four appointments over almost six weeks for me to finally receive my diagnosis and get a plan in place to start moving forward with all of that new information.

Lindsay Guentzel (05:05):

It’s hard to look back at the last couple of years and see the positives. The COVID 19 pandemic has been so destructive in so many ways, and there are certain ways of life that we just won’t ever get to see again. But one area I’ve been so inspired by is the growth and acceptance of telemedicine, specifically for mental healthcare. ADHD Online is healthcare run by tech, not tech running healthcare. And I really think that’s an incredibly important distinction. It was started and is run by healthcare professionals who treat the whole person from diagnosis to treatment, to medication management and teletherapy. If you’ve been wondering if you have ADHD or perhaps you’re seeing behaviors in someone you care about that have you questioning a connection, head on over to ADHD Online, to find out more about their diagnostic process and how their team of healthcare professionals across the country can help you move forward in life with more answers and understanding.

Lindsay Guentzel (05:58):

If you’ve been enjoying what you’ve been hearing on Refocus with Lindsay Guentzel please subscribe, rate, and review wherever you get your podcast. Those quick little action items help get this podcast into the ears of other people who might be looking for similar answers. I am so appreciative of everyone who’s taken the time to do that. There are some very, very lovely reviews online. To those of you who’ve sent emails or notes on social media, thank you so much for supporting the work that we’re doing here.

Keith Boswell (06:27):

Did you know, we lose up to nine items per day. It’s true. That’s according to the National Association of Productivity and Organizing Professionals. That’s 63 items a week, 252 a month, and more than 3,200 things a year. Now that’s an average, but for people with ADHD, reduced executive function means organizing and staying organized is simply harder. So it’s understandable that we’re losing more things, more often. Coming up on June 8th, we’ve got the second in our Learn How to Organize Your Home series with Lisa Woodruff. Lisa’s a productivity specialist, home organization expert and Founder and CEO of Organized 365, where she shares physical and motivational resources, teaching busy people how to take back control of their lives with functional systems that work. Wednesday’s event is the second in her learn how to organize your home series. This one focused on home organization tips, tricks, and workarounds for the ADHD brain. The webinar’s free to attend. Simply head over to adhdonline.com/webinars to register. We also have the link shared in the show description.

Keith Boswell (07:39):

Then on June 15th, a look at what goes into diagnosing ADHD with Dr. Gregory Harms. We know ADHD symptoms can ebb and flow based on what’s going on in our lives, so what are clinicians looking for? And what does the process look like? Dr. Harms has worked in the mental health field for over 20 years and in addition to being a licensed clinical psychologist, he’s also a certified alcohol and drug counselor. Again, both of these events are free to attend and will be available to watch online afterwards. That means we have a great collection of archived webinars available for you right now over on adhdonline.com. Check them out wherever and whenever is most convenient and comfortable for you.

Lindsay Guentzel (08:28):

I want to dive right into this episode’s topic with Dr. Gale Jensen Saboixt, the Division Chief of Psychology for ADHD Online. Gail, thank you so much for joining me again.

Gail Jensen Saboixt (08:37):

Thank you for having me.

Lindsay Guentzel (08:38):

I’m hoping we can do a couple of things. First, I’m hoping you can walk me through the three different types of ADHD and explain the markers and symptoms that professionals like yourself look for during the diagnostic and treatment process. But I’m also hoping we can talk about how the different types present in real life, because I think it’s easy to read the list of symptoms and understand what they are, but it’s also beneficial to hear how they play out in our day to day lives.

Gail Jensen Saboixt (09:07):

I’d be happy to. First off, when we’re looking at how do you diagnose ADHD, there’s no simple test like there is for a lot of other medical disorders. So we have to look at symptoms and it is all about the symptoms. So we use the Diagnostic and Statistical Manual, the DSM 5 and right now it’s the DSM 5 TR that we use that has the list of symptoms. There are the three major types of ADHD. There is the ADHD inattentive type, the ADHD hyperactive impulsive type, and then ADHD combined type. We’ve gone through many renditions since I’ve been in this business of ADD and ADHD and now it is all ADHD, but you have the type inattentive, hyperactive, impulsive, or combined.

