ADHD

Different Types of ADHD Overview

The Different Types, or Styles, of ADHD

* What are these different types of ADHD?
o "Inattentive Type": Just like Winnie the Pooh
o "Classic ADHD": Tiggers like to bounce...
o "Over-Focused ADHD": Rabbit tends his garden
o "ADHD with Anxiety": Piglet is nervous and worries...
o "ADHD and Depression": Eeyore says, "Thanks for noticing me..."
* What are the best treatment strategies for each of these types of ADHD?
* How you can find out more about the different types of ADHD?

Different Types, or Styles, of ADHD

Research literature, recent books, and common sense, all point to the fact that there are different types, or styles, of ADHD. In the past we referred to Attention Deficit Disorder: Inattentive Type, or Impulsive/Hyperactive Type, or a Combined Type. Today the diagnostic differences are a bit less clear, but the reality doesn't change.

1. Classic ADD - Inattentive, distractible, disorganized. Perhaps hyperactive, restless and impulsive.
2. Inattentive ADD - Inattentive, and disorganized.
3. Over-focused ADD - Trouble shifting attention, frequently stuck in loops of negative thoughts, obsessive, excessive worry, inflexible, oppositional and argumentative.
4. Temporal Lobe ADD - Inattentive and irritable, aggressive, dark thoughts, mood instability, very impulsive. May break rules, fight, be defiant, and very disobedient. Poor handwriting and trouble learning are common.
5. Limbic System ADD - Inattentive, chronic low-grade depression, negative, low energy, feelings of hopelessness and worthlessness.
6. Ring of Fire ADD - Inattentive, extremely distractible, angry, irritable, overly sensitive to the environment, hyperverbal, extremely oppositional, possible cyclic moodiness.

Our classifications are based more on our clinical observation and experiences. They are based on the classic children's stories of Winnie the Pooh and his friends in the Hundred Acre Wood.

Winnie the Pooh Type ADD - Inattentive, distractible, disorganized. Nice, but lives in a cloud.

Tigger Type ADD - Inattentive, impulsive, hyperactive, restless, bouncy.

Eeyore Type ADD - Inattentive, with chronic low-grade depression.

Piglet Type ADD - Trouble shifting attention, excessive worry, easily startled.

Rabbit Type ADD - Trouble shifting attention, inflexible, argumentative.

Troubled Type ADD - Irritable, aggressive, impulsive, defiant, disobedient. Learning problems.

Each of these types of ADHD will have different treatment needs and approaches.

The Different Types of ADHD: in Detail...

Tiggers Like to Bounce... Bouncin' is What Tiggers Do Best!

We call this type of ADHD "Tigger Type." Classic ADHD is characterized by Inattention, Impulsivity, Hyperactivity, Restlessness, and Disorganization. This type of ADHD reminds us of Tigger from the Winnie the Pooh stories.

Dr. Daniel Amen refers to this type of ADHD as "Classic ADHD" for good reasons. When you think about someone who has Attention Deficit Hyperactivity Disorder, this is the classic picture that you think of.

Those with this type of ADHD are often seen as:

* Being easily distracted
* Has a LOT of energy, and is perhaps Hyperactive
* Can't sit still very long
* Is figety
* Talks a LOT, and can be LOUD
* Is very impulsive, does not think before he acts
* Has trouble waiting his turn in line, or in games
* and more...

Tigger Type ADHD results from UNDERACTIVITY in the Prefrontal Cortex, both when at rest, and when performing concentration tasks.

This type of ADHD is most often seen in males.

Treatment Strategies for "Classic ADHD"

We recommend our Eating Program to start with. We believe that it is important to use the eating program even if you are using other interventions, such as medications, biofeedback training, or a combination of the nutraceuticals ATTEND, EXTRESS, and MEMORIN.

We also recommend at least a 30 to 60 day trial with these nutraceuticals...

* ATTEND for ADHD symptoms; 4 capsules per day in divided doses
* EXTRESS for symptoms of impulsivity, temper, restlessness; 4 capsules per day in divided doses
* MEMORIN for increased focus and concentration to task. 2 capsules per day in divided doses

The ATTEND contains L-Tyrosine, which increases dopamine production. ATTEND also contains GABA, DL-Phenylalyne, Ginko, Pycnogenol and Grape Seed Extracts, 5-HTP, pregnenolone, DMAE, and more. See the ATTEND ingredients list here.

The EXTRESS contains GABA, DL-PA, 5-HTP, and St. John's Wort.

The MEMORIN contains more ginko, plus lots of Phosphatidyl Serine and other phosphatidyls, and more pregnenolone.

