ADHD Comes in Different Types

ADHD: The Different Types, or Styles, of Attention Deficit Hyperactivity Disorder

The diagnosis of "Attention Deficit Hyperactivity Disorder" is very broad, including several different types of ADHD.

What are these different types of ADHD?

And in each article we will discuss the best targeted alternative treatment strategies for each of these five types of Attention Deficit Hyperactivity Disorder.

Different Types, or Styles, of ADHD

Research literature, recent books, and common sense, all point to the fact that there are different types, or styles, of ADHD.

In the past we referred to Attention Deficit Disorder: Inattentive Type, or Impulsive/Hyperactive Type, or a Combined Type. Today the diagnostic differences are a bit less clear, but the reality doesn't change.

Dr. Daniel Amen has written a great book on the subject, titled "Healing ADHD:The Breakthrough Program That Allows You to See and Heal the 6 Types of ADD" where he uses his SPECT scans of patient's brain activity to help in making his six classifications.

His classifications include these "Types" ...

1. Classic ADD - Inattentive, distractible, disorganized. Perhaps hyperactive, restless and impulsive.

2. Inattentive ADD - Inattentive, and disorganized.

3. Over-focused ADD - Trouble shifting attention, frequently stuck in loops of negative thoughts, obsessive, excessive worry, inflexible, oppositional and argumentative.

4. Temporal Lobe ADD - Inattentive and irritable, aggressive, dark thoughts, mood instability, very impulsive. May break rules, fight, be defiant, and very disobedient. Poor handwriting and trouble learning are common.

5. Limbic System ADD - Inattentive, chronic low-grade depression, negative, low energy, feelings of hopelessness and worthlessness.

6. Ring of Fire ADD - Inattentive, extremely distractible, angry, irritable, overly sensitive to the environment, hyperverbal, extremely oppositional, possible cyclic moodiness.

We will be discussing these classification in more detail in this section.

Here our classifications are a bit different, and are based more on our clinical observation and experiences.

Our classifications are based on the classic children's stories of Winnie the Pooh and his friends in the Hundred Acre Wood.

Each of these types of ADHD (using either Amen's system or ours) will have different treatment needs and approaches.



ADHD Inattentive Type

Just Like Winnie the Pooh

Winnie the Pooh is the classic picture of Inattentive ADHD. Although Pooh is very lovable, loyal, and kind, he is also inattentive, sluggish, slow-moving, unmotivated. He is a classic daydreamer with brain fog. In other works we have called this "Space Cadet" style ADHD.

People with this type of ADHD are:

Inattentive ADHD Explained

Normally in the brain the prefrontal cortex will speed up activity when there is work to concentrate on. But with this type of inattentive ADHD the prefrontal cortex actually slows down when placed under a work load, like reading or doing homework.

This part of the brain looks normal when "at rest," but actually looks like it is starting to fall asleep when asked to "go to work." This makes it very hard to pay attention to school work, get homework done, listen to the teacher, clean your room, and so on.

We have actually observed this hundreds of times with subjects on an EEG. When at rest, the brainwave activity is pretty normal. But once the subject is asked to read, or to do a math worksheet, the subject's brainwave activity begins to look like the subject is falling asleep. And often times they do fall asleep! This sure makes school hard for these students!

Winnie the Pooh style inattention is seen more in girls than in boys.

It responds well to stimulants, such as ritalin and adderall, but other interventions like Attend and diet work well also, and without the side effects.


We have much more on Inattentive Type (Winnie the Pooh Type) ADHD for you, including an in-depth look at some alternative treatment strategies.



Classic Hyperactive ADHD

Tiggers Like to Bounce... Bouncin' is What Tiggers Do Best!

We call this bouncy type of ADHD "Tigger Type" for good reason. This classic form of ADHD is characterized by adhd with hyperactivity like tigger

This type of ADHD reminds us of Tigger from the Winnie the Pooh stories.

Dr. Daniel Amen refers to this type of ADHD as "Classic ADHD" for good reasons. When you think about someone who has Attention Deficit Hyperactivity Disorder, this is the classic picture that you think of.

Someone with this type of ADHD typically:

Tigger Type ADHD results from UNDER-ACTIVITY in the Prefrontal Cortex, both when at rest, and when performing concentration tasks.

This type of ADHD is most often seen in males, and can respond well to stimulants.


We have more in-depth information about ADHD with Impulsivity-Hyperactivity for you to learn, including alternative treatment strategies.



