Dr. Daniel Amen is the founder of the Amen Clinics and has been researching brain-based disorders for over 20 years.
Through his studies of blood flow and brain activity using SPECT brain scans and other diagnostic techniques, he concludes there are 7 types of ADD, each with their own symptoms, brain function and neurotransmitter activity.
ADHD impacts upon these areas of the brain:
PREFRONTAL CORTEX and CEREBELLUM
- Controls executive functions of concentration
- Attention span
- Impulse control
- Helps the brain shift gear
- Detect errors
- Emotional reactions
- Mood stability
- Visual processing
- Large structures deep within the brain responsible for the production of the neurotransmitter dopamine
- Sets emotional tone
ADHD affects the activity of these neurotransmitters:
NEUROTRANSMITTERS are chemicals in the brain that communicate information throughout the brain and body. They relay signals between nerve cells, or neurons and are responsible for such things as, telling your heart to beat, your lungs to breathe and your stomach to digest.
Neurotransmitters also affect mood, sleep, concentration and weight. Stress, poor diet, neurotoxins, genetic predisposition, drugs (prescription and recreational), alcohol and caffeine can alter neurotransmitter levels.
Excitatory neurotransmitters are responsible for stimulating the brain while Inhibitory neurotransmitters are calming and create balance.
DOPAMINE is a special neurotransmitter as it is considered to be both excitatory and inhibitory. Dopamine helps with depression as well as focus – it is our main focus neurotransmitter.
When dopamine levels are either elevated or low, it can result in issues with focus, such as not remembering where you put your keys, forgetting what a paragraph said just after reading it, or daydreaming and not being able to focus or stay on task.
Dopamine is also responsible for our drive or desire to get things done – or motivation. Stimulant medications used to treat ADD/ADHD, and caffeine cause dopamine to be pushed into the synapse so that focus is improved.
SEROTONIN is an inhibitory neurotransmitter. Adequate amounts of serotonin are necessary for mood stability and to balance any excessive excitatory (stimulating) neurotransmitter firing in the brain.
Serotonin also regulates many other processes such as carbohydrate cravings, sleep cycle, pain control and digestion.
If you use stimulant medications or caffeine in your daily regimen, it may lead to a depletion of serotonin over time. Low serotonin levels are associated with decreased immune system function.
GABA is an inhibitory neurotransmitter that has been referred to as “nature’s Valium.” When GABA is out of range (high or low excretion values) it is likely that an excitatory neurotransmitter is firing too often in the brain. In this instance, GABA will be sent out in an attempt to correct this stimulating over-firing.
The 7 Types of ADHD
Following is a summary of the cause, associated symptoms and suggested treatments for the 7 types of ADHD as identified by Dr. Amen through SPECT brain scanning and other diagnostic techniques.
1. Classic ADD
- CAUSE: Dopamine deficiency. Decreased blood flow in prefrontal cortex and cerebellum as well as basal ganglia, which helps produce dopamine.
- SYMPTOMS: Inattentive, easily distracted, hyperactive, impulsive and disorganized. Normal brain activity at rest. Decreased brain activity during concentrated tasks.
- TREATMENT: Stimulant medications such as Ritalin, Adderall, Vyvanse or Concerta. Stimulating supplements such as rhodiola, green tea, ginseng as well as the amino acid L-tyrosine, which is a building block of dopamine. Extra physical activity. Fish oil that is higher in EPA than in DHA.
2. Inattentive ADD
- CAUSE: Dopamine deficiency. Low activity in the prefrontal cortex.
- SYMPTOMS: Short attention span, easily distracted, disorganized with procrastination tendencies. May daydream and be introverted. No real signs of hyperactivity or impulsiveness. Impacts girls as much or more than boys.
- TREATMENT: Stimulant medications such as Adderall, Vyvanse or Concerta. Stimulating supplements such as amino acid L-tyrosine. High-protein, lower-carbohydrate diet. Regular exercise.
3. Over-Focused ADD
- CAUSE: Dopamine and serotonin deficiencies. Over-activity in anterior cingulate gyrus, which makes flexibility difficult.
- SYMPTOMS: Core symptoms of Classic ADD, plus trouble shifting attention, going from thought-to-thought or task-to-task. Tendencies toward negative thought patterns or behaviors.
- TREATMENT: Antidepressants Effexor, Pristiq or Cymbalta. Supplements such as L-tryptophan, 5-HTP (dietary supplement used as antidepressant), saffron and inositol (naturally occurring nutrient used to boost alertness, focus, mood and mental clarity). Avoid high-protein diet which may trigger mean behavior. Neurofeedback.
4. Temporal Lobe ADD
- CAUSE: Abnormalities in the temporal lobe. Decreased activity in prefrontal cortex.
- SYMPTOMS: Core symptoms of Classic ADD as well as learning and memory difficulties. Behavioral problems such as quick anger, aggression, and mild paranoia.
- TREATMENT: Amino acid GABA (gamma-aminobutyric acid) to calm neural activity and inhibit nerve cells from over-firing or firing erratically. Magnesium to help with anxiety and irritability. Anticonvulsant medications to help with mood stability. Gingko or vinpocetine to help with learning and memory problems.
5. Limbic ADD
- CAUSE: Too much activity in the limbic part of the brain (the mood control center). Decreased prefrontal cortex activity, whether concentrating on a task or at rest.
- SYMPTOMS: Core symptoms of Classic ADD as well as chronic low-level sadness (not depression). Moodiness. Low energy. Frequent feelings of helplessness or excessive guilt. Chronic low self-esteem.
- TREATMENT: Supplements DL-phenylalanine (DLPA), L-tyrosine and SAMe (s-adenosyl-methionine). Antidepressants Wellbutrin or Imipramine. Exercise. Fish oil. Diet modifications.
6. Ring of Fire ADD (ADD Plus)
- CAUSE: A ring of hyperactivity around the brain (the entire brain is overactive, with too much activity across the cerebral cortex and other areas).
- SYMPTOMS: Sensitivity to noise, light and touch. Periods of mean, nasty behavior. Unpredictable behavior. Speaking fast. Anxiety and fearfulness.
- TREATMENT: Stimulants alone may make symptoms worse. Begin with an elimination diet. If an allergy is suspected, neurotransmitters GABA and serotonin are boosted through supplements such as GABA, 5-HTP, and L-tyrosine and medication if necessary. For medications begin with anticonvulsants and the blood pressure drugs Guanfacine and Clonidine which calm overall hyperactivity.
7. Anxious ADD
- CAUSE: High activity in basal ganglia (the opposite of most types of ADD, where there is low activity).
- SYMPTOMS: Core symptoms of Classic ADD as well as being anxious and tense. Having physical stress symptoms like headaches and stomachaches. Pessimism – always predicting the worst. Freezing in anxiety-provoking situations especially if being judged.
- TREATMENT: Promote relaxation and increase dopamine and GABA levels. ADD stimulants taken alone make patients more anxious. Begin with a range of “calming” supplements such as L-theanine, relora, magnesium, and holy basil. Tricyclic antidepressants Imipramine or Desipramine to lower anxiety, depending on the individual. Neurofeedback to decrease symptoms of anxiety, especially to calm the prefrontal cortex.
Dr. Daniel G. Amen’s book – Healing ADD: The Breakthrough Program That Allows You to See and Heal the 7 Types of ADD (Penguin Group, 2013)