An adult would take these in divided doses. A child could take half of that. Consult your health care professional.

Inattentive ADD: Just Like Winnie the Pooh

Winnie the Pooh is the classic picture of Inattentive ADHD.

In other works we have called this "Space Cadet" style ADHD.

Dr. Daniel Amen refers to this as "Inattentive ADD". These are people that suffer from "brain fog" as they go through their day.

Although Pooh is very lovable and kind, he is also inattentive, sluggish, slow-moving, unmotivated. He is a classic daydreamer.

People with this type of ADHD are often seen as being:

* Easily distracted
* Having short attention spans to a task that is not interesting, or is hard
* Daydreams when others are talking to him/her
* A person who cannot find anything that they have just put down somewhere...
* A person who is always late
* Is easily bored

This type of ADHD is caused by the prefrontal cortex of the brain actually slowing down (instead of speeding up activity) when placed under a work load, like reading or doing homework. This part of the brain looks normal when "at rest" but actually looks like it is starting to fall asleep when asked to "go to work." This makes it very hard to pay attention to school work, get homework done, listen to the teacher, clean your room, and so on.

We have actually observed this hundreds of times with subjects on an EEG. When at rest, the brainwave activity is pretty normal. But once the subject is asked to read, or to do a math worksheet, the subject's brainwave activity begins to look like the subject is falling asleep. This sure makes school hard for these students!

Winnie the Pooh style inattention is seen mostly in girls. It responds well to stimulants, such as ritalin and adderall, but other interventions work well also.

Treatment Strategies for "Inattentive" or Winnie the Pooh style ADHDORDER ATTEND NOW

We recommend our Eating Program to start with. In addition, we recommend for Inattentive, or Winnie the Pooh style ADHD the following:

* ATTEND for ADHD symptoms, 4 capsules per day
* MEMORIN for increased focus and concentration to task, 2 capsules per day

The ATTEND contains L-Tyrosine, as Dr. Amen recommends in his protocols. It also contains GABA, DL-Phenylalyne, Ginko, Pycnogenol and Grape Seed Extracts, 5-HTP, pregnenolone, DMAE, and more. See the ATTEND ingredients list.

The MEMORIN contains more Ginko, plus lots of Phosphatidyl Serine and other phosphatidyls, and more pregnenolone.

A child could take half of this, although many children will take up to four Attend per day. Consult your health care professional. For more information call 1.800.248.8292 during east coast business hours.

Over-Focused ADHD: Rabbit Tends to His Garden... and don't bother him.

The least flexible character in all of the stories of Winnie the Pooh and Christopher Robin has got to be Rabbit. Oh, he can get a lot of things done, and he's the one character who will be prepared when winter comes, but he has a very hard time shifting from one activity to another. He is absolutely "task oriented" and is focused to whatever that task might be.

The person with "Over-Focused ADHD" is much the same. He has trouble shifting attention from one activity to another, and he frequently "gets stuck" in loops of negative thoughts. He can be obsessive, and very inflexible. He can also be oppositional and argumentative to parents.

He may be like a "bull dog" and not give up until he gets his way, or until his worn-out parents finally say, "yes," to his 100th request for something. His parents are often worn-out, worn-down, fed-up, and ready to break. Parenting a child like this is hard.

Someone with "Over-Focused ADHD" is like Rabbit, in that he:

* May worry a LOT, even over things that don't really matter much
* Can be very oppositional to parents
* May like to argue
* May be somewhat compulsive about the way things ought to be done
* Will have a very hard time shifting from one activity to another
* Always wants to have his way

The cause of this type of ADHD is an over-active Anterior Cingulate Gyrus. This part of the brain is over-active all of the time.

And, to make things worse, when a "work load" is put on the brain, such as school work or a chore to be completed, there is the common ADHD symptom of decreased activity level in the Pre-Frontal Cortex.

In this type of ADHD some stimulants, and too much use of L-Tyrosine to increase dopamine production can actually make the problem of over-focus worse. So be careful.

Treatment Strategies for Over-Focused ADHD

For best results, try our Eating Program to start with.

In addition, some experts recommend 300 mg of St. John's Wort per day for children (600 mg per day for adults), 5-HTP, and B Vitamins.

We recommend for Over-Focused, or Rabbit style ADHD the following for adults. Children can take less.

* ATTEND for ADHD symptoms, take 2 capsules per day
* EXTRESS for symptoms of impulsivity, temper, restlessness, and anxiety take 4 capsules per day
* DEPREX for symptoms of worry, take 2 capsules per day

The ATTEND contains GABA, DL-Phenylalyne, Ginko, Pycnogenol and Grape Seed Extracts, 5-HTP, pregnenolone, DMAE, and more. See the ATTEND ingredients list below.

