Understanding ADD / ADHD

As homeopaths we recognize the fact that all of us are different, and this is even more noticeable when treating children, who have yet to be molded by society. With this in mind I have always felt that the old, three type definition of ADD/ ADHD was a bit limiting. It was classified as 1) ADD with Hyperactivity (impulsive), 2) ADD without hyperactivity (inattentive) and 3) Mixed type ADD, read more about this on healthline

For a number of years I have followed the work of Dr. Daniel Amen, and American psychologist and Psychiatrist, professor and author of many books including Healing ADD and The Brain Warriors Way. He pioneered the use of SPECT scans (which measure blood flow and activity) in diagnosing brain imbalances. From looking at thousands of scans of children with ADD he has proposed 7 different types of ADD, and even though SPECT scans are not freely available in South Africa, his definitions are revolutionary and have changed the way that many doctors understand ADD.

While there are some very good articles and interviews with Dr Amen (and of course his Healing ADD book) I would like to summarize:

1. Classic ADD
This is classic ADHD, with symptoms of inattentiveness, distractability, hyperactivity, disorganization, and impulsivity. On brain scan we can see a (relative) decrease in the function of the frontal part of the brain responsible for logical, rational thinking.

2. Inattentive ADD
This is the typical ADD with symptoms of disorganization, procrastination. These people are also easily distracted and have a short attention span and there is none of the hyperactivity of the Classic ADD. They tend to be daydreamers and can be introverted.

3. Over-Focused ADD
These people tend to have the main symptoms of Classic ADD but with a difficulty shifting their attention rapidly from topic to topic. Their brains are often stuck in negative thought patterns. These people tend to be very inflexible, and may not respond well to typical ADD medication.

4. Temporal Lobe ADD

Then this area of the brain is affected the Classic ADD symptoms are combined with difficulties with memory, mood stability and visual learning.  These people may also have mood problems such as aggression, anger and mild paranoia

5. Limbic ADD

Along with the distractability, inattentiveness and disorganization, people with an overactive limbic system in the brain and under active prefrontal cortex tend to show mood related symptoms. Although is is not a mood disorder they tend to have a chronic, low level sadness (not depression) with low self esteem, moodiness, low energy, helplessness and guilt.

6. Ring of Fire ADD
With this type of ADD Dr Amen describes, not an under-active prefrontal cortex, but rather an over-activity of the whole brain. He calls it “ADD plus.” Symptoms include unpredictable mood swings, aggressive behavior, anxiety and nervousness, rapid speech and hypersensitivity of the senses (sensitive to light, noise and touch). Again, typical (stimulant) ADD medication may not agree with these people.

7. Anxious ADD

Along with the central ADD symptoms people with this pattern of ADD are also anxious and stressed, they often feel their stress in their bodies with tension headaches and sore tummies. They may feel cold during times of high stress.

An interesting interpretation of Dr Amen’s ADD Types comes from the ADHD Information Library whose Clinical Director is Dr. Doug Cowan, and is based on clinical observation and experiences. He uses characters from the 100 Acre wood children’s stories to make Dr Amen’s types easier to understand and spot. They include:

  • Winnie the Pooh Type – (Inattentive ADD) Easily distracted, short attention span, disorganized. He’s a daydreamer.

  • Tigger Type- (Classic ADD) Impulsive, hyperactive, short attention span, restless, bouncy. “Bouncing is what Tiggers do best”

  • Eeyore Type – (Limbic ADD) Inattentive, with chronic low mood.

  • Piglet Type – (Anxious ADD), excessive worry, easily startled.

  • Rabbit Type – (Over-focused ADD) inflexible, difficulty shifting attention, argumentative.

  • Troubled Type ADHD – (Ring of fire ADD)  Irritable, aggressive, impulsive, defiant, disobedient. Learning problems. (Similar toTasmanian Devil cartoon character)

While this tends to simplify things a little too much, it is a useful summary and highlights the fact that there are more than 3 types of ADD.  Please remember that the above 7 types also apply to adults with ADD.

If you suspect that you (or a loved one) may have ADD please consider doing Dr. Amen’s online test.

Another reason I really like Dr Amen’s approach is that he is a big believer in a good diet. He approaches ADD and most brain disorders with diet as an important healthy foundation. He also believes in the importance of, and prescribes supplements to help the various types of ADD, calming or boosting different areas of the brain to encourage more balanced function.

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