Funny, as much as I am on here and thnking about my ADHD, I honestly still do not truly understand what is meant by my diagnosis of "Primarily Inattentive Type". Is this why I isloate and withdraw from the world? Why I feel so locked inside myself? Or is it some of the co-morbid anxiety and dysthymia that cause this and the inattentive symptomology is different?

If anyone can shed some light on what it means to be an adult with ADHD "Primarily Inattentive Type" I would appreciate the help or insights.

Anxiety and depression (dysthymia), if it becomes somewhat dissociative (disconnected from the outer world or disconnected from the internal world), can become inattentive or 'spacey'.

Do you think you are emotionally 'shut down'? Like this is more than just ADD? Or like you are living in the past, or in feelings from the past, at times?

I ask b/c Anxiety is often a 'conditioned emotional response'.

We can get something called 'bottom up hijacking' where we are emotionally taken to a more painful time or old set of events, even if we cannot 'name' those factors.

Depression (dysthymia) and Anxiety are two extreme ends of the emotional spectrum, but tend to co-occur in tandem. Depression is being shut down (a defensive response) and Anxiety is a state of overactivation (uncomfortable hyperarousal) of the sympathetic nervous system. You can read more on this at Pat Ogden's website at www.sensorimotorpsychotherapy.org (http://www.sensorimotorpsychotherapy.org)

Great post Queensu girl!

I'll add a couple of points:

1.) Many people with adhd also have another disorder such as depression (my case) or anxiety ...

2.) It is not always the case that treating your adhd will solve the second problem ...

3.) Sometimes the second problem is it's own independent disorder ....and needs its own treatment plan ...

4.) Inattentive adhd has to do with inability to focus, concentrate and plan, which is different from the hyperactive part of not being able to sit still etc ...

5.) Inattentive adhd is still a serious problem, as one of the key aspects of bonding with others and building friendships is the ability to read body language, mood, etc ... the ability to "read" a social situation. Inattentives apparently have great difficulty reading the right signals because we take in too much or don't prioritize what we're taking in ....

6.) I would, if I were you, see a psychotherapist as well as a medical doctor. A good therapist can help you sort out these various symptoms and disorders ... most med doctors just give medicine rx's.

Good luck.

this is what i have been questioning, since i was diagnosed the inattentive type. i have also been diagnosed dysthymia, first, which was just a few months before adhd diagnosis. i think my psychiatrist was unsure at first, cause at that point i was further "depressed" (much lower state than dysthymic condition, which is a "normal" state for me). i treated that depression (wellbutrin) in a few months, and now am just treating adhd (adderall). i plan to begin dysthymia treatment, soon, when adderall stabilizes for me. it's been app 6 months, but i am still quite un-adjusted (if that's a word:).

i explain, cause these diagnosis have come at an age of 35, and i am now trying to make sense of all this. i have come to think that i had inattentiveness from very early on as a kid, but no one recognized it or even thought about it (cause i grew up in a country in east asia, where there was no "mental illness" category, until very recently). i think i had gotten it from my mom, secretly. but i have also always been withdrawn--and that was what was recognized as my "personality." to this day, that is what my family would say. it was dysthymia from early on, which i'm in the process of trying to figure out how/where it began. my psychologist (and psychiatrist) says you have it from you're really young... i think this may be from my dad... but not sure cause I was a first child and there was a culture of encouraging calmness, or, reservedness. it all could've led to a permanent generally-low-mood condition.

it's been really hard to figure out, which came first, which is the root cause, what adhd and dysthymia had meant for me. i wonder, maybe because i initially was inattentive, while the general family/society culture didn't recognize variations in personal capabilities and only forced me to do things, i had become withdrawn. and come to enjoy being withdrawn, while figuring out by myself how to deal with adhd (e.g., working on deadlines). Or maybe the two co-occurred.

In any case, i have come to think that causal explanation, while I believe is a coerced logic, might be "necessary" for oneself to become "better" (thru overcoming past by fixing the meaning of the past). in that respect, i agree that having a good person to talk to (like psychotherapist) helps, cause he/she can help sort things out. that's what i've been doing, although i cant say i'm completely satisfied with my 2 doctors.

(sorry for being incoherent but just wanted to reply:)

Anxiety and depression (dysthymia), if it becomes somewhat dissociative (disconnected from the outer world or disconnected from the internal world), can become inattentive or 'spacey'.

Do you think you are emotionally 'shut down'? Like this is more than just ADD? Or like you are living in the past, or in feelings from the past, at times?