The EXTRESS contains GABA, DL-PA, 5-HTP, and St. John's Wort.

The DEPREX contains more GABA, as well as lots more DL-Phenylalyne, 5-HTP, and just 2 capsules of DEPREX contain 320 mg of St. John's Wort.

Piglet is a great friend, but sure scares easily...

Piglet is that small, almost frail character from the Hundred Acre Wood. He is a great friend, and very loyal. But he is always worried, nervous, and easily startles. Sometimes he is so nervous that he stutters. So it is with some kids with ADHD.

This style of ADHD is very similar to the Rabbit style, except that with "Piglet style" the child's mid-brain is so over-aroused that the child is hypervigilant and very easily startled. He may be talking all of the time, and is probably touching everything in the room. And, this child is nervous or worried, or anxious. He has trouble shifting attention from one activity to another, and he frequently "gets stuck" in loops of negative thoughts. He can be obsessive, and very inflexible.

In this type of ADHD some stimulants, and too much use of L-Tyrosine to increase dopamine production can actually make the problem of over-focus worse. So be careful.

Treatment Strategies for Piglet style ADHD

For best results, try our Eating Program to start with.

In addition, we recommend for Anxious, Piglet style ADHD the following for adults. Children can take less.

* ATTEND for ADHD symptoms, take 2 capsules per day
* EXTRESS for symptoms of impulsivity, temper, restlessness, and anxiety take 4 or more capsules per day

The ATTEND contains GABA, DL-Phenylalyne, Ginko, Pycnogenol and Grape Seed Extracts, 5-HTP, pregnenolone, DMAE, and more. See the ATTEND ingredients list below.

The EXTRESS contains GABA, DL-PA, 5-HTP, and St. John's Wort.

"Thanks for Noticin' Me" says Eeyore...

He walks slowly. He looks sad. He doesn't accomplish much. He's just glad to be noticed. This is Eeyore, the stuffed donkey who is so often in need of his tail being pinned back on.

Those with this type, or style of ADHD are often:

* Inattentive;
* Have a chronic sadness or low-grade depression;
* The seem to be negative, or apathetic;
* They have low energy levels;
* They just do not seem to care. They often feel worthless, or helpless, or hopeless.

This type of ADHD is called "Limbic System ADHD" by Daniel Amen. And for good reason. SPECT scans show that when the brain is at rest, there is increased activity deep in the limbic system, in parts of the brain called the thalamus and hypothalamus. There is also a decreased level of activity in the underside of the pre-frontal cortex.

When the brain is placed under a work load, as during a homework assignment, nothing changes. The over-active limbic system remains over-active, and the under-active pre-frontal cortex remains under-active.

This type of ADHD looks very much like a combination of ADHD and Depression. Some have suggested that up to 25% of children with ADHD are also depressed or suffer from a mild depression called Dysthymic disorder.

Treatment Strategies for Limbic System, or Eeyore style ADHD

For best results, try our Eating Program to start with.

In addition, experts recommend DL-Phenylalyne (up to 600 mg per day for adults), 5-HTP, and B Vitamins and St. John's Wort (up to 600 mg per day for adults).

We recommend for Limbic System, or Eeyore style ADHD the following for adults. Children can take less.

* ATTEND for ADHD symptoms, take 2 capsules per day
* EXTRESS for symptoms of impulsivity, temper, restlessness, and anxiety take 2 capsules per day
* DEPREX for symptoms of worry and depression, take 2 capsules per day

The ATTEND contains GABA, DL-Phenylalyne, Ginko, Pycnogenol and Grape Seed Extracts, 5-HTP, pregnenolone, DMAE, and more. See the ATTEND ingredients list below.

The EXTRESS contains GABA, DL-PA, 5-HTP, and St. John's Wort.

The DEPREX contains more GABA, and just 2 capsules of DEPREX contain 320 mg of St. John's Wort and 420 mg of DL-Phenylalyne.

Other, More Difficult Kinds of ADHD

There are two other kinds, or types, of ADHD that you should be aware of. There are no Winne the Pooh characters for these two types, as the creator of these children's stories would never have created a character with these challenging, difficult traits.

These two distinct types of ADHD can be very severe. They require significant treatment, and great patience on the part of the parents.

The Temporal Lobes and ADHD

Some people with ADHD can be very hard to live with. They can have gigantic mood swings, get very angry for almost no reason, and be nearly impossible to live with on a daily basis. The key to look for with this type of ADHD is anger outbursts for little or no reason...

