Highlights
- Officially, ADHD is divided into three subtypes in the DSM-5 — inattentive, hyperactive-impulsive, and combined — but Dr. Daniel Amen proposed 7 “types of ADD.”
- The 7 types of ADHD include Classic, Inattentive, Overfocused, Temporal Lobe, Limbic, Ring of Fire, and Anxious — each with its own set of symptoms, according to Dr. Amen.
- Amen’s framework isn’t agreed upon by the medical community due to the limited nature of his research methods. It can’t be used for diagnosis, yet many people find it useful for describing their own experiences.
- Evidence-based treatments for ADHD remain stimulant medications, non-stimulant medications, and structured therapy approaches.
Officially, there are only three recognized subtypes of attention-deficit hyperactivity disorder (ADHD): predominantly inattentive, predominantly hyperactive-impulsive, and combined. In adults, combined-type ADHD is the most common. But Dr. Daniel Amen, a controversial psychiatrist, also outlined 7 types of ADHD — each with his own description and treatment recommendations.
Dr. Amen’s 7 types are not based on research, but many people find them helpful for describing their own experiences with ADHD. Here, we’ll go over each of Amen’s 7 types of ADHD and their descriptions.
The Standard Clinical View of ADHD
Dr. Amen’s 7 subtypes have gained popularity with the general public, but they’re not how ADHD is categorized in official texts.
Medical professionals use the Diagnostic and Statistical Manual of Mental Disorders (DSM) to make mental health diagnoses and treatment decisions. In the DSM, ADHD is listed as a neurodevelopmental condition. It’s split into three subtypes:
- Predominantly Inattentive Type: Trouble sustaining focus, disorganization, forgetfulness, and losing things easily.
- Predominantly Hyperactive-Impulsive Type: Restlessness, frequent interrupting, acting without thinking, and difficulty staying still.
- Combined Type: A mix of inattentive and hyperactive-impulsive symptoms.
Until 1987, ADHD was known as “attention-deficit disorder,” or ADD. Back then, you could be diagnosed with ADD with or without hyperactivity. Since 1987, and in the current edition of the DSM, the official term for the diagnosis is “ADHD” (and its three subtypes).
The 7 Types of ADHD in Adults
Dr. Amen first outlined his proposed “7 types of ADD” in a 1998 paper, followed by a book he published in 2013. He states that he’s studied over 200,000 brain scans in order to identify different presentations of this condition.
However, Dr. Amen has faced criticism from the scientific community for his assertions that SPECT brain scans can help differentiate between ADHD types. There is no empirical basis for these statements, and research shows that SPECT scans are not recognized by the American Psychiatric Association as a diagnostic tool for ADHD.
Overview of the 7 ADHD Types
Dr. Amen’s ADHD types are not listed in the DSM-5 (or any other official text), so you can’t be diagnosed with any of them. All of these descriptions are based on Dr. Amen’s book and website. However, this information can help you better understand and describe your experiences. Let’s take a look at his proposed core symptoms as well as the signs of all 7 types.
Core Symptoms
According to Amen, anyone with ADHD experiences the condition’s core symptoms. He lists these as:
- Short attention span for everyday tasks like chores or work assignments
- Distractibility (by external events or internal thoughts)
- Chronic procrastination
- Ongoing disorganization in daily life
- Difficulty completing what you start
- Impulsive behaviors, such as blurting out comments without thinking
On top of these, there are also unique symptoms discussed next.
Type 1: Classic ADHD
Amen’s description of Type 1, Classic ADD, is similar to the DSM’s combined type. He states that it’s “often referred to as ADHD” (rather than his preferred term, ADD), and claims it’s the most common type.
Symptoms include:
- Difficulty paying attention
- Struggling to listen during conversations; interrupting others often
- Careless mistakes from lack of focus on details
- Restless energy and hyperactivity
- Trouble waiting in line or for their turn
- Acting as if constantly “on the go”
- Talking more than others expect
Type 2: Inattentive ADHD (Formerly Called ADD)
Amen’s Type 2, inattentive ADD, can be most closely related to the predominantly inattentive type of ADHD recognized in the DSM.
Symptoms include:
- Struggling to focus for long periods
- Often misplacing or losing important items
- Making errors from overlooking details
- Getting bored quickly
- Appearing unmotivated or indifferent
- Moving slowly, seeming tired or sluggish
- Coming across as “spaced out” or preoccupied
Type 3: Overfocused ADHD
Amen’s Type 3, overfocused ADD, describes people who experience what Amen calls “overattention,” rather than inattention. He says that people with this subtype can get “stuck” on negative thoughts, and that they can be argumentative. From a clinical perspective, this type may look like co-occurring obsessive-compulsive disorder (OCD) and ADHD.