I ask b/c Anxiety is often a 'conditioned emotional response'.

We can get something called 'bottom up hijacking' where we are emotionally taken to a more painful time or old set of events, even if we cannot 'name' those factors.

Depression (dysthymia) and Anxiety are two extreme ends of the emotional spectrum, but tend to co-occur in tandem. Depression is being shut down (a defensive response) and Anxiety is a state of overactivation (uncomfortable hyperarousal) of the sympathetic nervous system. You can read more on this at Pat Ogden's website at www.sensorimotorpsychotherapy.org (http://www.sensorimotorpsychotherapy.org)

I am completely shut out, but not necessarily shut down, if that makes any sense. I still feel like crap. Once my daughter goes to bed, I just go into our bedroom and read or watch TV, and close the door to the world. It's all I look forward to. It is to the point now where I only feel comfortable doing this in our BR even. It's like it is some sort of protective cocoon for me. I can't read and watch TV downstairs for example, without wanting to retreat to the isolation of the bedroom, with a closed door.

My wife does this in the living room, just goes into her own world watching her shows. While I do it in the bedroom.

http://www.addforums.com/forums/showthread.php?t=60661

Hi The D,

Just a few thoughts on what I've found about the inattentive subtype of ADHD:


It appears to be slightly more genetically "hard-wired" than the more hyperactive and impulsive forms of ADHD. For example, a form of the gene called Serotonin Receptor 1B (http://adhd-treatment-options.blogspot.com/2008/09/adhd-gene-6-serotonin-receptor-1b-gene.html) is thought to be somewhat tied down to the primarily inattentive ADHD.
Primarily inattentive ADHD is thought to be connected to having more of a difficulty in maintaining higher frequency brainwave states (http://adhd-treatment-options.blogspot.com/2009/01/genes-and-adhd-brainwave-patterns.html). There appears to be a strong genetic component to this as well.
One of the good things about Primarily Inattentive ADHD is that it often requires smaller doses of stimulant medication such as Concerta (http://adhd-treatment-options.blogspot.com/2008/11/benefits-and-risks-of-different.html), to treat than for the more Hyperactive/Impulsive forms of the disorder.
Are you taking stimulant medications for your Primarily Inattentive ADHD? If so, since medication dosage levels are typically lower, it is possible that you may have been overprescribed. This is why ADHD subtype diagnosis is so important, because you probably would not need the same dosage as someone who is the hyperactive/impulsive, bouncing off the walls type of ADHD. Anxiety and dysthymia and other similar experiences, which often fall more along the depression side of the spectrum can often creep up if stimulant medication doses for ADHD are too high. Just a thought
Hope this helps out a bit...

Good luck with your treatment, and please let us know if there are any changes, positive or negative!

Funny, as much as I am on here and thnking about my ADHD, I honestly still do not truly understand what is meant by my diagnosis of "Primarily Inattentive Type". Is this why I isloate and withdraw from the world? Why I feel so locked inside myself? Or is it some of the co-morbid anxiety and dysthymia that cause this and the inattentive symptomology is different?

If anyone can shed some light on what it means to be an adult with ADHD "Primarily Inattentive Type" I would appreciate the help or insights.

Hi The D,

Just a few thoughts on what I've found about the inattentive subtype of ADHD:

Just wanted to thank for this post! I had replied above to The D, but found this info you gave really exciting. Cause it's good to know that I'm not alone in this kind of situation.

I'm still in the process of finding my right dose (I'm on adderall now), but have been unable to figure out why I'm having such a long period of search. I went from 10mg-to 40mg, then developed what is kind of like "overfocus" issue. Overfocus is not quite right though, cause I found myself really unresponsive to situations, and like to dwell on things, and seek constant seclusion (although I tended to prefer this all throughout). I am now back down to 10mg/day, but am still having this issue. Maybe I should go down a bit more, like 5mg a day, or try changing...

I dont know where you got that thing about dosages, but I definitely respond better on the lowest dose of adderall! I can't notice it most of the time but I do feel "smarter", while a higher dose barely shows or makes me extremely hyper focused on bad things.

It means you are (a) non Hyperactive and (b) non Impulsive.

The ADHD diagnosis can involve three domains of symptoms: Hyperactivity, Impulsivity and Inattention.

Inattentives are probably mostly missed in diagnosis.

You are VERY VERY lucky to be diagnosed!!!

yes, we're mostly invinsible to the people around us.

inattentive ADD is so weird and I wish we could understand what is going on in our heads most of the time and figure out how to learn!

