Amen’s “7 Types of A.D.D.” Are B.S.

Amen’s “7 Types of A.D.D.” Are B.S.

Jan 29, 2022

They’re nothing more than repackaging a condition in order to sell products

Photo by Hussain Badshah on Unsplash

In my previous piece, ADHD Quackery, I railed against the harmful lies that so-called professionals are spreading in order to sell vulnerable people a quick fix or “cure” for what ails them. In this particular case, ADHD.

My latest expression of contempt was directed at Dr. Amen and his false statements about what causes ADHD. I now move on to his completely made-up ADD types, which he uses to sell “treatments” at his private clinics in the United States.

Back to my soapbox I go!Created by author — (can you tell?)

“7 Types of ADD”

First off, it hasn’t been called “ADD” in nearly 35 years. The APA released a revised version of the DSM (DSM-III-R) in 1987, where the APA removed the hyperactivity distinction, and changed the name to attention deficit hyperactivity disorder (ADHD).

The quack — I mean, “doctor” — has made up his own seven types of ADHD, with zero backing from the psychiatric community, nor any published peer-reviewed research to support his claims.

His invented types are:

1. “Classic ADD”

Symptoms: Inattentive, distractible, hyperactive, disorganized and impulsive.

So, y’know, ADHD.

Cause: Dopamine deficiency; decreased blood flow in prefrontal cortex and cerebellum, as well as basal ganglia, which helps produce dopamine.

Yep, all well-established causes of ADHD. Except, if we’re going to be precise — as a doctor should be — ADHD is not quite a deficiency of dopamine, more of an inefficiency.

The two primary theories of dopamine “deficiency” are:

  1. Hyperactive re-uptake of dopamine, meaning the brain clears away the dopamine too quickly, so there isn’t enough available to be used by the brain. I guess that’s sort of a deficiency, but not in the way people think. Our brains are thought to produce enough dopamine, we just don’t have as much available for use.

  2. Inadequate dopamine transporters and receptors in the brain, resulting in less dopamine being transported to where it needs to go, and fewer receptors available to utilize the neurochemical as needed. So, the same amount of dopamine is being produced in the brain, but it gets stuck and under-utilized.

2. “Inattentive ADD”

Symptoms: Short attention span, distractible, disorganized, procrastinates, may daydream and be introverted; not hyperactive or impulsive.

Also known as ADHD, predominantly inattentive type.

Cause: Dopamine deficiency; low activity in the prefrontal cortex.

See above. Also: reduced activity and delated maturity in the Prefrontal Cortex (PFC) has been implicated in ADHD for a very long time, this is not new.

3. “Over-Focused ADD”

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 behaviours.

Difficulty with set shifting, or task switching, and cognitive rigidity are already considered core features of ADHD. Research from between 2013 (when the DSM-V was published) and now has clearly demonstrated a connection between cognitive rigidity and ADHD in both adults and children.

Cause: Dopamine and serotonin deficiencies; over-activity in anterior cingulate gyrus, which makes flexibility difficult.

Huh. I searched for published research that conclusively identified a serotonin deficiency in ADHD, but I could find none. Perhaps the doctor might submit his findings for peer-review, so the rest of us can learn?

Studies I found had mixed results, and one even found an increase in serotonin levels in the brains of children with ADHD.

As for the anterior cingulate gyrus (ACG), yes, it has also been well-established that the ACG is overactive in ADHD brains, so we can call “over-focused ADD”… ADHD.

Treatment: Supplements such as L-tryptophan, 5-HTP, saffron, and inositol, anti-depressants, avoid high-protein diet, Neurofeedback.

What a coincidence: These supplements are available on the Amen Clinic’s online store at costs ranging from $50-$150! They also offer neurofeedback at their clinics, but of course, they don’t provide prices for any of those services on their website.

4. “Temporal Lobe ADD”

Symptoms: Core symptoms of Classic ADD, as well as learning, memory, and behavioural problems, such as quick anger, aggression, and mild paranoia.

Once again, all of these symptoms have already been well established as core features of ADHD, stemming from deficits in executive functioning.

With regards to paranoia, I would refer to Rejection Sensitivity Dysphoria (RSD), and the higher incidence of Hostile Intent Attribution (HIA) bias in people with ADHD.

HIA is the tendency to attribute hostile intent to others in social situations where the intention of the other person is ambiguous or unclear, which again, are considered to be a result of executive functioning deficits.

