ADD is a neurodevelopmental disorder that has been diagnosed in children and adults. It was originally called hyperkinetic impulse disorder until the late 1960s when the American Psychiatric Association (APA) formally recognized AD(H)D as a mental disorder.1
It is characterized by symptoms (not restricted to) such as:
- The inability to maintain attention on a task
- Trouble organizing tasks
- Avoidance of time and energy-demanding activities, and follow-through.
- Problems with hyperactivity (fidgeting, excessive talking, restlessness)
- Impulsivity (difficulty with delayed gratification, interrupting others, etc.)
Attention Deficit Disorder (ADD) and ADHD are often used to pertain to the same disorder because of similarities in symptoms, however, ADD is a subtype of ADHD that specifically identifies diagnosed individuals who do not display hyperactivity.2
The latest publication from the APA released back in 2000 has identified three main subtypes of ADHD.1
- Combined type ADHD
- Predominantly inattentive type ADHD
- Predominantly hyperactive-impulsive type ADHD
However, in 2013, Dr. Daniel G. Amen, MD, a child and adult psychiatrist and a nuclear brain imaging specialist published a book that identified seven subtypes of ADHD. He used single-photon emission computerized tomography (SPECT) scans on tens of thousands of patients to support his conclusions.3
(Note: In Dr. Amen’s study, he preferred to use ADD to pertain to the disorder, thus, this article will use the same term to reference his work.)
The 7 subtypes of ADD, according to Dr. Amen, are:
1. Classic ADD (ADHD) – Symptoms include inattentiveness, easily distracted, disorganised pattern of thoughts and activities, hyperactivity, restlessness, and impulsivity. Procrastination can also be an issue.
2. Inattentive ADD – Individuals under this type are often told to be daydreamers or couch potatoes because of traits that include being sluggish and slow-moving with low levels of motivation. These symptoms are combined with inattentiveness and a lack of focused attention.
3. Overfocused ADD – Serotonin and dopamine-deficiency are associated with this subtype. Individuals exhibit classic ADD symptoms, with trouble shifting attention, rumination with negative thoughts or behaviours, obsessive, excessive worrying, rigidity, and abrasive behaviour.
4. Temporal Lobe ADD – People diagnosed with this ADD type have irregularities in their temporal lobes and more limited activity in the prefrontal cortex part of the brain. Visual and auditory hallucinations have been observed symptoms, along with classic ADD behaviours, irritability, quick-temperedness and aggression, and having consistent dark thoughts, mood fluctuation, and mild paranoia.
5 Limbic ADD – Individuals with limbic ADD have excessive activity in the limbic region of the brain, which controls a person’s mood. They also have decreased activity in the prefrontal cortex when relaxing or concentrating on a task. Observable traits are classic ADD symptoms with chronic low-level sadness (but not depression), low energy, and feelings of hopelessness, and low self-esteem.
6. Ring of Fire ADD – For this subtype, there is excessive activity in the cerebral cortex and other areas that results in an overactive brain. Diagnosed people were recognised to show a more extreme version of classic ADD, extremely distracted behaviour, anger, irritability, and hypersensitivity to noise, light, certain textiles, and physical contact. They are also often inflexible, verbally abrasive, and have cyclic moodiness.
7. Anxious ADD – High levels of activity in the basal ganglia that aid in the production of dopamine is the main determinant of this subtype. Anxious ADD includes classic ADD signs along with anxiety that can manifest as headaches and stomach aches, low body temperature (feeling cold when anxious), and chronic pessimism.
The initial identification of the disorder may be done by checking if a person exhibits at least three symptoms over an extended period of time. An interference in one’s normal daily activity, as a result of the symptoms, is also indicative of ADD.
ADHD in Childhood: Alternative Perspectives
Dr. Gabor Maté, the co-founder of Compassion for Addiction and a renowned speaker, offers a different perspective on ADD in his book “Scattered Minds”. He proposes that ADD is not an inherited condition but originates from early childhood experiences during the first years of critical brain and personality development.6
His approach suggests the adjustment and management of the child’s environment to create a more conducive setting for him to thrive despite the disorder.