Definitely check with a physician before downsizing dosage, but I'm glad you enjoyed some of the info! I've just started researching the stuff myself, and am trying to share my findings with as much of the world as possible. But yes, I really do believe that medication overdosing is an extremely common occurrence. Fill us in how on how everything's going! Scientific studies are fine, but at the end of the day, I prefer hearing about success stories from real people!

Best of luck to you!

Just wanted to thank for this post! I had replied above to The D, but found this info you gave really exciting. Cause it's good to know that I'm not alone in this kind of situation.

I'm still in the process of finding my right dose (I'm on adderall now), but have been unable to figure out why I'm having such a long period of search. I went from 10mg-to 40mg, then developed what is kind of like "overfocus" issue. Overfocus is not quite right though, cause I found myself really unresponsive to situations, and like to dwell on things, and seek constant seclusion (although I tended to prefer this all throughout). I am now back down to 10mg/day, but am still having this issue. Maybe I should go down a bit more, like 5mg a day, or try changing...

my doc has talked about taking me off strattera, i responded last fall and tried again a month ago. My memory might be better, supposively stims dont help that and that does, is this true?

Here's a couple other links you might find useful:

http://www.chrisdendy.com/executive.htm - About the effects of executive function impairment.

http://www.adda-sr.org/reading/Articles/mooreinattentive.htm - A description of inattentive ADD.

http://www.pbs.org/wgbh/misunderstoodminds/attentionbasics.html - Gives examples of what a visual/auditory distraction is like for an ADDer. I disagreed with their visual example, but their auditory example was spot on for me.

I was recently diagnosed -- at the age of 41 -- with ADHD, primarily inattentive type.

When I was 4 years old, my preschool teacher would send notes to my parents complaining that I wasn't "mentally with us in class." She said that I would often give inappropriate answers to questions because I wasn't listening.

Despite having an IQ over 130, I got poor grades through much of school. Mostly this was because:

A) I had trouble following a lecture for more than a few minutes at a time. Even if I really wanted to listen, it was as though I would inevitably start to daydream.

B) I was chronically disorganized. I never remembered assignments. When I did do an assignment, I would forget and leave it at home.

When I reached my mid 20's I gradually started to learn ways to succeed in spite of these difficulties. I taped the lectures in college and took notes at home. That way, I could simply pause the playback periodically when my mind wandered. If I missed something, I could simply re-wind and listen again. Today, I'm doing pretty well (I'm a research scientist).

I still have the same kind of problems at 41, it's just that they are not as bad as they once were. I have a PhD, but I still can't follow a lecture in my own field of expertise for more than 15 or 20 minutes before my mind wanders. I have simply come to accept that I'm not going to absorb information from listening to someone talk because it's too hard to maintain my attention. :( I learn by reading. The advantage of that for me is that -- again -- I can simply go back and re-read something if I miss something and I can't pause the reading and think as long as I want.

Basically, I am absent minded -- I tend to think about what interests me, rather than what is going on around me. My desk, car, house, whatever are always in a state of disorder. I have trouble remembering to do ordinary things like paying bills or running by the bank to deposit a check. (Today I carry a PDA that I use to keep a daily checklist of things to do).

Unlike many people with ADHD, I never had hyperactivity or impulsiveness.

When I reached my mid 20's I gradually started to learn ways to succeed in spite of these difficulties. I taped the lectures in college and took notes at home. That way, I could simply pause the playback periodically when my mind wandered. If I missed something, I could simply re-wind and listen again.

Yup, this is exactly the same thing I did in college for a few of my classes.

I still can't follow a lecture in my own field of expertise for more than 15 or 20 minutes before my mind wanders. I have simply come to accept that I'm not going to absorb information from listening to someone talk because it's too hard to maintain my attention. :( I learn by reading.

Yup again. It's easier for me to follow something if the speaker has handouts, otherwise my mind is all over the place. I've always picked things up much better from reading as well.

I was recently diagnosed -- at the age of 41 -- with ADHD, primarily inattentive type.

When I was 4 years old, my preschool teacher would send notes to my parents complaining that I wasn't "mentally with us in class." She said that I would often give inappropriate answers to questions because I wasn't listening.

Despite having an IQ over 130, I got poor grades through much of school. Mostly this was because:

A) I had trouble following a lecture for more than a few minutes at a time. Even if I really wanted to listen, it was as though I would inevitably start to daydream.

