When people think of ADHD (Attention Deficit Hyperactivity Disorder), the image that often comes to mind is a hyperactive child who can’t sit still or focus in class. But ADHD in adults is much more complex, with symptoms that vary widely depending on the individual. In fact, Dr. Daniel Amen, a psychiatrist and brain disorder specialist, has identified seven different types of ADHD based on brain activity, behavior, and emotional patterns. His work challenges the conventional view of ADHD and shows that it is not just about hyperactivity or a single type of brain activity.
In this post, we will explore these seven types of ADHD, take a closer look at how they impact adults, and examine whether ADHD is truly only about brain activity.
What Are the 7 Types of ADHD?
According to Dr. Amen, ADHD can manifest in seven distinct forms, each of which affects individuals in different ways. These seven types of ADHD are:
- Classic ADD
- Inattentive ADD
- Over-focused ADD
- Temporal Lobe ADD
- Limbic ADD
- Ring of Fire ADD
- Anxious ADD
While each type shares core symptoms like difficulty focusing and impulsivity, each has its own unique characteristics and underlying brain activity patterns. Let’s dive into the details of each type.
A Close Look at ADHD Types
1. Classic ADD
Classic ADD is the form most commonly associated with ADHD. This type involves typical ADHD symptoms such as hyperactivity, impulsivity, and inattention. Adults with Classic ADD may have trouble staying focused, organizing tasks, or controlling impulsive behaviors. They are often restless and can experience mood swings.
From a brain activity standpoint, Classic ADD is characterized by low activity in the prefrontal cortex—the part of the brain responsible for focus, decision-making, and impulse control. Stimulant medications like Ritalin or Adderall are commonly prescribed to increase brain activity and alleviate symptoms.
2. Inattentive ADD
Inattentive ADD is less well-known but is quite common, especially in adults. People with this type of ADHD don’t exhibit hyperactivity; instead, they struggle with attention, focus, and organization. They may appear sluggish, daydream a lot, or have difficulty completing tasks that require sustained mental effort.
Inattentive ADD is often seen in women and girls, who are frequently misdiagnosed or undiagnosed because their symptoms are less disruptive than those of Classic ADD. Brain scans show decreased activity in the prefrontal cortex, similar to Classic ADD, but without the hyperactive element.
3. Over-focused ADD
Over-focused ADD involves excessive attention to certain tasks or thoughts, leading to an inability to shift focus when needed. People with this subtype often exhibit obsessive behavior, repetitive thinking, and a tendency to get stuck on negative thoughts. They may have difficulty with flexibility in thinking or problem-solving.
Over-focused ADD is linked to overactivity in the anterior cingulate gyrus, a part of the brain responsible for managing focus and cognitive flexibility. Treatment for this type often involves stimulant medication, along with antidepressants or other medications to help regulate mood and flexibility in thought.
4. Temporal Lobe ADD
Temporal Lobe ADD affects not only attention and focus but also mood regulation. People with this type often experience mood swings, memory problems, learning disabilities, and difficulty controlling anger or aggression. Emotional sensitivity is a hallmark of this subtype, which can complicate relationships and everyday interactions.
The temporal lobes of the brain, which control emotion, memory, and language, are underactive in individuals with Temporal Lobe ADD. Treatment typically involves mood stabilizers or anticonvulsant medications, in addition to stimulant medications to address the ADHD symptoms.
5. Limbic ADD
Limbic ADD is characterized by chronic sadness, low energy, and a lack of motivation. People with this type may experience symptoms that resemble depression, but they also exhibit classic ADHD symptoms like inattention, difficulty concentrating, and disorganization. The emotional component of Limbic ADD can be particularly challenging for adults trying to maintain relationships or careers.
In Limbic ADD, there is underactivity in both the prefrontal cortex and the limbic system, the part of the brain responsible for regulating emotions. Treatment often involves a combination of stimulant medication to boost focus and antidepressants to manage mood.
6. Ring of Fire ADD
Ring of Fire ADD is one of the more severe types of ADHD and is named after the “ring-like” pattern of brain activity seen in SPECT scans of individuals with this type. It involves extreme mood instability, hyperactivity, impulsivity, and aggression. People with this subtype may have frequent anger outbursts, anxiety, and emotional overwhelm.
