Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
ADDitudeSlideShow
PublishedonADDitudeMag.com
The7TypesofADDandHowtoTreatEachOne
OneADHDexpertsaystherearemanytypesofADHD.Heexplainsthemhere,andoffershis
treatmentplansformanagingthem.
byDanielG.Amen,M.D.,doubleboardcertifiedpsychiatrist/photoscreditedtoAmenClinics
OneTreatmentDoesNotFitEveryone
AsthefounderofsixAmenClinics,Ibringamultidisciplinaryapproachtodiagnosingandtreatingbrainbased
disordersincludingattentiondeficitdisorderandcoexistingconditions.Forovertwentyyears,IveusedSPECT
brainscans(alongwithotherdiagnostictechniques)todevelopindividual,targetedtreatmentplansforeach
patient.Earlyon,IdiscoveredthroughbrainSPECTpatternsthatattentiondeficitisnotasingleorasimple
disorder.
MyADDIsNotYourADD
ADD,anxiety,depression,bipolardisorder,autism,andotherconditionsarenotsingleorsimpledisorders.
Theyallhavemultipletypes.ADDaffectsmanyareasofthebraintheprefrontalcortexandcerebellum
primarily,butalsotheanteriorcingulate,thetemporallobes,thebasalganglia,andthelimbicsystem.The7
typesofADDthatIstudiedarebasedaroundthreeneurotransmittersdopamine,serotonin,andGABA.
ClassicADD
Thisistheeasiesttypetospotofthe7typesofADD:Primarysymptomsareinattentiveness,distractibility,
hyperactivity,disorganization,andimpulsivity.Scansofthebrainshownormalbrainactivityatrest,and
decreasedactivity,especiallyintheprefrontalcortex,duringaconcentrationtask.Peoplewiththistypeof
ADDhavedecreasedbloodflowintheprefrontalcortex,cerebellum,andthebasalganglia,thelastof
whichhelpsproducetheneurotransmitterdopamine.
TreatingClassicADD
Thegoalhereistoboostdopaminelevels,whichincreasesfocus.Idoitwitheitherstimulatingmedications
Ritalin,Adderall,Vyvanse,Concertaorstimulatingsupplementslikerhodiola,greentea,ginseng,andthe
aminoacidLtyrosine.Gettinglotsofphysicalactivityalsohelpsincreasedopamine,asdoestakingfishoilthat
ishigherinEPAthanDHA.
InattentiveADD
Thistype,aswellasClassicADD,havebeendescribedinTheDiagnosticandStatisticalManual(DSM)of
MentalDisorderssince1980.Thistypeisassociatedwithlowactivityintheprefrontalcortexandlowdopamine
levels.Symptomsareshortattentionspan,distractibility,disorganization,procrastination.Peoplewiththistype
arenothyperactiveorimpulsive.Theycanbeintrovertedanddaydreamalot.Girlshavethistypeasmuchas,
ormorethan,boys.
TreatingInattentiveADD
InattentiveADDisusuallyresponsivetotreatment.Itisoftenpossibletochangethecourseofaperson'slifeif
heorsheisproperlytreated.Thegoal,aswithClassicADD,istoboostdopaminelevels.Iusethe
supplementsliketheaminoacidLtyrosine,whichisabuildingblockofdopamine.Takeitonanempty
stomachformaximumeffect.IoftenprescribeastimulantlikeAdderall,VyvanseorConcerta.Iputpatientsona
highprotein,lowercarbohydratediet,andIhavethemexerciseregularly.
OverFocusedADD
PatientswiththistypehaveallofthecoreADDsymptoms,plusgreattroubleshiftingattention.Theygetstuck
http://www.additudemag.com/slideshow/61/print.html
1/3
8/19/2015
ADDitudeSlideShow
orlockedintonegativethoughtpatternsorbehaviors.Thereisadeficiencyofserotoninanddopamineinthe
brain.Whenthebrainisscanned,youseethatthere'stoomuchactivityintheareacalledtheanteriorcingulate
gyrus,whichisthebrain'sgearshifter.Thisoveractivitymakesitdifficulttogofromthoughttothought,taskto
task,andtobeflexible.
TreatingOverFocusedADD
Thegoalistoboostserotoninanddopaminelevelsinthebrain.Treatmentistricky.PeoplewithOverFocused
ADDgetmoreanxiousandworriedonastimulantmedication.IusesupplementsfirstLtryptophan,5HTP,
saffron,andinositol.Ifsupplementsdon'thelpwithsymptoms,IprescribeEffexor,Pristique,orCymbalta.I
avoidahigherproteindietwiththistype,whichcanmakepatientsmean.Neurofeedbacktrainingisanother
helpfultool.