Gail Jensen Saboixt (10:06):

A couple things that they all have in common, all three types, when we’re looking at diagnosing, you have to get six of nine symptoms. You have to display symptoms before the age of 12. Also, your symptoms have to be present in more than just one setting. So if for a child example, if they’re only hyperactive and impulsive at school, but not at home or church or with their friends, they wouldn’t meet the criteria. It has to be in at least more than one setting like home in school. And the symptoms have to interfere with everyday life. Those are required of whether it’s inattentive hyperactive or combined. So if we want to look first at inattentive type and maybe just kind of run through those nine descriptions and then remembering that you have to have six of them to meet the diagnostic criteria.

Gail Jensen Saboixt (11:06):

So for inattentive type, often fails to give close attention to details. Making careless mistakes whether it’s in school, work, activities. Number two, they often have difficulty sustaining attention in task, even when they’re playing. Number three, often does not seem to listen when spoken to directly. Often does not follow through on instructions and fails to finish task. Often has difficulty organizing task and activities. Avoids dislikes. Is very reluctant to engage in tasks that require any sustained mental effort. Often loses things necessary for task and for task of daily living. Is often easily distracted by extraneous stimuli. And is often forgetful in daily activities.

Lindsay Guentzel (12:03):

Since we’re going to be coming back around to combined type, I think it might be better to run through the symptoms of ADHD, hyperactive-impulsive type so we can hit all of the key identifiers before talking about how we see all of these different symptoms in our actual lives.

Gail Jensen Saboixt (12:18):

Got it. I think that’s great. So if we look at ADHD, hyperactive and impulsive type, remembering, you have to have six of these nines. So the first one be often fidgets, tap your feet, squirms around in your seat, often leaves your seat in situations where you’re supposed to be expected to stay seated, for a child, if it’s in the classroom or adult, maybe in a meeting. Often runs about or climbs in situations where it’s inappropriate. Often unable to play or engage in leisure activities quietly. The one everybody knows is, acts as if driven by a motor, on the go. Often talks excessively. The next one, often blurts out an answer before a question has been completed. Often has difficulty waiting his or her turn and then often interrupts or intrudes on others. So again, remembering of those, you need six of those nine.

Gail Jensen Saboixt (13:24):

Then with combined type, you have to have six from each of those two categories. Combined meaning you don’t fall into exclusively inattentive or hyperactive. That you will have symptoms from both.

Lindsay Guentzel (13:40):

Let’s go back now and talk about inattentive ADHD. Inattentive in some ways is less physical. When we think of the hyperactive impulsive side of ADHD, it’s very in your face, it’s hard to ignore. And yes, there are things that you’ve mentioned for the inattentive type that would fall into that physical category, like forgetting your backpack at school or leaving your coffee on the counter every morning before you leave for work. All of those things are physical. But I think sometimes with the inattentive types, it’s so easy to just categorize it as, “Oh, I’m forgetful.” So is it harder to pinpoint some of those inattentive symptoms because they’re more internalized?

Gail Jensen Saboixt (14:19):

Absolutely. And I think a couple things, one, sometimes families are grateful, especially if they have more than one child, if they have this one child who seems to be quiet and they’re just grateful. “Oh, she plays by herself,” or “Oh, well she forgot her backpack because she was so interested in what she was doing.” Where they’re missing symptoms of that she wasn’t interested, she was distracted, she was just gazing out the window. So I think it is very difficult. Oftentimes we just miss it because we think everybody forgets things. But if we look at the forgetfulness, for example, we all misplace our car keys. Thank goodness, you don’t have to put them in the ignition anymore, so often they can just stay in the bottom of our purse. We don’t lose them as often, but we all lose our car keys. We lose our cell phone.