Brain scans show overactivity in multiple regions of the brain, creating a “ring of fire” pattern. This type requires a combination of treatments, including stimulants, mood stabilizers, and sometimes antipsychotic medications, to manage the diverse and intense symptoms.
7. Anxious ADD
Anxious ADD combines ADHD symptoms with high levels of anxiety. Individuals with this type may feel tense, nervous, and easily overwhelmed. They often worry excessively and may avoid social situations or stressful environments. Alongside these anxiety symptoms, they also struggle with focus and attention, typical of ADHD.
Anxious ADD is linked to a combination of decreased activity in the prefrontal cortex and increased activity in the basal ganglia, a brain region associated with anxiety. Treatment often involves both stimulant medication and anti-anxiety treatments to manage the dual nature of the symptoms.
Can ADD Types Create a Combination?
It’s important to note that while these seven types of ADHD are presented as distinct categories, many people may exhibit a combination of symptoms from multiple types. For example, someone may have both Over-focused ADD and Anxious ADD, making diagnosis and treatment more complicated. In such cases, a more personalized approach to treatment is necessary, as there is no “one-size-fits-all” solution for managing ADHD.
Dr. Amen’s approach emphasizes the importance of identifying a person’s unique ADHD profile. By doing so, treatment can be tailored to target the specific combination of symptoms that are present. For many adults, this means a mix of medications, therapy, lifestyle changes, and cognitive behavioral strategies to achieve the best outcome.
SPECT Scans in Dr. Amen’s Books & 7 Types of ADHD
Dr. Amen’s research on ADHD is heavily based on the use of SPECT (Single Photon Emission Computed Tomography) scans. These scans measure blood flow and activity levels in different regions of the brain, offering a detailed look at how ADHD affects brain function. In his books, Dr. Amen discusses how SPECT scans have helped identify the unique brain activity patterns associated with each type of ADHD.
For example, SPECT scans have revealed that individuals with Classic ADD tend to have low activity in the prefrontal cortex, while those with Over-focused ADD show overactivity in the anterior cingulate gyrus. This information allows for a more precise diagnosis and more effective treatment plans.
While brain imaging is a crucial tool in understanding ADHD, it’s important to remember that ADHD is not only about brain activity. Environmental factors, genetics, lifestyle choices, and even diet can all influence how ADHD manifests and how well it responds to treatment.
Is ADHD Only About Brain Activity?
Although Dr. Amen’s work focuses on brain activity as a primary factor in ADHD, it’s clear that ADHD is a multifaceted condition. Brain scans provide valuable insight into how different types of ADHD affect brain function, but they are just one piece of the puzzle. Factors such as genetics, environment, nutrition, and stress levels all play a role in shaping how ADHD presents itself.
In treating ADHD, especially in adults, it’s essential to take a holistic approach that goes beyond just managing brain activity. Cognitive behavioral therapy, mindfulness techniques, regular exercise, and dietary adjustments are all important elements of a comprehensive treatment plan.
What Is Trauma?
At its core, trauma is the result of experiencing something so overwhelming that it disrupts a person’s sense of security and well-being. It can shake the foundation of how someone views themselves and the world around them. Trauma often leaves people feeling powerless, helpless, or disconnected, and it may cause lasting changes in their emotional and mental state.
While many people think of trauma as something that results from catastrophic events, it can also stem from more subtle, ongoing experiences like emotional neglect, bullying, or living in a highly stressful environment.
Types of Trauma
There are several types of trauma, each with different causes and impacts on individuals:
- Acute Trauma: This type of trauma results from a single, distressing event, such as a car accident, natural disaster, or physical assault. Acute trauma can lead to intense emotional reactions like fear, anxiety, and confusion.
- Chronic Trauma: Chronic trauma occurs from prolonged or repeated exposure to highly stressful events, such as ongoing abuse (physical, emotional, or sexual), domestic violence, or living in a war zone. Over time, chronic trauma can severely impact a person’s mental health and lead to conditions like depression, anxiety, or PTSD (Post-Traumatic Stress Disorder).