Symptoms include:
- Being often oppositional or argumentative
- Having difficulty shifting focus or considering alternatives
- Becoming stuck in negative thought patterns
- Holding grudges
- Rigid or obsessive thinking
- Displaying compulsive habits
- Insisting on doing things in a very specific way
- Pursuing an idea or behavior even when it isn’t helpful
Type 4: Temporal Lobe ADHD
Amen claims that people with Type 4, Temporal Lobe ADD, experience memory challenges and behavior problems. They may also have difficulty managing their anger, or even develop paranoid thoughts.
Symptoms include:
- High irritability
- Episodes of zoning out or feeling confused
- Trouble understanding spoken information
- Sudden fear or panic without clear cause
- Physical complaints like headaches or stomach pain without explanation
- Disturbing or dark thoughts
- Learning challenges or memory issues
- Hyperactivity may or may not be present
Type 5: Limbic ADHD
Type 5, Limbic ADD, is characterized by symptoms that can look like depression. Dr. Amen states that this type of ADHD is caused by changes to the brain’s limbic system.
Symptoms include:
- Persistent low mood or irritability
- Social isolation or withdrawal
- Feelings of hopelessness or worthlessness
- Loss of interest in daily activities
- Disrupted sleep patterns
- A pessimistic perspective on life
- Fatigue or low energy
Type 6: Ring of Fire ADHD
Dr. Amen claims that in Type 6, Ring of Fire ADD, there is a “ring of hyperactivity around the brain” that shows up in SPECT scans. He also states that the clinical presentation of this ADHD type appears linked to food or environmental allergies. There is no evidence base for this, but
Symptoms include:
- Short temper and irritability
- Impulsive actions
- Strong reactions to noise, light, textures, or touch
- Sudden harsh or aggressive behavior
- Inflated or rigid beliefs about oneself
- Rapid speech and racing thoughts
- Restlessness or anxiety
Type 7: Anxious ADHD
Lastly, Dr. Amen’s Type 7, Anxious ADD, is characterized by co-existing anxiety. Dr. Amen claims that SPECT scans show “overactivity in the basal ganglia” in people who have this type of ADHD. He also states that stimulant medications can make anxiety worse in people with Type 7 ADHD. This has some scientific basis — one side effect of stimulants is worsened anxiety.
Symptoms include:
- Frequent feelings of nervousness or worry
- Ongoing muscle tension or stress
- Often expecting the worst outcome
- Avoiding conflicts
- Strong fear of being judged or criticized
- Tendency to go quiet in groups or social settings
- Headaches or other physical symptoms of stress
- Extreme nerves when speaking in public
|
Type |
Key Traits |
How It Appears in Adults |
|
Classic |
Inattention, hyperactivity, impulsivity |
Restlessness, distractibility, difficulty finishing tasks |
|
Inattentive |
Daydreaming, disorganization, poor follow-through |
Losing track of details, procrastination, seeming “spaced out” |
|
Overfocused |
Rigid thinking, difficulty shifting attention |
Being stuck on negative thoughts, trouble transitioning tasks |
|
Temporal Lobe |
Irritability, memory and learning issues, aggression |
Mood swings, impulsive outbursts, forgetfulness |
|
Limbic |
Low energy, negative outlook, chronic sadness |
Persistent low mood, low motivation, overlap with depression |
|
Ring of Fire |
Overactivity across many brain regions, extreme mood changes |
Racing thoughts, rapid anger, sensitivity to stimuli |
|
Anxious |
Tension, nervousness, physical stress symptoms |
Worry, fear of failure, perfectionism, avoidance behaviors |
DSM-5 vs. Amen’s 7 Types: A Side-by-Side Comparison
Amen’s Types 1 and Type 2 ADD — “Classic” and “Inattentive” ADD — directly correlate with the official criteria and descriptions of ADHD types in the DSM-5.
- Type 1, Classic ADD, describes the symptoms of predominantly hyperactive-impulsive and combined-type ADHD as listed in the DSM-5.
- Type 2, Inattentive ADD, describes predominantly inattentive type of ADHD in the DSM-5.
Most of Dr. Amen’s other 5 types revolve around known, if not officially recognized, symptoms of ADHD. For example:
- Type 4, Temporal Lobe ADD, includes learning and memory problems. Dr. Amen says that some individuals with this type of ADHD may have learning disabilities.
Research shows[2] that ADHD and learning disabilities often go hand-in-hand. This isn’t specific to this type of ADHD. - Type 5, Limbic ADD, is characterized by symptoms that look like depression. Research shows that over 50% of people with ADHD may also live with co-occurring depression. Again, people with any type of ADHD can experience co-occurring depression.
- Type 7, Anxious ADD, describes what would likely be diagnosed as ADHD with a co-occurring anxiety disorder.
Research shows[3] that people with ADHD, in general, are more likely to live with co-existing anxiety. This doesn’t necessarily mean it’s a different “type” of ADHD.