Gail Jensen Saboixt (15:16):

But folks that have the inattentive type of ADHD, they lose these things that are important for daily living and they lose them in places like … They may find their glasses in the refrigerator or they’ve put the frozen strawberries in their purse. I do know oftentimes with the inattentive type, people think that they’re just lazy. And I remember years ago, a therapist and I were discussing inattentive type and ADHD, and at that time I was kind of new in the business and she said to me, “There are no lazy people. Typically, those are folks with ADHD.” And again, we hear so often people will say, “If he could pay attention, if he tried, she just is lazy. They don’t want to. They want to do something else. They want to be paying attention to what they want to pay attention to.”

Lindsay Guentzel (16:18):

And I know from experience, if we appear to have trouble paying attention and someone asks us in whatever manner, politely or not so politely to pay attention to what’s going on, it ends up making it worse.

Gail Jensen Saboixt (16:31):

And without treatment, folks that really have the inattentive type, they’re really prone to losing friends and jobs because of the fact that they’re not able to pay attention to what needs to be paid attention to. They’re paying attention to a million other things. Remembering that attention deficit hyperactivity disorder is not about a lack of attention, it is about too much attention.

Lindsay Guentzel (17:00):

I’m very glad you mentioned the confusion or lack of actual understanding over what ADHD is because the word deficit makes people think a lack of attention. You mentioned the word lazy. I want to touch on the example you used about finding the frozen strawberries in your purse. I hear this example used a lot to describe people with ADHD. It’s thinking of the brain and all the activity as having a ton of tabs open on an internet browser. For me almost every day, I walk into a room and I have to go, why am I in here? And honestly, it’s only been 30 seconds, maybe a minute that I went from the task I was doing to knowing I needed to go into that room. But in that very short timeframe, my brain is trying to click through every single tab that’s open. And so by the time I get into that room, I cannot remember why I’m there. And sometimes yes, I’m able to backtrack and go, “Okay, I was doing this. And then I went here,” and sometimes I’m able to figure it out.

Lindsay Guentzel (17:57):

But the one thing I found, so eye opening for me, following my diagnosis was realizing the connection between the ADHD brain, especially inattentive type and daydreaming. And we think, “Oh, that person, they are lazy and they can’t focus.” But in reality, our brains are actually just very, very busy.

Gail Jensen Saboixt (18:16):

Exactly. Exactly. I remember one time a teacher was telling me, “Well, you know that little boy, he cannot be ADHD, he’s so good. And every day he just sits in class and he’s looking out the window. He’s just daydreaming. I’m sure he’s really paying attention.” Okay, so I’m talking to the little boy and I’m like, “So, you sit in class and you’re looking out the window. The teacher says you’re really absorbing the material.” He goes, “No, there’s this lizard and every day he goes right by the window.” He had no idea what the teacher was talking about. And again, typically we think of young girls as being inattentive, but boys can as well. And it’s not that they’re just daydreaming. Again, they’re thinking about all sorts of things in the world going on, so you are exactly right.

Gail Jensen Saboixt (19:08):

And I think, when we think about people that have inattentive type and losing things, I heard somewhere, they said that inattentive adults are prone to the worst of the ADHD symptom, which is that disorganization. You have 14 tabs open. You don’t know why you go into the room, because you’ve already thought about 76 other things on your way into the room, on your way to look at another tab. I think that oftentimes with inattentive ADHD, you have a million little projects. You start a million things, but again, finishing it is the issue. So whether you’re a child and you don’t finish your homework or you don’t finish in class because of you’re now looked outside and seeing a bird fly by. As an adult, I see lots of assessments that people will say, “I have one room that has 16 projects I’ve started. I started trying to sew. I started trying to have a garden. I started whatever.” And the dress is half finished. The garden was great till it had to be watered.