Over-Focused ADHD

Rabbit Tends to His Garden... and don't bother him.

The least flexible character in all of the stories of Winnie the Pooh and Christopher Robin has got to be Rabbit.

Oh, he can get a lot of things done, and he's the one character who will be prepared when winter comes, but he has a very hard time shifting from one activity to another. He is absolutely "task oriented" and is focused to whatever that task might be.

over focused adhdThe person with "Over-Focused ADHD" is much the same.

He has trouble shifting attention from one activity to another, and he frequently "gets stuck" in loops of negative thoughts.

He can be obsessive, and very inflexible. He can also be oppositional and argumentative to parents.

He may be like a "bull dog" and not give up until he gets his way, or until his worn-out parents finally say, "yes," to his 100th request for something. His parents are often worn-out, worn-down, fed-up, and ready to break.

Parenting a child like this is hard.

Someone with "Over-Focused ADHD" is like Rabbit, in that he:

The cause of this type of ADHD is an over-active Anterior Cingulate Gyrus. This part of the brain is over-active all of the time.

And, to make things worse, when a "work load" is put on the brain, such as school work or a chore to be completed, there is the common ADHD symptom of decreased activity level in the Pre-Frontal Cortex.

In this type of ADHD some stimulants, and too much use of L-Tyrosine to increase dopamine production can actually make the problem of over-focus worse. So be careful.



Nervous, Anxious, Hypervigilant, and ADHD

Piglet is a great friend, but sure scares easily...

Piglet is that small, almost frail character from the Hundred Acre Wood. He is a great friend, and very loyal.

But he is always worried, nervous, and startles easily . Sometimes he is so nervous that he stutters. So it is with some kids with ADHD.

This style of ADHD is very similar to the Rabbit style, except that with "Piglet style" the child's mid-brain is so over-aroused that the child is hypervigilant and very easily startled.

He may be talking all of the time, and is probably touching everything in the room. And, this child is nervous or worried, or anxious. He has trouble shifting attention from one activity to another, and he frequently "gets stuck" in loops of negative thoughts.


Learn more about ADHD and Anxiety Worry, including alternative treatment approaches.

He can be obsessive, and very inflexible.



25% of People with ADHD are also Depressed

Eeyore is slow, and sad...

many with ADHD suffer from depression too"Thanks for Noticin' Me" says Eeyore...

He walks slowly. He looks sad. He doesn't accomplish much. He's just glad to be noticed. This is Eeyore, the stuffed donkey who is so often in need of his tail being pinned back on.

Those with this depressive type of ADHD are often:

This type of ADHD is called "Limbic System ADHD" by Daniel Amen. And for good reason.

SPECT scans show that when the brain is at rest, there is increased activity deep in the limbic system, in parts of the brain called the thalamus and hypothalamus. There is also decreased activity in the underside of the pre-frontal cortex.

When the brain is placed under a work load, as during a homework assignment, nothing changes. The over-active limbic system remains over-active, and the under-active pre-frontal cortex remains under-active.

many with ADHD are also depressedThis type of ADHD looks very much like a combination of ADHD and Depression.

Learn much more about ADHD and Depression, including a look at the recent research on ADHD, Depression, and Teenage Girls (Video).

Learn more about each of the DIFFERENT TYPES OF ADHD:


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ADHD Inattentive Type | Winnie the Pooh ADHD

ADHD Inattentive Type

ADHD : Just Like Winnie the Pooh

Winnie the Pooh is the classic picture of Inattentive ADHD. Although Pooh is very lovable, loyal, and kind, he is also inattentive, sluggish, slow-moving, unmotivated. He is a classic daydreamer with brain fog. In other works we have called this "Space Cadet" style ADHD.


People with this type of ADHD are:

Inattentive ADHD Explained

Normally in the brain the prefrontal cortex will speed up activity when there is work to concentrate on. But with this type of inattentive ADHD the prefrontal cortex actually slows down when placed under a work load, like reading or doing homework.

This part of the brain looks normal when "at rest," but actually looks like it is starting to fall asleep when asked to "go to work." This makes it very hard to pay attention to school work, get homework done, listen to the teacher, clean your room, and so on.

We have actually observed this hundreds of times with subjects on an EEG. When at rest, the brainwave activity is pretty normal. But once the subject is asked to read, or to do a math worksheet, the subject's brainwave activity begins to look like the subject is falling asleep. And often times they do fall asleep! This sure makes school hard for these students!

