Highlights
- Ring of Fire ADHD is not an official diagnosis: it is a subtype proposed by Dr. Daniel Amen.
- It’s characterized by intense emotions and sensory sensitivities; the brain scans show a widespread ring of brain activity.
- Dr. Amen cites brain inflammation, allergies, and infection as causes of Ring of Fire ADHD, although conventional psychiatry links ADHD to environmental and genetic factors.
Many people with attention deficit hyperactivity disorder feel as though they don’t fit the standard ADHD subtypes (predominantly inattentive, predominantly hyperactive, and combined), which may leave them confused. To help with this, some clinicians have proposed additional ADHD types. Dr. Daniel Amen, in particular, utilized brain scans to designate seven types of ADD, with Ring of Fire ADD being one of them. Even though this type is not officially recognized by the medical community, it can be helpful to learn more to better understand your symptoms.
What Is “Ring of Fire” ADHD?
Although Dr. Amen uses the term attention deficit disorder (ADD), this condition is now clinically diagnosed as
The Ring of Fire ADHD subtype (or Type 6 ADHD) was first characterized by Dr. Daniel Amen, a psychiatrist and brain imaging specialist. He used single-photon emission computed tomography (SPECT) to come up with seven distinct types of ADHD:
- Classic ADD
- Inattentive ADD
- Over-focused ADD
- Temporal lobe ADD
- Limbic ADD
- Ring of Fire ADD
- Anxious ADD
SPECT imaging offers a way to visualize variations in brain activity and blood flow. It can help physicians identify brain activity patterns, which can aid the diagnosis and treatment planning processes. However, note that ADHD is diagnosed using behavioral assessments, not brain scans.
The Ring of Fire ADHD subtype receives its name due to the “ring of fire” pattern of increased brain activity seen on the SPECT scans. It is characterized by intense emotions and sensory sensitivities — symptoms that may cause it to be mistaken for bipolar disorder or autism. However, a qualified healthcare provider understands the differences between these conditions and can help you find the right course of action for managing symptoms.
An important note is that Amen’s classification system is not officially recognized in conventional psychiatry and requires more research. So, Ring of Fire ADHD is not a formal diagnosis. The three official types of ADHD that can be diagnosed using DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) include:
Symptoms of Ring of Fire ADHD
The Ring of Fire brain often comes with a wide range of severe and, often, unpredictable symptoms resulting from generalized overactivity across the brain. These symptoms may include:
- Rapid speech
- Sensitivity to noise, light, touch, or clothing
- Anxiety
- Unpredictable and challenging behaviors
- Oppositional defiance
- Demanding that things be done a certain way
- Grandiose thinking
- Irritability
- Cyclic mood changes
Generally, Ring of Fire ADHD can have more intense variations of the classic ADHD symptoms, for example:
ADHD | Ring of Fire ADHD |
Having a hard time getting along with others | Periods of mean behavior, insensitive comments, or increased impulsivity |
Talking too much | Rapid speech and racing thoughts with grandiose thinking |
High distractibility | Unpredictable and challenging behavior with cyclic mood changes from high to low and back |
Difficulty waiting turns | Demanding that things be done a certain way and oppositional defiance |
Disliking activities with significant mental effort | Anxiety and irritability |
It’s important to keep in mind that the symptoms associated with Ring of Fire ADHD follow a descriptive pattern, and it is not a separate disorder. Knowing this, professional assessment remains key.
It’s also worth noting that some of these symptoms are noticeable to other people, while other symptoms, especially emotional dysregulation, can remain undetected. Women, in particular, can be more likely to have hidden ADHD symptoms, which is why Ring of Fire ADHD in women often goes undiagnosed.
Speak with a licensed healthcare provider to get your symptoms assessed and receive a diagnosis and treatment online.
What Causes Ring of Fire ADHD?
Amen Clinics proposes that the Ring of Fire pattern seen in SPECT imaging due to brain overactivity is linked to inflammation, allergies, or infection. It may also be related to bipolar disorder. However, these are only hypotheses, not established science, and the Amen model remains controversial due to the lack of research backing it up.
Traditional scientific communities suggest that
Ring of Fire ADHD vs Bipolar Disorder
The Ring of Fire ADHD type may sometimes be mixed up with
It is possible to have both disorders, but distinguishing between them, even if both are present, is crucial to ensure that each condition receives the appropriate treatment. Given the similarities between these conditions, seeking a diagnosis from a healthcare professional, not self-diagnosing, is essential.
Ring of Fire ADHD vs Autism Spectrum Traits
Ring of Fire ADHD and autism also share similar symptoms but they are two distinct conditions that require different treatments.