Debates Around the 7 Types Model in Clinical Practice
Dr. Amen has faced wide criticism and controversy in the medical community. Mostly, this is due to his claims that SPECT scans can help diagnose ADHD (and even differentiate between different types). There is no scientific evidence that SPECT scans can diagnose ADHD.
Completing these SPECT scans when you are trying to get an ADHD diagnosis is generally considered unnecessary. One session to conduct these scans costs at least $3500, which has led other mental health professionals to worry that he’s taking advantage of people with ADHD who may not be equipped with the right information.
Even though Amen has had the opportunity to have his claims validated by the Brain Imaging Council of the Society of Nuclear Medicine (by submitting blind — and therefore unbiased — scan analyses), he declined the offer.
Amen also makes unfounded claims about the causes of ADHD. For example, he states on his website that ADHD can be caused by “limited physical education in schools,” “excessive use of video games,” and diet — processed foods, artificial coloring, and pesticides. However, currently there is no evidence that any of this is true. The causes of ADHD are still being studied, but it’s been found to have a genetic component.
Critics also worry that Dr. Amen’s claims could discourage people with ADHD from seeking evidence-based and effective treatments — specifically stimulant medications. Dr. Amen states he isn’t against stimulants in every case, but he sometimes makes unfounded claims against them.
For example, he claims that stimulants can make Limbic ADHD (which could be characterized as co-occurring depression and ADHD) worse. But research shows that stimulant medications not only are the most effective treatment for most people with ADHD, but that
Supporters of Dr. Amen state that his work has given them hope and a new understanding of their ADHD symptoms. It may be safe, and even helpful, to use Dr. Amen’s model as a way to understand yourself better. But for treatment and science-based education, always talk with your healthcare provider.
Pros and Cons of Dr. Amen’s Brain-Based Model
|
Potential Benefits |
Limitations & Criticisms |
|
May help some people understand their ADHD symptoms better. |
Not part of DSM-5 or accepted by the psychiatric community. |
|
May help patients and caregivers better relate to their experiences. |
Scientific evidence is largely nonexistent. |
|
May raise awareness of emotional and behavioral differences in ADHD that go beyond core symptoms. |
Risk of guiding people away from effective, evidence-based ADHD treatments, like stimulant medications. |
|
May inspire more tailored treatment discussions with providers in addition to stimulant medication. |
SPECT brain-imagining scans cannot diagnose ADHD. |
|
Accessible, easy-to-understand framework for the public. |
Could oversimplify ADHD or cause confusion if used without professional guidance. |
Treatment Insights: Does Each Type Need a Different Approach?
One of the biggest controversies surrounding Dr. Amen’s work is that he suggests different treatment methods for each of the ADHD types. Although many of these treatments can be helpful as complementary lifestyle changes — things like learning organizational skills and exercising — often, they can’t replace evidence-based ADHD treatment.
According to reputable medical organizations, including the American Psychiatric Association, the most effective treatment for adults with ADHD is stimulant medication. Some people can’t or don’t want to take stimulants, and that’s acceptable. There are non-stimulants that can help as well. Certain therapy techniques can also be helpful, although research shows they’re not usually as effective as medication for ADHD.
The best thing to do is to talk to a qualified healthcare provider. They can walk you through the most effective treatment options for your symptoms, including the benefits and risks of each.
If you have any questions about Dr. Amen’s recommendations, ask your provider for additional, evidence-based resources to make an informed decision about your course of action. You can book an appointment at MEDvidi to see a licensed provider for online ADHD assessment and treatment.
Can Tests or Quizzes Identify Your ADHD Type?
Because Dr. Amen’s 7 types of ADHD have become so popular with the general public, you can find different online quizzes and tests that claim to tell you which of these types you might be experiencing.
However, no test you can find online relating to Dr. Amen’s 7 types is a diagnostic tool. First of all, this model isn’t recognized in the DSM-5, so you can’t actually be diagnosed with any of these types. In addition, Dr. Amen himself states that in order to figure out what “type” of ADHD you have, you need to have SPECT scans conducted (at his clinics).
Taking these quizzes may give you some insight into how your ADHD symptoms could present. But to get an accurate ADHD diagnosis, you need to get evaluated by a licensed provider.
Conclusion
ADHD has been historically underdiagnosed, especially in certain communities. Its symptoms can present differently in different people, because every person with ADHD is unique. So if you see yourself in one of Amen’s 7 types, that’s valid. However, note that the official diagnostic criteria for ADHD can only be found in the DSM-5, and only a qualified medical provider can make a diagnosis.
At MEDvidi, you can connect with a licensed clinician who can provide a proper ADHD evaluation and guide you toward evidence-based treatment options.
FAQs
Is the 7 types model official?
Are there 12 types of ADHD?
Are there 3 or 7 types of ADHD?
What is the rarest ADHD type?
The DSM doesn’t list ADHD types by rarity, however, there is evidence of