Winnie the Pooh style inattention is seen more in girls than in boys.

It responds well to stimulants, such as ritalin and adderall, but other interventions like Attend and diet work well also, and without the side effects.


Here are some of the questions from our Online ADHD screening tool (click here)that can help you clarify if the problem is Inattentive ADHD.

Answer every statement below by rating the behavior on a scale from one (1) to five (5).
(1) You have not noticed this behavior before.
(2) You have noticed this behavior a little, but it is not a significant problem.
(3) You have noticed this behavior, and see it fairly often.
(4) You have noticed this behavior, and see it almost daily or everyday.
(5) You have noticed this behavior, and it is really a big problem.

Section One:

_____ My child does not complete tasks or jobs that I give him to do.
_____ My child does not listen to me, or does not pay attention to me when I’m talking.
_____ My child daydreams a lot.
_____ It seems that we are always looking for things that my child has misplaced or lost.
_____ My child has poor concentration on tasks that are difficult, hard, or boring.
_____ My child changes from one play activity to another a lot, more than most kids his age.
_____ My child is easily distracted.
_____ My child often makes us late.
_____ Most of the time I am doing my child’s homework for him.
_____ After taking two hours to complete what should have been a 20 minute homework assignment, the next day my child loses his homework or fails to turn it in to his teacher.

_____ Add these scores up here. Scores of 10 to 24 are common.

Scores of 25 to 34 are in the "at risk" ranges, and scores of 35 or greater are at "high risk."

Alternative Treatment Strategy Specifically for Inattentive ADHD

Here is what we recommend for Winnie the Pooh types if you are trying to avoid using stimulant medications:






ATTEND is the single best alternative treatment that we know of. It is an excellent product with an excellent product guarantee. MEMORIN works well with ATTEND to increase memory and concentration for Inattentive types.

ATTEND contains:

See the ATTEND formula list.

MEMORIN contains additional Ginko, plus lots of Phosphatidyl Serine and other phosphatidyls, and additional pregnenolone, a naturally occurring memory hormone.








Order ATTEND and MEMORIN NOW for "INATTENTIVE ADHD" or "WINNIE THE POOH TYPE ADHD" through VAXA's secure online store. Increase or adjust the quantities as needed.

Save about $15 off the list price when you order an "Attend Strategy Pac" with 1-Attend, 1-Memorin, and 1-Extress together for just $81.95.


Or for more information phone VAXA directly at 1-800-248-8292 during business hours on the east coast. They are located in Florida. Ask for Daniel, the supervisor in customer service. He is a friend who will give you great service. Tell him that Dr Cowan said "hello."

Try Attend Risk Free! VAXA offers a great guarantee of satisfaction. Attend either works for you, or you get your purchase price back.

See the details of their money back guarantee here.

ADHD Impulsive Hyperactive Tigger Type

Classic Hyperactive ADHD - "Impulsive Hyperactive ADHD"

Impulsive Hyperactive ADHD

Tiggers Like to Bounce... Bouncin' is What Tiggers Do Best!
We call this bouncy type of ADHD "Tigger Type" for good reason. This classic form of ADHD is characterized by adhd with hyperactivity like tigger

This type of ADHD reminds us of Tigger from the Winnie the Pooh stories.

Dr. Daniel Amen refers to this type of ADHD as "Classic ADHD" for good reasons. When you think about someone who has Attention Deficit Hyperactivity Disorder, this is the classic picture that you think of.

Someone with this type of ADHD typically:

  • Is easily distracted
  • Has a LOT of energy
  • Is hyperactive
  • Can't sit still very long
  • Is fidgety
  • Talks a LOT, and can be LOUD
  • Is very impulsive, does not think before he acts
  • Has trouble waiting his turn in line, or in games
  • and more...

Tigger Type ADHD results from UNDER-ACTIVITY in the Prefrontal Cortex, both when at rest, and when performing concentration tasks.

This type of ADHD is most often seen in males.




Alternative Treatment Strategies Specifically for Hyperactive Impulsive "Tigger-Type ADHD"

Here is what we recommend for bouncy "Tigger-type" ADHD if you are trying to avoid medications:

We recommend at least a 30 to 60 day trial with the following nutraceuticals. And you are covered by the manufacturer's money back guarantee for a full year.

Together these three nutraceutical medicines combine to make an excellent alternative treatment for Tigger-type ADHD. Consult your health care professional.