Lindsay Guentzel (20:17):

I’m over here, cringing and laughing because I can see out of the corner of my eye, I have that room. It’s the craft room, office, junk room, whatever you want to call it. And honestly, I don’t want to live this way, but I also feel like every time I’m starting to make strides, I take on something else. And a part of that is because we know that for some people with ADHD, we thrive on the excitement of doing things. That dopamine rush. It’s interesting with people who have ADHD, the excitement of starting something and then there’s the excitement of finishing it. But for a lot of us, we get lost in that middle area. It’s like, we need that midpoint of someone walking in and being like, “Oh, Lindsay, you are doing such a great job. This is going to look amazing. I cannot wait until it’s finished.” But when we don’t have that, we lose steam. We lose excitement and we never get to the end point.

Gail Jensen Saboixt (21:10):

Right. And sometimes I wonder if the end point isn’t as exciting. Not only do you lose the steam in the middle, but I also wonder, the excitement part. If you’re thinking about sewing a dress, for example, all of that excitement of what goes into it and getting a sewing machine and getting thread and getting a color and figuring out what dress, but the rest of it’s the boring part. People that have inattentive type thinking about, okay, now sitting down and sewing it, you’ve already solved world peace. I mean, it has to be so much at just the beginning. And I think, you wonder if the brain, if we could get the excitement to finish, if that would somehow be able to get the middle part exciting as well.

Lindsay Guentzel (21:58):

I want to touch on one last thing before we move on to the hyperactive impulsive type of ADHD. There’s something to be said about how much work the ADHD brain does and we can use that example of the browser with tons of tabs open. We’ve all gotten to the point where maybe we open a program on our computer that slows things down and your computer starts to make that humming noise and it gets really hot. After my diagnosis, I had this moment where I realized this is why I’m always so tired. I’m not tired because I’m physically tired. I’m tired because my brain from the moment I get up is going so fast, for so long, that by the middle of the day, I can barely see straight.

Gail Jensen Saboixt (22:40):

You can compare it to the hyperactive type. Children with hyperactivity, oftentimes when they wake up, they’re still tired. Because oftentimes they don’t get any rest when they’re asleep either because they’re still moving. You’ll see hyperactive kids oftentimes fall out of the bed, they’re the kind that are kicking. In the morning you go wake your child up and their head’s at the foot of the bed, not at the head of the bed because they’ve been moving all night. So they’re still exhausted. It’s the same when it’s your brain, absolutely.

Lindsay Guentzel (23:13):

So let’s talk about hyperactivity and impulsivity. This category to me really falls into the old outdated mindset of what ADHD is. It’s the young boy in class who can’t sit still. He gets removed from the classroom for being a disruption. And the symptoms like we’ve talked about, tend to be very noticeable. They’re very in your face. Are there ways that this type of ADHD presents itself in life that is less commonly talked about? Because I think this is the one where people who maybe don’t know a lot about ADHD, this is the one area where they’re like, “Oh, well I can see this. This is something I’m very familiar with.” But with this type of ADHD, are there things that you see working with your patients that falls into this category, but is less commonly known?

Gail Jensen Saboixt (24:01):

Probably the one that comes to mind mostly is restlessness. And in that respect, yes, with a young kid, you’ll see him running around, crashing into walls, they’re jumping out of trees. But when you get to be sometimes even a teenager, but definitely adult, that restlessness is not outward. Oftentimes it’s inward and it’s that internal feeling of just being restless. So I think that’s one that oftentimes people don’t see. We’ll see it a little bit in folks that are maybe adults that are in a meeting and they’re the ones that are swinging their legs or fixing their hair on zoom all the time, not being able to necessarily sit still, but not being that disruptive. But I would say hands down, the restlessness is the big one.

Gail Jensen Saboixt (24:53):

The other one sometimes is that people don’t recognize and even don’t even recognize they’re doing it is, as a child would be noisy, always talking, loud talking. But oftentimes as an adult, you might see somebody that just hums to themselves or is the kind of folks that just sing a little bit quietly all the time to themselves.

Lindsay Guentzel (25:19):

Everything you said right there, the restlessness. So a couple weeks ago I had this realization that I had stopped cracking my knuckles. At some point after my diagnosis, probably around the time that my medication and my knowledge and my self-acceptance and weekly therapy all started working together, at that point, I stopped cracking my knuckles. I can’t tell you when, I just know that I have cracked my knuckles for as long as I can remember. My entire life and I did it every day, multiple times a day and all of a sudden it’s not there anymore.

