Attention deficit hyperactivity disorder (ADHD) has three subtypes. Hyperactive ADHD is a subtype that mainly causes high energy, restlessness, and impulsive behavior.

In contrast, inattentive ADHD mostly affects focus and concentration, while combined ADHD causes both sets of symptoms in equal measure.

A person with hyperactive ADHD may find it hard to sit still, fidget a lot, and have a more difficult time controlling their impulses than others. However, they can also be spontaneous, fun, socially engaging, and energetic.

This article explores hyperactive ADHD, including the symptoms in children, adults, and females. It also explains how doctors diagnose it and what the treatments are.

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ADHD is a neurodevelopmental disorder, meaning it is a condition that affects how the brain develops and functions. The symptoms begin in childhood and can manifest in three main ways:

  • predominantly hyperactive-impulsive
  • predominantly inattentive
  • combined

People with the hyperactive-impulsive form of ADHD mainly experience hyperactivity and impulsive behavior rather than difficulty concentrating or remembering things. These are the most prominent symptoms of the inattentive subtype.

This does not necessarily mean that a person with hyperactive ADHD will not experience any inattentive symptoms — only that the hyperactivity or impulsivity is more apparent.

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR), children with hyperactive ADHD have six or more of the following behaviors:

  • frequent fidgeting, such as squirming in their seat or tapping their hands or feet
  • leaving their seat in situations where they need to stay seated, such as during school
  • running and climbing at inappropriate times
  • having difficulty engaging in activities or playing quietly
  • acting as if “driven by a motor” or always being “on the go”
  • talking a lot
  • blurting out answers, completing other people’s sentences, or interrupting others in conversation
  • having difficulty waiting their turn
  • intruding on others, such as entering into games or activities, or using other people’s things, without asking

For a child to receive an ADHD diagnosis, these behaviors must have lasted for at least 6 months and occur in two or more settings, such as home and school.

They also must not be things the child is doing on purpose or solely because they are angry or upset. ADHD symptoms are not a choice.

Adolescents and adults ages 17 years and older with hyperactive ADHD typically exhibit at least five of the above behaviors from the DSM-5-TR. They may also have other symptoms, such as:

  • extreme restlessness
  • difficulty remaining still for extended periods, such as in restaurants or long meetings
  • impulsive spending, which may have a negative effect on their finances
  • impulsive decision-making, which could affect their education, career, or relationships
  • frustration when doing tasks that are slow or boring
  • tendency to engage in potentially harmful behaviors

These symptoms typically occur at home, work, and during other activities and affect a person’s social and occupational functioning.

The symptoms of hyperactive ADHD can be similar in all genders. However, a 2020 review notes that fewer women receive this diagnosis than men. The reasons for this are uncertain, but there are several theories:

  • Sex differences: Some researchers have suggested that people with female biology may experience a “protective effect” against ADHD, making their symptoms less severe.
  • Internal symptoms: Girls may be more likely to have internalized ADHD symptoms, including internalized hyperactivity. For example, they might experience hyperactive thoughts rather than exhibit hyperactive behavior.
  • Gender expectations: Some cultures expect boys to be noisier or more active than girls. This can increase the stigma around ADHD for girls and women, which may lead to them “masking” or hiding their symptoms.
  • ADHD stereotypes: Conversely, the stereotype that ADHD mainly affects boys could mean more boys get a diagnosis.
  • Misdiagnosis: It is common for people with ADHD to have mental health conditions, such as anxiety, but this is even more common among girls. Doctors may misinterpret their anxiety as their primary condition.

Learn more about ADHD in women.

Mental health professionals, such as clinical psychologists or psychiatrists, can diagnose ADHD. They do this by assessing a person’s symptoms against diagnostic criteria.

Children ages 16 years and under may receive an ADHD diagnosis if they have at least six persistent symptoms of hyperactive ADHD present for at least 6 months. The symptoms occur in at least two settings and interfere with school and socializing.

People ages 17 years and over may receive a diagnosis if they have had symptoms since before the age of 12 years, and if they currently experience at least five persistent symptoms of hyperactive ADHD in two or more settings that reduce social and work functioning.

Anxiety, depression, sleep disorders, and other conditions can sometimes cause similar symptoms to ADHD, so healthcare professionals may also perform evaluations for these conditions.

The treatments for hyperactive ADHD are the same as for the other subtypes of the condition and may include:

Psychosocial interventions

Psychosocial interventions are a group of approaches that address the mental health and social aspects of a condition. In ADHD, the aim of these interventions is to help a person manage their symptoms and achieve their goals.

People with ADHD can try these interventions with or without medication. In children under 6 years old, they are the first-line treatment.

Some of the options include:

  • Behavioral therapy: This is a form of talk therapy that focuses on changing thoughts and behaviors that are interfering with a person’s well-being.
  • Parent training: This intervention can help caregivers learn about their child’s symptoms and how best to respond to them. It is often part of behavioral therapy for children with ADHD.
  • Classroom support: This can involve implementing strategies that teach organizational skills and encourage helpful behaviors.
  • Family or couples therapy: In cases where ADHD is affecting relationships, or vice versa, family or couples therapy may help. For example, in children with ADHD, family therapy could help caregivers and children communicate, set boundaries, and bond.
  • Other psychotherapy: Other types of psychotherapy may also help people with ADHD in a variety of ways. It may give them a safe space to talk about how ADHD affects them, to build self-esteem, or to discuss co-existing conditions, such as anxiety or depression.


There are two broad categories of ADHD medication: stimulants and nonstimulants. Stimulants are fast-acting, whereas nonstimulants are slower but can last longer.

ADHD medications may reduce hyperactivity, but it can take some trial and error to find one that suits a person. They can cause side effects such as difficulty sleeping or loss of appetite. Similarly, though, some people find them very helpful.

According to the Centers for Disease Control and Prevention (CDC), 70–80% of children with ADHD have reduced symptoms when taking stimulants.

Healthcare professionals will work with the person to determine the most suitable medication.

Hyperactive ADHD is one of three subtypes of ADHD. People with this type of ADHD often feel fidgety and restless, find it hard to sit still for long periods, and have very high energy levels. They may also have difficulty with impulsive behaviors but can also be spontaneous and dynamic.

Doctors can diagnose hyperactive ADHD via an assessment. For children with ADHD, behavioral therapy and parent training are among the first-line interventions. Older children and adults may also try medications to manage the symptoms.