Save about $15 off the list price when you order an "Attend Strategy Pac" with 1-Attend, 1-Memorin, and 1-Extress together for just $81.95. This is a bargain!

Try Attend Risk Free! VAXA offers a great guarantee of satisfaction. Attend either works for you, or you get your purchase price back. See the details of their money back guarantee here.

Or phone VAXA directly at 1-800-248-8292 during business hours on the east coast. They are located in Florida. Ask for Daniel, the supervisor in customer service. He is a friend who will give you great service. Tell him that Dr Cowan said "hello."

Hyepractivity

Attention Deficit Hyepractivity Disorder

Hyepractivity

"Hyepractivity" is a common misspelling of the word "hyperactivity."

Attention Deficit Hyperactivity Disorder, often called ADD or ADHD, is a diagnostic label that we give to children and adults who have significant problems in four main areas of their lives:

+ Trouble staying focused to a task, trouble paying attention.
+ Being impulsive, not thinking before doing.
+ Being "hyepractive" (sic) or "hyperactive."
+ Being easily bored with work that is repetitive, or difficult.

What is Hyperactivity?

Hyperactivity is defined as "Excessive, non-goal directed, motor activity."

There are times when we all have to move quickly, or have to work very hard to accomplish a task. During these time we might display "excessive... motor activity." However, because we are working on a task, it is "goal directed" activity. In "hyperactivity" we see "excessive... motor activity" that is not goal directed. Individuals seem to go from one thing to another without ever finishing the first task, or the second task, or anything.

Hyperactivity in ADHD

ADHD and Depression : Over-active Limbic System

ADHD and Depression - 25% of People with ADHD are also Depressed



many with ADHD suffer from depression too"Thanks for Noticin' Me" says Eeyore...

He walks slowly. He looks sad. He doesn't accomplish much. He's just glad to be noticed. This is Eeyore, the stuffed donkey who is so often in need of his tail being pinned back on.

Those with this depressive type of ADHD are often:

This type of ADHD is called "Limbic System ADHD" by Daniel Amen. And for good reason.

SPECT scans show that when the brain is at rest, there is increased activity deep in the limbic system, in parts of the brain called the thalamus and hypothalamus. There is also decreased activity in the underside of the pre-frontal cortex.

When the brain is placed under a work load, as during a homework assignment, nothing changes. The over-active limbic system remains over-active, and the under-active pre-frontal cortex remains under-active.

many with ADHD are also depressedThis type of ADHD looks very much like a combination of ADHD and Depression.

Some have suggested that up to 25% of children with ADHD are also depressed or suffer from a mild depression called Dysthymic disorder. This may impact females more than males. View this video below reporting on new research on girls with ADHD and risks for depression.

Alternative Treatment Strategies for Limbic System, or Eeyore style ADHD

Experts recommend DL-Phenylalyne (up to 600 mg per day for adults), 5-HTP, and B Vitamins and St. John's Wort (up to 600 mg per day for adults). We know how to make that work, and what we recommend includes what the experts recommend, plus even more powerful ingredients.

We recommend for Limbic System, or Eeyore style ADHD the following for adults. Children may be able to take less.



Order all three products from the secure shopping cart. Used together these three homeopathic nutraceutical medicines combine to make a very good alternative treatment formula.

With anyone who is showing symptoms of depression, please consult with a physician, and please consider that depression is a very serious condition in children, teens, or adults.



Order ATTEND, EXTRESS, and DEPREX NOW from the secure shopping cart.

Or phone VAXA directly at 1-800-248-8292 during business hours on the east coast. They are located in Florida. Ask for Daniel, the supervisor in customer service. He is a friend who will give you great service. Tell him that Dr Cowan said "hello." When you order directly from the manufacturer (VAXA International) you get the freshest product (it hasn't been sitting in somebody's garage for a year or so), which means that the product will be the most powerful available. The order is professionally processed and shipped out to you quickly. Plus you get VAXA's 1 year money back guarantee!

Try Attend Risk Free! VAXA offers a great guarantee of satisfaction. Attend either works for you, or you get your purchase price back. See the details of their money back guarantee here.

ADHD, Depression, and Adolescent Girls

Depression and ADHD in Teenage Girls

Several studies in recent years have looked into the impact of ADHD on the lives of teenage girls. MRI studies report that teenager’s brains are rapidly maturing, but that they are not fully mature until the early 20’s in females, and perhaps the early 30’s in males. Long-term studies on behavior and emotional health report that girls with ADHD may struggle through the teen years. And other studies report that depression is common among teens with ADHD, and is so common among adolescents that the use of medications for ADHD, antidepressants, anti-psychotics, and even sleep medications, is up sharply with adolescent girls.

