How Hyperactivity Can Show Up in Adults with ADHD

When most people hear the word hyperactivity, they picture a child running around (often a boy), unable to sit still in class. However, hyperactivity doesn’t always manifest in this way, especially in adults. Some of my ADHD assessment clients identify with inattentive symptoms before completing their assessment, but come out with a combined presentation due to hyperactive symptoms they hadn't noticed (plus a few impulsive ones also).

I think of inattentive symptoms as generally the most impairing and the core symptoms of ADHD. Some highly impulsive people can suffer the consequences of their bad decisions. Physical hyperactivity, when present, can sometimes lead to rewarding outcomes, such as high-level performance in sports or the ability to harness hyperfocus to accomplish a significant amount of work. Mental hyperactivity, like internal restlessness and a busy mind, can make it difficult to relax.

Rethinking Hyperactivity in Adults

In adulthood, the DSM-5 criteria for ADHD explicitly note that hyperactivity often shifts from obvious physical movement to more internal experiences. While some adults still exhibit outward hyperactivity, for many, the energy turns inward and can feel like a constant hum that never quite subsides.

Common Ways Hyperactivity Appears in Adults

Hyperactivity in adults can look different from person to person, but common themes include:

• Restlessness: Unable to sit for long periods, pacing during phone calls, needing frequent breaks, making excuses to get up and move around.

• Fidgeting: Twirling hair, tapping a pen, bouncing a leg, squirming and repositioning frequently, or otherwise moving parts of the body.

• High energy levels: Always on the go, driven, seemingly less need for rest than others, needs frequent physical exercise to feel OK, others having difficulty keeping up with the person. This is more of the classic hyperactivity presentation.

• Mental hyperactivity: A racing or busy mind that jumps from thought to thought, or has multiple different conversations, thoughts, music, or obligations playing at the same time, making it hard to relax or switch off, often at bedtime.

• Talking a lot: Speaking at length, talking quickly, having a loud voice, or finding it hard to stay brief when excited or engaged.

The Impact of Adult Hyperactivity

Hyperactivity isn’t always negative. Many adults with ADHD use their energy productively—at work, in creative projects, or in sports. But it can also create challenges:

• Difficulty relaxing or unwinding

• Strained relationships if constant activity or talk becomes overwhelming for others

• Sleep problems due to a restless body or racing thoughts

• Burnout from taking on too many commitments at once

Strategies That Can Help

• Movement breaks: Allowing small bursts of activity can release restless energy.

• Mindful unwinding: Practices such as meditation, gentle stretching, or calming hobbies can help calm the mind and body.

• Structured outlets: Channelling energy into exercise, creative work, or meaningful projects can make hyperactivity feel like a strength at times.

• Support and treatment: ADHD medication, therapy, or coaching can help mitigate the disruptive side of hyperactivity while supporting focus and self-regulation, and when learning to avoid taking on too many tasks to reduce burnout.

  
  

Final Thoughts

Hyperactivity in adults doesn’t usually look like bouncing off the walls. It can manifest as racing thoughts, a restless body, rapid talking, or an urge to stay constantly busy. For many adults with ADHD, learning to recognise and manage this energy can lead to behavioural changes when accommodating hyperactivity and diverting it from more damaging (or exhausting) outcomes.

• ADHD Hyperactivity Doesn’t Stop in Childhood from the ADDitude website