Combined ADHD Women: A Practical Guide for Australians

What is ADHD combined presentation?

The combined presentation is one of three ways ADHD can show up, decided by which symptom thresholds a person meets.

• The Australian ADHD Guideline describes inattentive, hyperactive-impulsive and combined presentations, and combined means both thresholds are met (Australian ADHD Guideline).
• The Royal Children’s Hospital Melbourne says combined is the most common type and hyperactive-impulsive is rare (RCH Kids Health Info).
• A person with combined ADHD may notice both inattention and restlessness or impulsivity in daily life.

What does combined ADHD mean? Meaning and subtype explained

The combined ADHD meaning is simpler than the word “subtype” suggests: it is about which symptom thresholds are met.

• Combined ADHD means a person has enough symptoms from both lists, inattentive and hyperactive-impulsive, to meet the diagnostic threshold for each.
• Under DSM-5 there are 9 inattentive and 9 hyperactive-impulsive symptoms, and children need 6 of the 9 in a list to meet its threshold.
• For people aged over 17 years, only 5 of the 9 symptoms in each list are needed.
• A diagnosis also requires evidence of symptoms before age 12, symptoms present for at least 6 months and symptoms causing impairment in at least two settings, such as home, school or work (AADPA diagnosis checklist).

Combined type ADHD in women: what it can look like

ADHD in girls and women can be missed or recognised late, whatever the presentation.

• The Australian ADHD Guideline notes that girls and women with ADHD may frequently go unrecognised or be diagnosed late (AADPA high-risk groups).
• healthdirect says ADHD is more commonly diagnosed in young males but is also underdiagnosed in young females and adults (healthdirect).
• ReachOut Australia says teenage girls are more likely to experience inattentive ADHD and boys hyperactive ADHD, and that the inattentive type is less visible (ReachOut Australia).
• If you are a woman and recognise both inattentive and hyperactive-impulsive patterns, talk to your GP about an assessment.

Our guide to symptoms of ADHD in women goes into more detail on everyday signs.

ADHD combined type symptoms in adults

Adults with the combined presentation may notice both kinds of difficulty, across work, relationships and household tasks.

This table is for reflection only. Only a qualified professional can assess whether these patterns point to ADHD.

TQN Care support workers help with personal care, community access, respite and help around the home across Sydney, Melbourne and surrounding areas (NSW & VIC). Tell us what you need and we will call you back.

Is combined ADHD the worst? Severe combined ADHD explained

No presentation is “the worst”. The Australian ADHD Guideline defines the presentations by which symptom thresholds are met, not by how much support someone needs.

• The Royal Children’s Hospital Melbourne describes combined as the most common type, which says how often it occurs, not how hard life is.
• Every diagnosis needs symptoms that cause impairment in at least two settings, whatever the presentation.
• Someone with inattentive ADHD can need just as much support as someone with combined ADHD, and the reverse is also true.
• If you have heard the phrase severe combined ADHD, ask your clinician to describe your support needs rather than rely on a presentation name.

How combined ADHD is assessed in Australia

A diagnosis comes from a qualified clinician, not a quiz. These steps help you prepare.

1. 1Book a long GP appointment. Describe your symptoms, when they started and how they affect work, study, home and relationships.
2. 2Gather your history. School reports, old notes and a family member’s memories of your childhood help show symptoms before age 12.
3. 3Ask about a referral. Your GP can explain which qualified clinician to see for an ADHD assessment.
4. 4Complete the assessment. The clinician checks symptoms against diagnostic criteria and also looks for other conditions that can look similar or occur together.
5. 5Talk through the results and options. Ask about the presentation, supports and anything else that could help, and take notes or bring a support person.

Support for combined ADHD women and adults

Support is described here in general terms only; your treating clinician decides what suits you.

• Medicines are prescribed by a doctor, and healthdirect and your GP can explain the classes available; never start, stop or share medicine without medical advice.
• Ask your GP or specialist which non-medicine supports suit your situation.
• You can ask your workplace or place of study about adjustments, such as written instructions.
• The ADHD Foundation on 1300 39 39 19 offers ADHD support, as listed by healthdirect.
• If you meet the NDIS access requirements, your plan may fund support at home, such as help with routines, cooking and appointments.

Our guide to depression and ADHD in women covers how the two can occur together.

NDIS and other funding for combined ADHD

NDIS funding is only available if you meet the NDIS access requirements, so check with the NDIA what applies to you.

• Ask the NDIA what evidence it needs, and ask your treating clinician what they can provide about how ADHD affects your daily activities.
• Ask your GP whether any Medicare rebates apply to your appointments.
• Carers and families can ask the NDIA or their GP about supports available to them.

When to talk to a GP or specialist

You do not need to wait for a crisis to ask for an assessment. These are good reasons to book a visit.

• Attention, restlessness or impulsive behaviour keeps causing problems at work, study or home.
• You recognise lifelong patterns that were missed or put down to anxiety, stress or personality.
• Low mood, anxiety or burnout is making daily tasks harder, and you wonder whether ADHD is part of the picture.
• You are already diagnosed and your support no longer matches your needs, for example after a life change.
• You are worried about a daughter, sister or friend who is struggling quietly at school or work.

Call 000 in an emergency. If you are struggling with thoughts of suicide, call Lifeline on 13 11 14.

TQN Care support workers help with personal care, community access, respite and help around the home across Sydney, Melbourne and surrounding areas (NSW & VIC). Tell us what you need and we will call you back.

Your next step

If ADHD makes daily life harder for you or someone you love, practical support can help. TQN Care provides NDIS support workers for personal care, community access, respite and help around the home, and we never provide treatment or diagnosis. See our NDIS services, or make a referral and we will call you back.