Gail Jensen Saboixt (25:55):

Interesting. I had a patient one time that kind of chewed, well, didn’t kind of, chewed on the inside of their mouth. And one time had to get antibiotics because they had just chewed it and gotten infected and they didn’t even recognize it either. Had always done it just in that restlessness. And I think what we have to remember is when somebody’s fidgety, whether it’s a child or an adult, when you say to someone with ADHD, just be still, sit still for a minute, that’s really almost mentally and physically painful.

Lindsay Guentzel (26:34):

I’ve been doing a lot of body doubling lately. I think one of the things we do know because of when the pandemic started and people were forced out of their routines and had to stay home, I can’t work at home, it’s a very big struggle. There are so many things in the house that need to get done like that craft room, office, junk room, all of those little tasks, the laundry, the dishwasher, all of those little things that when you’re trying to work, become distractions. So for body doubling, my virtual assistant Camilla, she calls me and we just sit on the phone. And I know for that time period, I’m working on something very specific and she’s checking in on me. And it actually started doing similar things during my virtual therapy sessions where I’ll be speaking with my therapist and I’ve got her up on my computer screen, but because I know how I thrive, I’m folding laundry or I’m organizing things or I’m just working on a crochet project that’s sitting there.

Lindsay Guentzel (27:30):

Because having to sit still for a whole hour is incredibly painful. And also, for me, it doesn’t feel productive, which I know is a big part of the physical side of it. People with ADHD, we sometimes feel like doing nothing is a bad thing. And then the problem is then we think, “Okay, I’m going to multitask and it’s going to get all of these things done quicker.” But in reality, we end up sabotaging ourselves.

Gail Jensen Saboixt (27:53):

Right. That’s when we end up sending the email that was spelled wrong or to the wrong person. All of that, because you had that multitasking, we end up doing 16 things at one time.

Lindsay Guentzel (28:06):

So let’s talk about the combined type because the majority of people diagnosed with ADHD fall into this category. And as you mentioned, you have to have six of the nine symptoms in both inattentive and in the hyperactive impulsive category. And this is the one that I think is very tricky because this is where the physical side effects and symptoms of ADHD connect heavily with the emotional ones. And for me knowing the emotional side of it and how it affects my physical side has been really eyeopening.

Gail Jensen Saboixt (28:33):

Oftentimes you have both on. You have the six symptoms in inattentive and hyperactive, but your symptoms, since they don’t exclusively fall into one of those categories, it is that combination. Again, and you will see times where some of the symptoms come out more readily than others. I do think oftentimes people feel like they are more hyperactive or more inattentive when they are diagnosed with the combined type.

Lindsay Guentzel (29:04):

It can be hard to acknowledge that our symptoms ebb and flow in life, like a lot of things. I think for a lot of us, whatever we are doing to help control some of the things that might be detrimental in our life because of ADHD, once we feel like we’re doing really well, or we feel good, we let off the brakes a little bit, we let go of some of the safeguards we’ve put in place. And it’s like, I hate to use the example of weight loss, but I think there are a lot of people who think, “Oh, if I just lose the 30 pounds, that’s all I want to lose, everything will be great.” And yeah, if you want to lose the 30 pounds, that’s great. Once you lose them, you still have to keep those 30 pounds off. And that’s kind of how I view some of the things I’ve put into my life after my diagnosis. If I don’t keep doing them, I’m just going to go back to the starting line.

Gail Jensen Saboixt (29:51):

Yes. What a great example. That is the perfect example, it is. And it’s about a lifestyle. It really doesn’t matter what your diagnosis is. It is a lifestyle change and it’s a commitment to that. I think, although more so than many of the other diagnosis, getting folks past the fact that this is not about a badness. This is not about somebody trying to be hyperactive, trying not to pay attention. This is a brain issue. And I think so often as long as people can realize, you just change your lifestyle and go to accept that you are going to fold the clothes while you’re on a call, that’s fine. Or maybe start that craft, just realizing that all of those things that, that can be okay.

