Understanding the 7 types of ADHD

Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition that causes symptoms like distractedness, hyperactivity, disorganization, and more. If you live with ADHD, you may be looking for ways to better understand your brain and your symptoms. Learning about the 7 types of ADHD, defined by Dr. Daniel G. Amen, may help your self-discovery.

In this article, we discuss Dr. Amen’s 7 types of ADHD theory and how they compare with current ADHD research.

ADHD is treatable. If you live with ADHD symptoms, getting the right diagnosis is the first step to treatment. Find an ADHD provider on Klarity today for treatment, including medication and therapy.

Understanding ADHD 

ADHD is a neurodevelopmental condition that affects around 5% of U.S. adults and up to 10% of children. ADHD causes people to have difficulty with things like concentration, organization, and impulse control. It’s categorized as a mental health condition, but it’s also a form of neurodiversity, which is when the human brain works differently than it typically does.

What are the 7 types of ADHD, and why we cover 10?

There are 3 types of ADHD accepted in the scientific community. When people talk about the 7 types of ADHD, they’re referring to the work of Dr. Daniel G. Amen, a psychiatrist and ADHD expert. 

According to Dr. Amen, brain imaging shows that ADHD is more complex than once believed; he contends that there are 7 distinct types of the condition, each with brain differences that can be seen in single photon emission computed tomography (SPECT) brain scans.

Most experts say that Dr. Amen’s brain imaging techniques don’t show variations in ADHD symptoms and that there are no quantifiable biomarkers for ADHD. Evidence also shows SPECT scans are only 50% accurate for ADHD diagnosis.

Yet while Dr. Amen’s work isn’t supported by peer-reviewed evidence, many people find it helpful to dig into his 7 types of ADHD to understand the different, lesser-known ways that ADHD may present itself.

When you get an assessment and diagnosis for ADHD, your provider will most likely be taking the 3 recognized types of ADHD into account and not Dr. Amen’s proposed 7 types.

Here, we cover all 10 types of ADHD: the 3 types recognized by the scientific community and Dr. Amen’s 7 types of ADHD.

The 3 recognized types of ADHD

Official clinical guidelines, including the Diagnostic and Statistical Manual (DSM), the standard that mental health professionals use to make diagnoses, state that there are 3 forms of ADHD: 

• Predominantly inattentive ADHD
• Predominantly hyperactive-impulsive ADHD
• Combined ADHD

Predominantly inattentive ADHD

People who live with the predominantly inattentive type of ADHD have issues with distractedness, forgetfulness, and attention. They don’t usually have hyperactive symptoms. This type of ADHD used to be called “ADD” (attention deficit disorder).

The symptoms of predominantly inattentive ADHD

According to the DSM, the symptoms of the predominantly inattentive type of ADHD include:

• Lacking attention to detail
• Difficulty sustaining attention to tasks
• Not listening when spoken to directly
• Lack of follow-through on instructions
• Difficulty with organization
• Often losing things
• Being easily distracted by external stimuli
• Forgetfulness

Predominantly hyperactive-impulsive ADHD

People with predominantly hyperactive-impulsive ADHD have difficulty controlling their energy and impulses. In the media, children with ADHD are often depicted as running around and bouncing off the walls — the classic image of a child with hyperactive-impulsive ADHD.

The symptoms of predominantly hyperactive-impulsive ADHD

According to the DSM, the symptoms of the predominantly hyperactive-impulsive type of ADHD include:

• Fidgeting or squirming
• Often standing up or leaving the room when being seated is expected, such as in class or during meetings
• Feeling restless or running around
• Difficulty enjoying quiet leisure activities
• Acting as if “driven by a motor”
• Talking excessively and/or blurting things out
• Interrupting or intruding on others
• Difficulty waiting their turn

Combination ADHD

Some people with ADHD have both inattentive and hyperactive-impulsive symptoms. These people are diagnosed with combined-type ADHD.

The symptoms of combination ADHD

People with combination ADHD have some symptoms from each of both the inattentive and hyperactive-impulsive symptoms types of ADHD. The combination of symptoms and how they manifest may vary from person to person. People are usually diagnosed with this type of ADHD when they have at least 6 symptoms in both individual types of ADHD.

The best treatment for predominantly inattentive, predominantly hyperactive-impulsive, and combination ADHD

The most effective treatment for all 3 recognized types of ADHD symptoms, regardless of the specific type, is medication, specifically stimulant medications. Some effective medications approved to treat inattentive ADHD include the stimulant medications Ritalin (methylphenidate) and Adderall (amphetamine). In addition, a non-stimulant vs stimulant medication called Strattera (atomoxetine) can be effective for people with ADHD. 