B) I was chronically disorganized. I never remembered assignments. When I did do an assignment, I would forget and leave it at home.

When I reached my mid 20's I gradually started to learn ways to succeed in spite of these difficulties. I taped the lectures in college and took notes at home. That way, I could simply pause the playback periodically when my mind wandered. If I missed something, I could simply re-wind and listen again. Today, I'm doing pretty well (I'm a research scientist).

I still have the same kind of problems at 41, it's just that they are not as bad as they once were. I have a PhD, but I still can't follow a lecture in my own field of expertise for more than 15 or 20 minutes before my mind wanders. I have simply come to accept that I'm not going to absorb information from listening to someone talk because it's too hard to maintain my attention. :( I learn by reading. The advantage of that for me is that -- again -- I can simply go back and re-read something if I miss something and I can't pause the reading and think as long as I want.

Basically, I am absent minded -- I tend to think about what interests me, rather than what is going on around me. My desk, car, house, whatever are always in a state of disorder. I have trouble remembering to do ordinary things like paying bills or running by the bank to deposit a check. (Today I carry a PDA that I use to keep a daily checklist of things to do).

Unlike many people with ADHD, I never had hyperactivity or impulsiveness.


do you take meds?
I take meds, but i think i might have to do the tape recording as i dont think they work like they used to. Glad to know it works, i'm not so sure how i'd work with reading i generally lose consciousness while I read.

I thought i'd pass this along, yoga really helps calm my mind, i'm just spacey like you, as well as motivating me to do something else.

Hi The D,

Just a few thoughts on what I've found about the inattentive subtype of ADHD:


It appears to be slightly more genetically "hard-wired" than the more hyperactive and impulsive forms of ADHD. For example, a form of the gene called Serotonin Receptor 1B (http://adhd-treatment-options.blogspot.com/2008/09/adhd-gene-6-serotonin-receptor-1b-gene.html) is thought to be somewhat tied down to the primarily inattentive ADHD.
Primarily inattentive ADHD is thought to be connected to having more of a difficulty in maintaining higher frequency brainwave states (http://adhd-treatment-options.blogspot.com/2009/01/genes-and-adhd-brainwave-patterns.html). There appears to be a strong genetic component to this as well.
One of the good things about Primarily Inattentive ADHD is that it often requires smaller doses of stimulant medication such as Concerta (http://adhd-treatment-options.blogspot.com/2008/11/benefits-and-risks-of-different.html), to treat than for the more Hyperactive/Impulsive forms of the disorder.
Are you taking stimulant medications for your Primarily Inattentive ADHD? If so, since medication dosage levels are typically lower, it is possible that you may have been overprescribed. This is why ADHD subtype diagnosis is so important, because you probably would not need the same dosage as someone who is the hyperactive/impulsive, bouncing off the walls type of ADHD. Anxiety and dysthymia and other similar experiences, which often fall more along the depression side of the spectrum can often creep up if stimulant medication doses for ADHD are too high. Just a thought
Hope this helps out a bit...

Good luck with your treatment, and please let us know if there are any changes, positive or negative!

Thanks for the info, I'll check it out tonight.

It means you are (a) non Hyperactive and (b) non Impulsive.

The ADHD diagnosis can involve three domains of symptoms: Hyperactivity, Impulsivity and Inattention.

Inattentives are probably mostly missed in diagnosis.

You are VERY VERY lucky to be diagnosed!!!

You are right, as I never knew about it for years. I am diagnosed as Combined Type, Primarily Inattentive. I definitely can be impulsive although that has lessened some. The Hyperactive part of me rarely rears its head anymore, but used to especially when I was a teenager.

My main issues are a desire to isolate, low-motivation, and procrastination. I guess I was asking to see if there was a link between my increasing desire to be left alone, and the inattentive portion of my add. It seems to me that perhaps there may not be much of a link, other then poor coping skills that developed in concert with or as a result of the ADD and depression. I am not sure, but I do know that as I get older, the less interaction I want with people. I literally will, when engaged by someone to talk, will be walking away from them as they are still talking, just to get away from having to talk to them. I have to stop myself and wait for a more appropriate time to run away. It really is pathetic and I am tired of it. I do everything I can to keep from forming connections with people. It's like I just don't want them to look at me or see me. Just don't notice me, or talk to me, or look at me, or........anything. It seems to get worse as time goes by and I do not like it. I will start seeing a therapist again and try and figure out what is going on. It's not like this just started but it is worse. Thanks to all of you, I swear sometimes this board and all of you are the only relief in my life.