- Complex Trauma: Complex trauma arises from exposure to multiple traumatic events, often of an invasive, interpersonal nature. This is common in individuals who have experienced long-term abuse or neglect, particularly during childhood. Complex trauma can significantly impact one’s sense of identity and relationships with others.
- Secondary or Vicarious Trauma: This type of trauma affects individuals who are indirectly exposed to trauma, such as healthcare workers, therapists, or emergency responders who work with trauma survivors. Witnessing or hearing about traumatic events repeatedly can take an emotional toll on caregivers and professionals, leading to symptoms similar to those experienced by trauma victims.
Symptoms of Trauma
Trauma manifests in many ways, and the symptoms can be both psychological and physical. The symptoms of trauma often vary depending on the individual and the nature of the traumatic event(s). Common psychological and emotional symptoms include:
- Flashbacks or reliving the traumatic event
- Nightmares or distressing dreams related to the trauma
- Anxiety and feelings of constant fear or nervousness
- Depression or a pervasive sense of sadness and hopelessness
- Hypervigilance, or being overly aware of danger or threat
- Dissociation, or feeling detached from oneself or reality
- Emotional numbness or a lack of ability to feel emotions
- Anger and irritability over seemingly minor issues
Physical symptoms may include:
- Fatigue or extreme tiredness
- Headaches or body pain with no clear cause
- Sleep disturbances, including insomnia
- Increased heart rate or difficulty breathing during stressful moments
- Tension and restlessness
How Trauma Affects the Brain
Trauma can cause long-lasting changes in the brain. The brain’s fear center, the amygdala, becomes hyperactive, making it difficult for a person to regulate emotions and recognize what is safe versus what is threatening. Additionally, the prefrontal cortex, responsible for decision-making and rational thinking, can become less effective, making it harder to manage stress and emotional responses.
In cases of chronic trauma, the brain remains in a constant state of “fight or flight,” leaving the body and mind exhausted. The person may become hypervigilant, always on edge, and unable to relax even in safe environments.
The Connection Between Trauma and PTSD
Post-Traumatic Stress Disorder (PTSD) is a condition that develops in some individuals after experiencing trauma. While not everyone who experiences trauma will develop PTSD, those who do can face severe and disruptive symptoms that make it difficult to function in daily life.
People with PTSD may experience:
- Intrusive memories of the trauma that disrupt everyday life
- Avoidance behaviors, where they actively avoid places, people, or situations that remind them of the traumatic event
- Negative changes in thinking and mood, including feeling detached from others or having difficulty feeling positive emotions
- Hyperarousal, where they feel constantly on edge, irritable, or have difficulty concentrating
PTSD can affect anyone, but it is especially common in individuals who have faced extreme or prolonged trauma, such as soldiers in combat, victims of severe abuse, or survivors of violent attacks.
Healing from Trauma
While trauma can be deeply impactful, healing is possible with time, support, and proper treatment. Recovery from trauma often involves addressing both the emotional and physical symptoms. Some effective methods for healing include:
- Therapy: Trauma-focused therapy, such as Cognitive Behavioral Therapy (CBT) or Eye Movement Desensitization and Reprocessing (EMDR), can help individuals process their traumatic experiences and develop coping mechanisms.
- Mindfulness and Relaxation Techniques: Practices like meditation, deep breathing exercises, and yoga can help individuals reconnect with their bodies and reduce anxiety or hypervigilance.
- Support Networks: Having a strong support system of friends, family, or support groups can provide a safe space to share experiences, reduce feelings of isolation, and offer emotional support.
- Medication: In some cases, medications such as antidepressants or anti-anxiety medications may be prescribed to help manage the symptoms of trauma, particularly in individuals with PTSD or severe anxiety.
- Self-care: Engaging in self-care activities, maintaining a healthy routine, getting adequate rest, and setting boundaries can help a trauma survivor regain a sense of control and stability.
Conclusion
Dr. Daniel Amen’s classification of ADHD into seven distinct types has broadened our understanding of this complex condition. By looking at the different ways ADHD can affect brain activity and behavior, we can move away from a one-dimensional view of the disorder. For adults with ADHD, understanding which type (or combination of types) they have is crucial in finding the most effective treatment. Whether through medication, lifestyle changes, or a combination of both, addressing ADHD in a personalized way can lead to better outcomes and a higher quality of life.