Some types of therapy, including cognitive-behavioral therapy (CBT), are also helpful for people with all types of ADHD, especially when used in conjunction with medication.

Dr. Amen’s 7 types of ADHD

Dr. Amen describes 7 types of ADHD. He says these types have been identified by thousands of SPECT brain scans his clinics have conducted. The 7 types of ADHD he describes are:

• Classic ADHD
• Inattentive ADHD
• Over-focused ADHD
• Temporal lobe ADHD
• Limbic ADHD
• Ring of fire ADHD
• Anxious ADHD

According to Dr. Amen, all 7 types of ADHD have unique symptoms in addition to the core symptoms of all types of ADHD. These core symptoms of ADHD include:

• Short attention span for daily routine tasks
• Problems with organization
• Easily distracted
• Chronic procrastination
• Problems following through with tasks
• Poor impulse control

Note: In his books and website, Dr. Amen uses the outdated term for ADHD, ADD. He states that this is because many of the 7 types of ADHD don’t include hyperactivity symptoms. However, in this article, we use the medically approved term, ADHD.

Classic ADHD type

Dr. Amen’s classic ADHD type has many commonalities with the officially recognized predominantly hyperactive-impulsive type of ADHD. According to Dr. Amen, classic ADHD is the most common among the 7 types of ADHD, and the easiest to recognize.

The symptoms of classic ADHD

According to Dr. Amen, symptoms of classic ADHD include:

• Has trouble listening when others are speaking
• Makes careless mistakes/poor attention to detail
• Is hyperactive and restless 
• Has difficulty waiting their turn
• Talks excessively and interrupts others
• Acts like they’re driven by an internal motor

These symptoms are similar to the DSM diagnostic guidelines for hyperactive-impulsive ADHD.

The Best treatment for the classic type of ADHD

Although Dr. Amen isn’t opposed to treating ADHD with medications and recognizes that they can be life-changing, he prefers a holistic approach to ADHD treatment. In addition to medication when needed, he states the best interventions for the classic type of ADHD include:

• Frequent exercise to release hyperactive energy
• Presenting important tasks as games or obstacle courses
• Having an organized yet creative work environment

Inattentive ADHD

Dr. Amen’s described symptoms of inattentive ADHD look almost identical to the formally recognized symptoms of the predominantly inattentive type of ADHD.

The symptoms of inattentive ADHD

According to Dr. Amen, symptoms of inattentive ADHD include:

• Difficulty staying focused 
• Losing things frequently
• Making careless mistakes due to poor attention to detail
• Feeling bored frequently
• Lack of motivation
• Frequently feeling tired or sluggish
• Appearing “spacey” or thinking about other things

The Best treatment for the inattentive type of ADHD

Dr. Amen recommends behavioral therapy for inattentive ADHD, which research also shows to be effective, especially for children and teens. He also that learning important skills like breaking down tasks into smaller steps can be productive for people with this type of ADHD.

Over-focused ADHD

Amen’s third type of ADHD, over-focused ADHD, is where Dr. Amen’s 7 types of ADHD start to differ from the formally recognized types. According to Dr. Amen, people with the over-focused type of ADHD have a hard time shifting their attention. He states that this type of ADHD is often mistaken for obsessive-compulsive disorder (OCD).

The symptoms of the over-focused ADHD type

According to Dr. Amen, symptoms of over-focused ADHD include:

• Getting stuck in loops of obsessive or negative thoughts
• Being oppositional and argumentative
• Struggling with compulsive behaviors
• Difficulty seeing options; inflexible thinking
• Excessive worrying
• Difficulty shifting attention from one thing to the next
• Obsessive organization
• Holding grudges or being unable to consider others’ opinions
• Needing to have things done in a specific way
• May or may not be hyperactive

According to Amen, the difference between OCD and overfocused ADHD is that people with overfocused ADHD struggle with impulsivity, while people with OCD don’t. 

Studies show though that many people with OCD have impulsive behaviors. If you think you may have ADHD or OCD, it’s important to get a formal assessment and diagnosis instead of self-diagnosing yourself. Although ADHD and OCD are different conditions, some people have both.

The best treatment for over-focused ADHD

Amen states that one of the best interventions for over-focused ADHD is physical exercise, which has been shown in scientific research to improve symptoms of ADHD. He also claims that natural supplements, like St. John’s wort and L-tyrosine, can help.

Temporal lobe ADHD

People with temporal lobe ADHD have the symptoms of classic ADHD in addition to learning problems or difficulty controlling their tempers. Amen named this type after a region in the brain called the temporal lobe, because he says that his brain scans of people with this type have found “either increased or decreased blood flow in their temporal lobes.”