People with decreased activity in the left temporal lobes can especially have problems with temper outbursts, aggressive behaviors, and even violence toward animals or other people.

Temporal Lobe ADHD is characterized by:

* Inattention, just like in other kinds of ADHD because during concentration there is a decrease in activity in the pre-frontal cortex;
* Being easily irritated or frustrated;
* Aggressive behaviors;
* Dark moods, big mood swings;
* Impulsivity;
* Breaking rules, in trouble a lot, in fights a lot;
* Defiant toward authority, disobedient toward parents and others;
* Can't get along with others, can be anti-social or just in trouble a lot;
* Often has terrible handwriting and problems learning;
* You expect him to be arrested at any time...

Individuals with this type of ADHD are often treated with a combination of stimulants, like Ritalin, and anti-convulsants.

For someone who wanted to try an alternative treatment approach, or an additional treatment approach, we would recommend

* GABA (an inhibitory nerortransmitter) to act as an anticonvulsant and anti-anxiety agent,
* Phosphatidyl Serine (and other phosphatidyls), DMAE, Pregnenolone, and Ginko as memory enhancers to help with the learning problems
* and these people sometimes are helped by Ibuprofen in small doses.
* no St. John's Wort or Hypericum, as it could make things worse.

Using the VAXA nutraceutical product line, our recommended protocol would look like this:

* ATTEND, 2 capsules per day
* NEURAN, 4 capsules per day

Two capsules of the ATTEND contain GABA (33mg), and DL-PA (16mg) for mood stabilization, plus L-Tyrosine (67mg), Ginko (33mg), Phosphatidyl Serine (0.5mg) and other phosphatidyls (200mg) and DMAE (33mg) and Pregnenolone (8mg) for learning enhancement. There are over 70 total ingredients in ATTEND to help with learning, performance, and mood.

Four capsules of NEURAN contain GABA (240mg), and DL-PA (32mg) for mood stabilization. Children might take less. Consult your healthcare professional.

As you can see, using the Neuran along with the Attend can enhance the mood stabilization components without adding either St. John's Wort or Hypericum, which can make the problem worse. These two products together can also enhance learning and memory, and therefore school performance or work performance.

Essential Fatty Acid supplementation is important for these reasons:

* Because you body does not make them. They are only available through our diets or through supplementation, and
* Because a full 60% of our brain is composed of fats, and EFAs, especially the Omega 3s DHA and arachidonic acid, are the most abundant and the most important, and
* Studies show that children with ADD ADHD have lower levels of essential fatty acids than do non-ADD ADHD children, and
* Studies show that lower levels of EFAs can result in problems with learning, behavior, temper, sleep, and immune function. These problems can be significantly helped when EFA levels are brought up to normal levels.
* In addition to the EFAs included in the ATTEND, we also recommend further Essential Fatty Acid supplementation with Omegacin+ for the first month for all children, teens, and adults, and for a longer period of time for those who display symptoms of EFA deficiencies. These symptoms include drinking lots of water due to excessive thirst, frequent urination, dry skin, and dry hair. (We also recommend EFA supplementation for pregnant women and nursing mothers, especially with the Omega 3 EFA known as DHA.)

ATTEND helps the brain to develop new and better neural pathways, to process information better and faster, and improves the brain's ability to inhibit behaviors.

We also noted that the longer a subject used ATTEND, the better the outcomes. Because ATTEND is a nutritional product it gradually helps the body function more optimally. In the same way that weight training takes three or four months to really make a noticeable difference in your body, nutritional medicines often take a while to make a difference as well.

By the way, we had some college athletes in a clinical trial. Each athlete tested in the "normal" or even "better than normal" ranges on the baseline CPT, especially in measured reaction time (measured in 1000ths of a second). Each athlete was tested at baseline, at 30 days, at 60 days, and at 90 days. Each athlete continued to improve his performance as measured by the computer testing during each test administration. Reaction time especially improved, which was exciting, as that is a good measure of neurological performance.

Their use of ATTEND continued to improve their performance. The longer they used it the better their performance.

As a result, we are also recommending Attend for athletes wishing to achieve peak levels of performance.

ATTEND and Extress are produced by VAXA International of Tampa, Florida. The produce over 50 of the finest, and most advanced nutraceutical products available today.

You may order VAXA products directly by phone. Call (800) 248-8292 during normal business hours on the East Coast of the USA. Ask for Daniel in customer service.

Dr. Cowan is a member of the VAXA International Medical Advisory Board. He is also our Clinical Director here at our ADD ADHD Information Library and NewIdeas.Net Incorporated, and the ADHD Family of Web Sites