Some of the symptoms that both conditions share include sensory sensitivities, rigid thinking, and difficulties with emotional regulation. However, for Ring of Fire ADHD, the outburst of emotion is because they are intense, whereas, for those with autism, it’s often because of difficulty managing emotions.
Another difference between autism and Ring of Fire ADHD is that those with autism spectrum disorder (ASD) often have difficulties with social communication, while that is not a characteristic of ADHD. Additionally, those with ASD often exhibit repetitive behaviors and developmental delays.
ADHD and ASD very often occur together, with some research suggesting that
How Is Ring of Fire ADHD Diagnosed?
Since Ring of Fire is not an officially recognized subtype of
According to Dr. Amen’s work, the ‘Ring of Fire’ is recognizable through SPECT scans, where the ring of increased activity and blood flow is visible throughout the entire brain. However, utilizing brain scans for ADHD diagnosis is controversial because they only have a 54% sensitivity for predicting ADHD, meaning they’re accurate only half the time for diagnosing this condition.
When it comes to diagnosing ADHD, clinicians use behavioral assessments and interviews, as well as DSM-5 for diagnostic criteria, as they are evidence-based tools.
Noticing symptoms that bother you? Take a 5-minute test to see if you may have ADHD.
Treatment and Management Options
Amen Clinics recommends that Ring of Fire ADHD be treated with a combination of an elimination diet, neurotransmitter-boosting supplements, and anticonvulsants or blood pressure medications to decrease hyperactivity. While this approach does help some, the evidence supporting it is limited.
Dr. Amen also claims that traditional stimulant medication can worsen Ring of Fire ADHD symptoms. While stimulants may not be the best option for some people with this condition, they have proven effectiveness; so, there are certain concerns about the proposed course of treatment among the medical community. When prescribed appropriately, many people see improvements in their ADHD symptoms when taking stimulants.
Remember that your treatment should be guided by a licensed medical provider who knows your individual needs and can offer personalized instructions. Prevalent evidence-based treatments for ADHD include:
- Cognitive-behavioral therapy (CBT). CBT for ADHD can help with negative thinking patterns and teach other behavior modifications such as better organizational skills, time management, and social skills.
- Lifestyle changes. Certain lifestyle changes, such as daily exercise, improved sleep hygiene, an ADHD-friendly diet, and mindfulness practices, can help manage symptoms of ADHD.
- Medication. Stimulant and non-stimulant medications help regulate attention and manage ADHD symptoms.
Ultimately, Ring of Fire ADHD in adults or children requires a personalized approach centered on holistic care, and professional support is the best way to achieve this. At MEDvidi, you can get treatment for ADHD online that is evidence-based and tailored to your needs.
Schedule a comprehensive mental health assessment and receive a personalized treatment plan for ADHD online.
Living With Ring of Fire ADHD: Tips for Daily Life
Ring of Fire ADHD can come with intense and uncontrollable negative emotions, but it is possible to make your day-to-day life a little easier. Here are a few common recommendations:
- Try to be both active and mindful. Getting regular exercise can help reduce symptoms of ADHD, and practicing
mindfulness[6] can help manage anxiety and tamp down irritability. - Manage your exposure to triggers. If you experience sensory overload, defining your triggers can help you determine a way to limit their influence as much as possible. For example, if bright lights feel overwhelming, using softer lighting can help to minimize this trigger.
- Listen to yourself. Dysregulated feelings are common in Ring of Fire ADHD, so note what makes you feel your best and what makes you feel worse (to then avoid or limit it in the future). Notice your impulses and try impulse control techniques to build resilience — it can help make daily life more manageable.
- Invest in your social bonds. Build and strengthen a network of individuals who understand your condition and triggers and support you as you work on changing your environment to lessen your symptoms.
From Doubts to Clarity: Get Personalized Care for ADHD
It’s normal to feel confused or unsure of where you have ADHD, especially if your symptoms seem different or more intense than those listed in the diagnostic criteria. It’s important to find a qualified medical provider who is experienced in diagnosing and treating ADHD and explain the specifics of your subtype to you.
Ultimately, though, it’s important to focus on symptoms and treatment outcomes rather than subtypes, as the goal is to improve your daily life, regardless of the ADHD subtype. Online providers, such as those available with MEDvidi, can help you gain the support you need to manage your ADHD symptoms. Sign up today to get started with online ADHD treatment in 24 hours.
Frequently Asked Questions
Is Ring of Fire ADD real?
Ring of Fire ADD is a term coined by Dr. Daniel Amen as a part of his 7 ADD subtypes. However, it is not accepted by traditional psychiatry due to limited research.
Is Ring of Fire ADHD the worst?
Of Dr. Amen’s 7 types of ADD, Ring of Fire ADD is often described as being the most intense because the individual can experience intense feelings of irritability, anxiety, and hypersensitivity.