Cause: Abnormalities in the temporal lobe; decreased activity in prefrontal cortex.

The temporal lobe encompasses a huge portion of the brain, including the limbic system. The limbic system is responsible for emotions, emotional behaviour, and consolidating memory.

The limbic system has already been implicated in ADHD, as well as associated learning and memory difficulties, which are also covered under the umbrella of executive functioning deficits.

Treatment: Amino acid GABA, magnesium, anti-convulsant medications, gingko or vinpocetine.

You guessed it: these supplements are also available through the clinic’s store.

Created by author

5. “Limbic ADD”

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.

That would be called ADHD with inadequate supports.

When people’s experiences are minimized and invalidated, when people in their lives don’t “believe” in ADHD or how much it can impact their daily lives, or when people are constantly criticized for their struggles, you get “limbic ADHD”… which is ADHD without a support network.

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.

Yes, people with ADHD often struggle with emotional regulation as a result of an under-developed PFC and an over-active amygdala.

Aside from that, however, low self-esteem and sadness are either caused by a co-morbid mood disorder, or by the lack of support and constant criticism that many people with ADHD experience on a regular basis.

(Jellinek, 2010) — Image created by author

Treatment: Supplements DL-phenylalanine (DLPA), L-tryosine, and SAMe (s-adenosyl-methionine); anti-depressants; exercise; fish oil and diet modifications.

Lo and behold, Dr. Amen sells these exact supplements on his website and in his clinics, despite the fact that there is no conclusive evidence that they will improve ADHD symptoms – unless the person is actually deficient in any of these nutrients, which would be a separate medical condition.

6. Ring of Fire ADD (“ADD plus”)

You can’t make this stuff up.

Symptoms: Sensitivity to noise, light, touch; periods of mean, nasty behaviour; unpredictable behaviour; speaking fast; anxiety and fearfulness.

Sensitivities to noise, light, touch are highly common in neurodivergent folks. Those who have significant hyper- or hypo-sensitivities may have Sensory Processing Disorder (SPD), which is its own condition, but highly comorbid with ADHD.

“Mean and nasty” are highly subjective and judgemental terms. I wrote an entire series of stories about why people may display behaviours others perceive as “defiant” or “nasty”, and why it’s an inappropriate and inaccurate lens through which to view a person, especially a child.

Speaking fast is just something a lot of people with ADHD do. Our brains move quickly, and often our bodies are working hard to keep up.

In terms of fearfulness, anxiety is another condition that is highly comorbid with ADHD, which may be why the doc invented two different categories with anxious-type.

Treatment: GABA, 5-HTP, L-tyrosine, and medication, if necessary.

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.

Yeah, that’s a lot of people with ADHD, considering anxiety is the most commonly comorbid (co-occurring) condition with ADHD. “Anxious ADD” is somebody who has ADHD plus anxiety.

Cause: High activity in basil ganglia (the opposite of most types of ADD, where there is low activity).

I’m not a neuroscientist, but neither is Dr. Amen. He’s a psychiatrist. My limited understanding is that, yes, the basal ganglia is implicated in emotions such as anxiety.

There is certainly evidence that the basal ganglia is smaller and less active in the brains of people with ADHD, but I could find no peer-reviewed studies providing evidence to for the opposite effect in people with both ADHD and anxiety.

I guess when the Amen Clinics have their patients footing the bill for all of their brain scans they can collect a lot more data and do their own imaging studies, but that doesn’t help the rest of the neurodivergent population who can’t afford a huge bill at a private clinic.

Treatment: L-theanine, relora, magnesium, and holy basil. Tricyclic antidepressants, and Neurofeedback.

<insert eye roll>

To Each Their Own

Fellow neurodivergents, if you find it helpful to classify yourself under a sub-type of ADHD or anything else, please feel free.

My problem isn’t with these made-up categories, per-se. My problem is these types of clinics create new pathologies, or rebrand old ones, in order to “customize” your disorder so they can sell you services, treatments, and products.

Sure, I identify more with some ADHD symptoms than others, everyone’s neurodivergence manifests differently. Having labels for our experiences can be incredibly validating and helpful sometimes.

That said, please take these “modern” treatments with a grain of salt. Don’t waste your time and energy pursuing unproven treatments that will likely not help and could even be harmful.

You may or may not learn to love your brain, but it’s the only one you’ve got, and life will be easier if you learn to work with it rather than against it.

© Jillian Enright, ADHD 2e MB

Read the prequel here:

ADHD Quackery

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