Lindsay Guentzel (30:45):

It’s interesting you mentioned the connection between ADHD and this idea of being bad or it being bad or it making you bad or unworthy. Because I think sometimes when people hear the word impulsivity or that person is impulsive, there’s this negative connotation to it. And I think some of the people I know who are impulsive, they’re the ones who are great in an emergency. They’re the ones who step up when a disaster happens. They’re the ones we know who are taking on too much. And so the connection between that and these people who do so many important things in our lives and in our communities, and then that idea of ADHD being bad, it really does play into how we as a society view ADHD and those outdated stereotypes.

Gail Jensen Saboixt (31:28):

Absolutely. And I think that we’re getting there. I think that now that people and professionals are able to really explain the difference between what ADHD looks like in a child, a teen, an adult, that helps people see that it is a disorder, that it is a brain issue. So, all those years we spent saying, “Well, if you weren’t driven like a motor you must not have it.” Now to really expand and understand the entire symptomology of ADHD has just been refreshing from a professional standpoint.

Lindsay Guentzel (32:12):

That was Dr. Gail Jensen Saboixt, the Division Chief of Psychology for ADHD Online, helping break down the three different types of ADHD and the symptoms that go along with each of them. I want to wrap up this episode by touching on something Gail and I talked about. That example she used about wanting to sew a dress. A lot of people with ADHD are driven by filling up the pleasure and reward center in our brains. It’s that dopamine rush, and that can present itself as the desire to start a lot of projects but then as you might know, we tend to fizzle out in the middle. But there’s also this other side to pursuing that dopamine rush that I think really comes together when looking at ADHD combined type, which is what I have.

Lindsay Guentzel (33:00):

So let’s say I want to sew a dress. So I go and I buy a sewing machine and I’m going to pick out a pattern and get fabric and get thread. And that is very much something I think a lot of people with ADHD, we see that manic Side. But the other side, because we are so impulsive, we tend to do those things without proper research, without even reading the instruction manual. So then when we start a project we’re ill prepared and it goes wrong. And then we view ourselves as a failure because we were not good at something the first time.

Lindsay Guentzel (33:32):

So it really brings together this combined type of the hyperactivity, the impulsivity, but then the emotional side that comes with the inattentive type. A lot of that ties into rejection sensitive dysphoria and rumination. I see a lot of it in my own life where I get an idea, I jump right into it, I start it before I probably should. And then when I’m not perfect at it right away, the avalanche of feelings, it’s like the expectation that we are supposed to be perfect from the get go. It really ties in when we look at ADHD combined type.

Lindsay Guentzel (34:12):

In next week’s episode, we’ll look at how ADHD shows up in our lives. I’m hoping you’ll join the conversation by sharing some of your own story with us here on Refocus with Lindsay Guentzel. You can connect with me through email, [email protected]. There are links to all of our social media handles as well as the free webinars Boz mentioned earlier in the show. Those are all available in the show notes. And very soon we will have a page set up for each of the episodes on adhdonline.com. That’s going to include a transcript of each of the episodes. Thank you to Megan who reached out and made that suggestion.

Lindsay Guentzel (34:48):

If there’s something you want to hear or a resource you think would be helpful, please don’t hesitate to reach out. The email is [email protected]. Refocus with Lindsay Guentzel is a collaboration between me, Lindsay Guentzel, and ADHD Online, a telemedicine healthcare leader offering affordable and accessible ADHD assessments, medication management, and teletherapy. You can find out more about ADHD Online by heading to adhdonline.com.

Lindsay Guentzel (35:19):

The show’s theme was created by Lewis [Ingles 00:35:21] a songwriter and composer out of Perth, Australia, who was diagnosed with ADHD in 2020 at the age of 39. Remember to subscribe, rate, and review wherever you are listening right now and join us next week for another episode of Refocused with Lindsay Guentzel.

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