The symptoms of temporal lobe ADHD

According to Dr. Amen, symptoms of temporal lobe ADHD include:

• Memory problems, auditory processing issues (problems processing sounds), or learning disabilities
• Irritability
• Episodes of quick temper
• Periods of spaciness or confusion
• Periods of panic and/or fear for no reason
• Visual changes, such as seeing shadows or objects changing shape
• Headaches or abdominal pain of uncertain origin
• Dark thoughts that may involve suicidal or homicidal thoughts
• May or may not be hyperactive

The best treatment for the temporal lobe ADHD type

Amen recommends exercise and breathing techniques to counteract symptoms of temporal lobe ADHD. He also states that physical exercise can help with temporal lobe ADHD; research supports the effectiveness of exercise for all types of ADHD.

Limbic ADHD

The symptoms that Amen gives for limbic ADHD are similar to the officially recognized symptoms of major depressive disorder (MDD) Amen says that limbic ADHD is often mistaken for depression. But it’s important to note that up to a third of people with ADHD have co-occurring depression. If you live with both ADHD and depression, it’s critical to receive treatment for both.

The symptoms of limbic ADHD

Dr. Amen states that the symptoms of limbic ADHD include:

• Feeling chronically sad
• Moodiness or irritability
• Social withdrawal
• Feelings of helplessness and worthlessness
• Loss of interest in activities that you used to enjoy 
• Changes in sleep patterns; sleeping too much or too little
• May or may not be hyperactive

The best treatment for the limbic type of ADHD

For limbic ADHD, Amen recommends learning how to “structure your thoughts and actions,” such as avoiding an all-or-nothing thinking approach. This is a common cognitive-behavioral technique, and cognitive-behavioral therapy (CBT) is shown to help both ADHD and depression.

Ring of fire ADHD

According to Amen, ring of fire ADHD type is differentiated by oppositional behaviors and racing thoughts. Amen gave this type of ADHD this name because he claims that a “ring of hyperactivity around the brain” appears on SPECT scans.

The symptoms of the ring of fire type of ADHD

According to Dr. Amen, symptoms of ring of fire ADHD include:

• Frequent irritability
• Impulsive behaviors
• Sensory sensitivity, including to noise, light, clothes, or touch
• Periods of mean or insensitive behavior
• Grandiose or inflexible thinking
• Racing thoughts
• Sometimes includes heightened anxiety
• May or may not be hyperactive

The best treatment for ring of fire ADHD

Amen says that ADHD medication can make the symptoms of ring of fire ADHD worse; a claim isn’t substantiated by research. Evidence shows that stimulant medication is effective for most people with ADHD; it can have side effects, such as irritability, mood changes, or changes in appetite or sleeping patterns, but it doesn’t make ADHD symptoms themselves worse. Don’t stop taking your prescribed medication without talking to your healthcare provider.

Amen also recommends physical exercise and cognitive behavioral therapy techniques (like challenging automatic negative thoughts) for ring of fire ADHD.

Anxious ADHD

The last of Amen’s 7 types of ADHD is anxious ADHD. He states that people with this type of ADHD have constant anxiety. He differentiates this type of ADHD vs anxiety, stating that people with anxiety disorders tend to have ebbs and flows in their symptoms while people with anxious ADHD have constant symptoms. 

However, by definition, people with anxiety disorders experience symptoms almost constantly, which get worse over time. In addition, ADHD and anxiety disorders frequently appear together. If you think you may live with an anxiety disorder, it’s important to get the right treatment.

The symptoms of anxious ADHD

Dr. Amen states the symptoms of anxious ADHD include

• Frequently feeling anxious, tense, or stressed out
• Jumping to the worst-case scenario
• Avoiding conflict
• Fear of being judged, which can lead to a tendency to clam up in social situations
• Physical stress symptoms, like headaches or stomachaches
• Excessive fear of speaking in public
• Freezing during stressful or anxiety-provoking situations

The best treatment for the anxious type of ADHD

Dr. Amen recommends relaxation and stress management techniques to manage anxious ADHD. 

Pros and cons of Dr. Amen’s 7 types of ADHD approach

There are no peer-reviewed studies that back up Dr. Amen’s types of ADHD. Amen’s categories are based on the SPECT brain scans that his clinic conducts. However, these brain scans aren’t evidence-based, and other experts have expressed doubts about the ability of these scans to accurately measure the complex ways in which ADHD affects the brain.

Some of Dr. Amen’s claims may pose risks to people who have ADHD. For example, he claims that stimulant medications can make some types of ADHD worse, which isn’t based on evidence. This could prevent people with ADHD from getting the treatment they need. Working with a provider who understands your symptoms and how they affect your life can help you decide on the best treatment plan. 

