Neurodiversity within ADHD: Theories on Diagnostic Typologies

While there is no scientific consensus regarding the existence of these distinct types of ADD (which is categorized by the DSM as ADHD with three main types), we still find it useful to discuss them as different people absolutely do experience different sorts of symptoms.

1. Classic
The three core symptoms associated with Classic ADD include inattention, hyperactivity, and impulsivity.  Classic ADD is similar to what the American Psychiatric Association describes as ADHD-combined presentation. This is the typical hyperactive/impulsive combination where the individual struggles with staying on task.
Symptoms: Inattentive, distractible, hyperactive, disorganized, and impulsive. Normal brain activity at rest; decreased brain activity during concentrated tasks.
Cause: Dopamine deficiency; decreased blood flow in prefrontal cortex and cerebellum, as well as basal ganglia, which helps produce dopamine. Brain mapping commonly reveals excessively slow brainwaves in the frontal regions of the brain, and frequently abnormal connectivity within and/or between the prefrontal cortex and parietal lobes.
Treatment: Stimulant medications, such as Ritalin, Vyvance or Concerta, or 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
Patients suffering from Inattentive ADD often have difficulty with executive functioning such as organization, planning, prioritizing, time management, and self-monitoring. These individuals are easily distracted and/or lack the mental stamina for completing routine tasks that are non-preferred. They typically are not a behavioral problem since they are not hyperactive nor impulsive.
Symptoms: Short attention span, distractible, disorganized, procrastinates, may daydream and be introverted; not hyperactive or impulsive; this type impacts women as much as males.
Cause: Dopamine deficiency; low activity in the prefrontal cortex.
Treatment: Stimulant medications, such as Vyvance or Concerta, or stimulating supplements, such as amino acid L-tyrosine; high-protein, lower-carbohydrate diet; regular exercise.

3. Over-focused
In addition to the core symptoms of Classic ADD, those patients suffering from Over-focused ADD have difficulty shifting their attention from one task to the next. I
Symptoms: Core symptoms of Classic ADD, plus trouble shifting attention, going from thought-to-thought or task-to-task; getting stuck in negative thought patterns or behaviors.
Cause: Dopamine and serotonin deficiencies; over-activity in anterior cingulate gyrus, which makes flexibility difficult. In this scenario, qEEG brain mapping frequently shows the brain being stuck in excessive fast brainwaves of overstimulation, whereby the brain is also functioning in a more rigid and inflexible state.
Treatment: 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); otherwise anti-depressants Effexor, Pristique, or Cymbalta; avoid high-protein diet, which may trigger mean behavior. Neurofeedback.
4. Temporal Lobe
Individuals suffering from Temporal Lobe ADD can be over-reactive or moody, and prone to tantrums or meltdowns in childhood. This type of Temporal Lobe ADD can be associated with memory problems and difficulties in auditory processing.
Symptoms: Core symptoms of Classic ADD, as well as learning, memory, and behavioral problems, such as quick anger, aggression, and mild paranoia.
Cause: Abnormalities in the temporal lobe; decreased activity in prefrontal cortex.
Treatment: Amino acid GABA (gamma-aminobutryic acid) to calm neural activity and inhibit nerve cells from over-firing or firing erratically; magnesium to help with anxiety and irritability; anti-convulsant medications to help with mood stability; gingko or vinpocetine to help with learning and memory problems.

5. Limbic
In addition to the core symptoms of ADHD, sufferers of Limbic ADD may experience increased feelings of guilt, possible moodiness, and, in some cases,  damaged self-esteem. Limbic ADD affects a group of structures within the brain involved in our “flight” or “fight” response system, leaving the individual feeling excessively and unrealistically threatened at times by stressors. This can often mimic and/or go hand-in-hand with stress and trauma responses, or PTSD if applicable.
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, and chronic low self-esteem.
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.
Treatment: Supplements DL-phenylalanine (DLPA), L-tryosine, and SAMe (s-adenosyl-methionine); anti-depressants Wellbutrin or Imipramine; exercise; fish oil and diet modifications.

6. Ring of Fire (also called “ADD Plus”)
Ring of Fire ADD is characterized by over activity in a global sense, meaning that the brain is over stimulated in multiple areas. Those suffering from Ring of Fire ADD may experience an increase in anxiety, racing thoughts, difficulty falling asleep or sleeping through the night. This person might also be emotionally over reactive and quick to anger.
Symptoms: Sensitivity to noise, light, touch; periods of mean, nasty behavior; unpredictable behavior; speaking fast; anxiety and fearfulness.
Cause: A ring of hyperactivity around the brain (the entire brain is overactive, with too much activity across the cerebral cortex and other areas).
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
Symptoms: Core symptoms of Classic ADD, as well as being anxious and tense, having physical stress symptoms like headaches and stomachaches, predicting the worst, freezing in anxiety-provoking situations, especially if being judged.
Cause: High activity in basil ganglia (the opposite of most types of ADD, where there is low activity).
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.

References: The information in this list was compiled by Heather Good, a licensed professional counselor. Information was adapted from 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), and an article in ADDitude Magazine, The Seven Types of ADD – and How to Treat Each One.