Severe attention deficit hyperactivity disorder (ADHD) is not a medical diagnosis but an assessment of how ADHD affects a person’s life. People may use it to refer to those with significant ADHD symptoms that affect daily life.

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) does not distinguish severe ADHD from other types of ADHD.

Healthcare professionals may judge ADHD severity according to:

  • how well the diagnosis responds to treatment
  • how it affects a person’s life
  • by using validated measures such as the Conners Adult ADHD Rating Scale.

The treatment is the same as for less severe ADHD. However, a person with many symptoms that affect their daily life may need more support, different or more medication, and additional interventions such as occupational therapy.

Read on to learn more about severe ADHD.

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ADHD causes a person to be persistently hyperactive, inattentive, or both. To qualify for a diagnosis, a person’s symptoms cannot be primarily due to another cause, such as substance misuse.

Severe ADHD is a subjective label, not a diagnosis.

A person may feel their ADHD is severe if it affects many aspects of their life, does not respond to medication, or has symptoms that are difficult to control. When a person has more symptoms of ADHD, a doctor or psychotherapist may label their condition severe.

Clinicians may also use rating scales to determine how many symptoms are present and the extent to which those symptoms negatively affect daily life.

ADHD symptoms fall into two broad categories: hyperactive and inattentive. Clinicians determine the type of this condition a person has according to their symptoms.

Primarily inattentive means someone has mostly inattentive symptoms, while primarily hyperactive means that hyperactivity and impulsivity are the dominant symptoms. A mixed type means that a person has significant levels of both groups of symptoms.

The symptoms of ADHD include the following.

Inattentive symptoms

Inattentive symptoms mean someone has more difficulties with sustained, appropriate attention than is typical of their age. Some symptoms may include:

  • hyper-focusing on things they enjoy to the exclusion of other activities
  • issues with paying attention in class or at work
  • frequently losing things
  • issues with remembering deadlines or tasks
  • procrastinating
  • being easily distracted from tasks
  • seeming not to listen when others speak
  • daydreaming frequently

Hyperactive symptoms

Hyperactive symptoms mean that a person has a higher than usual level of activity, difficulties with impulse control, and that their level of hyperactivity is not typical for their age. Some examples of symptoms include:

  • issues with sitting still
  • fidgeting often
  • climbing or running in inappropriate situations
  • pacing
  • talking excessively
  • behaving impulsively
  • interrupting others frequently
  • blurting out answers in class
  • having difficulty waiting for one’s turn

When a person has severe ADHD, they may have more symptoms. Their symptoms may also be more pronounced.

For example, a child with severe ADHD may be unable to sit in their chair in class, frequently get in trouble at school, or seem unable to remember to do their homework.

An adult may experience intense impulsivity. This can look like frequently interrupting others during conversations or having ongoing work or relationship challenges.

Severe ADHD is not a medical diagnosis — rather, it is a clinical and subjective judgment of how significantly the condition affects a person’s life.

In a 2018 study of 925 adolescents with ADHD, researchers labeled 10.3% of ADHD cases as severe. It found that the only risk factor that reliably predicted the condition’s severity was having the hyperactive subtype of ADHD.

A 2023 review reports that untreated ADHD is a risk factor for complications such as substance misuse. Treatment improves symptoms and therefore reduces severity.

The treatments for severe ADHD are the same as those for other forms of ADHD. It may include the following.


Medication is the primary treatment for ADHD. Doctors commonly prescribe stimulant drugs such as Ritalin and Adderall.

However, stimulants do not work for everyone — they may be ineffective or unsafe for some. When this happens, a doctor may recommend an antidepressant or a group of drugs called alpha-agonists that have similar effects to stimulants.

A person may have to try several medications, a combination of medications, or different doses to find the right fit. An experienced healthcare professional can help a person find the medication that works for them.


The American Academy of Pediatrics (APP) recommend that for children younger than 6 years old, psychotherapy and other social interventions should be the first line of treatment.

Therapy can help a person learn to control their emotions, identify strategies for managing ADHD symptoms, and better understand their own needs. With young children, family therapy can support a family to develop a plan to cope with ADHD-related behaviors.

Psychosocial interventions

Psychosocial interventions are a group of interventions that help support a person with ADHD. They might include:

  • coaching a parent or caregiver to care for a child with ADHD more effectively
  • educating a person about ADHD
  • teaching a person how to advocate for themselves
  • teaching skills in occupational therapy
  • creating schedule or lifestyle changes to work around a person’s symptoms


Disability accommodations allow a person to work around their disability.

For example, a child might get extra time to complete a test, or an adult might get permission to work remotely or in a distraction-free environment.

There are varying definitions of disability. Whether health experts consider ADHD a disability depends on the type of disability benefits or accommodations a person is seeking and how significantly the condition affects their life.

The Americans With Disabilities Act covers ADHD. This means that it is illegal to discriminate against someone with the condition and that workplaces must make reasonable accommodations for people with ADHD, including severe ADHD.

Severe ADHD can affect a person’s relationships, work, education, and quality of life.

A clinician knowledgeable about ADHD can offer a range of options, though a person may need to experiment with interventions before they find the right support.

Parents or caregivers of children with ADHD need to advocate for their children to ensure they get the best possible treatment.