The proponents of Dr. Amen’s work stress the importance of holistic mental health treatment. They state that understanding ADHD in this way can help people understand alternative treatment methods, especially those who have not been helped by or do not want to take medication. Many of the recommendations that Dr. Amen makes for ADHD, including exercise, nutritional changes, and stress management techniques, are shown by research to be effective for people with ADHD as well as all people. 

Holistic mental health treatment methods can be a valuable addition to more traditional treatment plans, but shouldn’t be used alone without the guidance of a mental health practitioner. Talk to your healthcare provider before starting or stopping any treatment for ADHD, even if it’s a natural treatment like herbal supplements. 

How to cope with ADHD

ADHD can be difficult to live with, but it’s treatable. The first step to living better with ADHD is to receive an assessment and official diagnosis by a licensed mental health provider. Once you’re diagnosed, you get effective ADHD treatment whether it’s therapy and/or medication. 

Keep in mind that although any licensed mental health professional can provide a diagnosis, only medical providers, such as psychiatrists, physician’s assistants/associates, or nurse practitioners, can prescribe medication.

Lifestyle changes to cope with any type of ADHD

In addition to medication and therapy, lifestyle habits can help you cope with ADHD regardless of what type you live with. These include:

• Physical exercise: Exercising is a healthy habit that has been found to have enormous benefits for ADHD. Some studies have even found that a single session of aerobic activity can lead to an immediate improvement in symptoms.
• Stress management: ADHD symptoms often get worse with stress. Learning effective stress management techniques, like relaxation strategies, establishing boundaries, and giving yourself time to be creative or play, can prevent your stress levels from becoming overwhelming.
• Sleep: Sleep and ADHD have a complex relationship. The symptoms of ADHD can make it difficult to sleep, but stimulant ADHD medication can also disrupt sleep for many. And poor sleep habits can make ADHD symptoms worse. To help yourself get a good night’s sleep, prioritize restful sleep each night, practice good sleep hygiene habits, talk to your provider, and consider timing when taking your ADHD medication.

Understanding medication management for ADHD

Many ADHD medications are effective for helping people manage symptoms of ADHD. 

Common ADHD medications and their uses for the 7 types of ADHD

Research shows that the most effective treatment for ADHD is stimulant medication. The 2 FDA-approved stimulant medications for the treatment of ADHD are:

• Methylphenidate hydrochloride, a generic medication and the active ingredient in Ritalin, Concerta, and Quillivant (methylphenidate) and other medications
• Amphetamines, including Adderall, Evekeo, Vyvanse (lisdexamfetamine dimesylate), and others

For those who choose not to take stimulants, effective non-stimulant ADHD medication options include:

• Norepinephrine reuptake inhibitors (NRIs), Strattera (atomoxetine) and Qelbree (viloxazine)
• Alpha agonists, Kapvay (clonidine) and Intuniv (Guanfacine ER)

For Dr. Amen’s ADHD types that appear to mimic other mental health conditions, like depression (limbic ADHD), OCD (over-focused ADHD), or anxiety (anxious ADHD), other medications may be needed to manage symptoms. 

If you live with both ADHD and another mental health condition, it’s essential to get an accurate diagnosis and that the symptoms of both be treated.

Key takeaway

Dr. Amen’s 7 types of ADHD aren’t backed by peer-reviewed research. Officially, only 3 types of ADHD are recognized: predominantly hyperactive-impulsive ADHD, predominantly inattentive ADHD, and combined-type ADHD. 

However, Amen’s 7 types theory presents an alternative way of understanding your ADHD symptoms and introduces holistic treatment methods for those who don’t want to take medications. Research shows that medication is the most effective treatment method for ADHD. 

Get ADHD treatment on Klarity

ADHD is highly treatable; getting the right diagnosis is the first step. Find an ADHD provider on Klarity today for a diagnosis and to start treatment.

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The information provided in this article is for educational purposes only and should not be construed as medical advice. Always seek the guidance of a qualified healthcare professional with any questions or concerns you have regarding your health.

If you’re having a mental health crisis or experiencing a psychiatric emergency, it’s crucial to seek immediate help from a mental healthcare professional, such as a psychiatrist, psychologist, or therapist. You can also call your local emergency services, visit your nearest emergency room, or contact a crisis hotline, such as the National Suicide Prevention Lifeline, by calling or texting 988 or dialing the Lifeline’s previous phone number, 1-800-273-TALK (1-800-273-8255) in the U.S.

How we reviewed this article: This article goes through rigorous fact-checking by a team of medical reviewers. Reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the author.