According to Dr. Maté, parents should look at the internal and external stresses in the family, at the quality of the relationships that surround the child, and the amount of structure and security the family provides when making changes in the child’s environment.6
He further highlights a deeper analysis of stressors in the family of which they are unaware; noting that people can experience a stressful situation as a norm when they are unconscious of its negative effects. Thus, the recommendation to seek psychological and emotional therapy to pinpoint the source of the stress, manage the symptoms of AD(H)D brought about by the trigger; and prevent further strain.
ADD and Gut Health
Another alternative perspective is from the examination of the gut biome and its relationship to ADHD.
Research published by the American Academy of Pediatrics examined the Gastrointestinal Conditions in Children With Autism Spectrum Disorder which has helped draw a connection between gut health and many disorders, including autism and ADHD.
Key findings from the study have suggested that:
- 90% of a child’s serotonin levels are located in the gut.8
- Food allergies such as aversion to gluten, dairy, and artificial sweeteners can cause depressive-symptoms, lack of clarity in thinking, anxiety, and general irritability – all of which are symptoms of ADHD.8
- The fact that there are more neurons surrounding a child’s gastrointestinal tract than in the entire spinal cord suggests that improving gut health with a controlled diet may aid in the management of ADD symptoms.8
Such an approach further supports the recommendation to examine all approaches to ADHD to create a 360 plan for the child’s overall wellbeing.
According to Amen Clinics Inc., 4% to 5% of the adult population in the US is affected by ADD, while the number is higher – 10% – for school-aged children.4
Up to 60% of children with AD(H)D will continue to have symptoms until adulthood.4 This is for both diagnosed and undiagnosed individuals.
The key insight about adult ADD is that a majority of them have never been diagnosed, which can lead to misdiagnosis of their current condition with mental, mood, or cognitive disorders such as depression, anxiety, bipolar disorder, or a learning disability.
The Attention Deficit Disorder Association (ADDA) is an organization dedicated to helping adults and their families deal with ADD. They also provide reliable and scientific education on alternative treatment such as Cognitive Behavioral Therapy (CBT), ADHD coaching, and drug treatments.
Here is a Symptom Checklist for adults provided by the ADDA.
One of the organization’s objectives is to present both scientific and holistic approaches (such as mindfulness practice, exercise, and diet) to manage ADD. Advancements in research have implied that a combination of interventions pose more benefits to the individual because such an approach addresses more symptoms.
While classic ADD symptoms can cause problems in many areas of adult life, these indications can be particularly damaging to relationships. This is especially true if the symptoms have never been properly diagnosed or managed. Common feelings of family members and partners that live with a diagnosed person are isolation, frustration, and resentment of their role as caregiver, and distrust because of the lack of follow-through. This is why interdisciplinary interventions are encouraged to support the needs of both parties.5
When both parties have knowledge about the disorder, then they’ll be equipped to provide the best response in certain situations – eliminating the destructive cycle in the relationship.
One of the most observed effects of ADD in an adult relationship is the prevalence of the parent-child dynamic. Both parties often feel stuck with their roles resulting in resentment towards the other person and their predicament. This is where therapy and coaching come into play so that action plans and effective communication are practised in addition to proper medication.
Here is a free Emotional Intelligence Tool Kit to add to your existing treatment.
It’s also worth exploring complementary health practitioners who offer interventions such as Neuro-linguistic Programming (NLP), controlled diets, and regression therapy, that serve as supplemental interventions to medical and psychiatric treatments.
Hundreds of studies about ADD have presented an array of information that stems from various health and wellness disciplines. People diagnosed with ADD and their families are presented with challenges that can often put a strain on their health and relationships, thus, the need to provide as many options for intervention.
What’s important to note is that ADD is readily treatable. Patience is essential in finding the right treatment for an individual.
The proper combination of medication, psychotherapy, and complementary health interventions such as Mindfulness-based Interventions (MBI) and even the use of therapy dogs can help manage the disorder to live normal, fulfilling lives.
Considering all the available options to effectively navigate the waters of ADD is always better than none.
Important reminder: Do not self-diagnose. Find an ADD specialist who can help analyse the symptoms and behaviours related to the disorder.