TemporalLobeADD
Ofthe7typesofADD,thistypehascoreADDsymptomsalongwithtemporallobe(TL)symptoms.TheTL,
locatedunderneathyourtemple,isinvolvedwithmemory,learning,moodstability,andvisualprocessingof
objects.Peoplewiththistypehavelearning,memory,andbehavioralproblems,suchasquickanger,
aggression,andmildparanoia.Whenthebrainisscanned,thereareabnormalitiesinthetemporallobesand
decreasedactivityintheprefrontalcortex.
TreatingTemporalLobeADD
IusetheaminoacidGABA(gammaaminobutryicacid)tocalmneuronalactivityandinhibitnervecellsfrom
overfiringorfiringerratically.Takingmagnesium80percentofthepopulationarelowinthismineralhelps
withanxietyandirritability.Anticonvulsantmedicationsareoftenprescribedtohelpwithmoodinstability.For
learningandmemoryproblems,Iusegingkoorvinpocetine.
LimbicADD
ThistypelookslikeacombinationofdysthymiaorchroniclowlevelsadnessandADD.Symptomsare
moodiness,lowenergy,frequentfeelingsofhelplessnessorexcessiveguilt,andchroniclowselfesteem.Itis
notdepression.Thistypeiscausedbytoomuchactivityinthelimbicpartofthebrain(themoodcontrol
center)anddecreasedprefrontalcortexactivity,whetherconcentratingonataskoratrest.
TreatingLimbicADD
ThesupplementsthatworkbestforthistypeofADDareDLphenylalanine(DLPA),Ltryosine,andSAMe(s
adenosylmethionine).WellbutrinismyfavoritemedicationforthistypeofADD.Researchersthinkitworksby
increasingdopamine.Imipramineisanotheroptionforthistype.Exercise,fishoil,andtherightdietwillhelp
apersonwithLimbicADDbettermanagesymptoms.
RingofFireADD
Patientswiththistypedon'thaveanunderactiveprefrontalcortex,aswithClassicandInattentiveADD.Their
entirebrainisoveractive.Thereistoomuchactivityacrossthecerebralcortexandmanyoftheotherpartsof
thebrain.Icallit"ADDplus."Symptomsincludesensitivitytonoise,light,touchperiodsofmean,nasty
behaviorunpredictablebehaviortalkingfastanxietyandfearfulness.Inbrainscans,itlookslikearingof
hyperactivityaroundthebrain.
TreatingRingofFireADD
Stimulants,bythemselves,maymakesymptomsworse.Istartoutwithaneliminationdiet,ifIsuspectanallergy
isinvolved,andboosttheneurotransmittersGABAandserotoninthroughsupplementsandmedication,if
necessary.IprescribeGABA,5HTP,andLtyrosinesupplements.IfIprescribemedication,Istartwithoneof
theanticonvulsants.Thebloodpressuremedicinesguanfacineandclonidinemaybehelpful,calmingoverall
hyperactivity.
AnxiousADD
http://www.additudemag.com/slideshow/61/print.html
2/3
8/19/2015
ADDitudeSlideShow
PeoplewiththistypehavehallmarkADDsymptoms,andtheyareanxious,tense,havephysicalstress
symptomslikeheadachesandstomachaches,predicttheworst,andfreezeinanxietyprovokingsituations,
especiallywheretheymaybejudged.Whenthebrainisscanned,thereishighactivityinthebasalganglia,
largestructuresdeepinthebrainthathelpproducedopamine.ThisistheoppositeofmosttypesofADD,where
thereislowactivityinthatregion.
TreatingAnxiousADD
ThetreatmentgoalistopromoterelaxationandboostGABAanddopaminelevels.ADDstimulants,
takenalone,makepatientsmoreanxious.Ifirstusearangeof"calming"supplementsLtheanine,relora,
magnesium,andholybasil.Dependingonthepatient,Iprescribethetricyclicantidepressantsimipramineor
desipraminetoloweranxiety.Neurofeedbackalsoworkstodecreasesymptomsofanxiety,especiallytocalm
theprefrontalcortex.
ForMoreInformation:
Learnmoreaboutthe7TypesofADD:
LearnabouttheAmenClinics
CheckoutHealingADDatHomein30Days
ListentoDr.Amen'spodcastonthe7TypesofADD
WatchDr.Amen'sTEDxtalkonSPECTimaging
ReadoneofDr.Amen's30booksincludingTheDanielPlan,ChangeYourBrain,ChangeYourLife,
MagnificentMindatAnyAge,andHealingADD.
Copyright19982013NewHopeMediaLLC.Allrightsreserved.Youruseofthissiteisgovernedbyour
TermsofService(http://www.additudemag.com/adhd/terms.html)and
PrivacyPolicy(http://www.additudemag.com/adhd/privacy.html).
ADDitudedoesnotprovidemedicaladvice,diagnosis,ortreatment.Thematerialonthiswebsiteisprovidedforeducational
purposesonly.
Seeadditionalinformationathttp://www.additudemag.com/adhd/disclaimer.html
NewHopeMedia,39W.37thStreet,15thFloor,NewYork,NY10018
http://www.additudemag.com/slideshow/61/print.html
3/3