It has been reported that while many children and teens with ADHD also suffer from some degree of sadness or discouragement, as many as 25% are clinically depressed. Children and teens with ADHD are as much as 300% more likely to also suffer from depression than are children or teens without ADHD.

The co-morbid depression seems little associated with the ADHD symptoms such as inattention, impulsivity, hyperactivity, or academic problems. These problems might result in discouragement, sadness, or frustration, but not clinical depression.

Rather, the depression seems to be most correlated to social awkwardness or interpersonal difficulties that are often a part of having ADHD. The lack of friendships, the sense of loneliness, or the sense of being a “social outcast” seemed to be behind the depression. And these feelings are, of course, much stronger in the teenage years.

In girls who were diagnosed with ADHD, and were followed by long-term studies through the years, it was observed that as they moved from childhood to adolescence their “outward” symptoms of ADHD, such as hyperactivity and impulsivity, tended to decrease.

We do want to note that most girls with ADHD do not have the symptoms of hyperactivity or impulsivity. Most girls with ADHD are inattentive, distracted, disorganized, or “space cadets,” which is why girls are so under-diagnosed for ADHD. Girls tend to just sit in the classroom, get distracted, and do poorly on the tests. But they don’t cause trouble in the classroom so they don’t get the attention that might lead to a diagnosis and treatment.

But for those girls were did have the symptoms of hyperactivity or impulsivity, and had been diagnosed as children, their “outward” symptoms tended to decrease as they reached the teenage years.

However, as these girls reached the teenage years, it was noted that their academic performance continued to be a problem, and that the academic gap between them and their non-ADHD peers continued to widen with each passing year.

These researchers also noted that, while some girls with ADHD actually “out-grew it” as they reached adolescence, for the most part the girls not only continued to suffer from it but many began to get into serious trouble. Both behavioral and emotional problems began to emerge in many of these girls, and the need for specialized treatment greatly increased.

There were increased problems with friends, which led to increased levels of depression. There were increased levels of substance abuse (both alcohol and drug abuse). School delinquency increased as the academic problems got worse. And, surprisingly, eating disorders became a serious problem among many of these girls.

All of these problems were at higher levels among these ADHD girls than among their non-ADHD peers.

SPECIFIC TREATMENT STRATEGIES FOR ADHD AND DEPRESSION

As we have noted elsewhere, twice as many teens with ADHD will run away from home than teens without ADHD. About 16% of teens run away from home at some point, versus 32% of teens untreated for Attention Deficit Hyperactivity Disorder - ADD ADHD. And as many as 50% of all teenagers in juvenile facilities have Attention Deficit Hyperactivity Disorder but were untreated for ADHD.

Teenagers untreated for ADHD are ten times more likely to get pregnant, or cause a pregnancy, than those without ADHD, and teenagers untreated for Attention Deficit Hyperactivity Disorder are 400% more likely to contract a sexually transmitted disease than teens without ADHD: 16% to 4%.

ADHD, and Depression

With as many as 25% of teenagers with ADHD being clinically depressed, it is important to understand what depression looks like, why it is important to treat it and manage it, and the treatment options available.

When we think of someone who is depressed, we usually picture a sad, tearful, lonesome person. But teenagers with depression don't look like adults with depression.

Current studies show that there are about as many teenagers who are depressed as there are adults that are depressed, about 10% of the general population. And as we have noted, as many as 25% of teens with ADHD are depressed.

However, depression in teenagers doesn’t always look like depression in adults. Teenagers do not commonly display gloom, self-depreciation, or talk about feeling hopeless like adults do.

Teenagers with Major Depression are described as often becoming negative and antisocial. Feelings of wanting to leave home or wanting to run away will increase. There may be a strong sense of not being understood and approved of by parents, siblings, or peers.

The teen often changes, and becomes more restless, grouchy, or aggressive. A reluctance to cooperate in family ventures, and withdrawing from the family by retreating into their room is pretty common.

School difficulties are likely even in those few ADHD teens who were doing pretty well in school, as concentration is even more affected than from the ADHD alone.

SPECIFIC TREATMENT STRATEGIES FOR ADHD AND DEPRESSION

Sometimes the teen will stop paying attention to personal appearance, and sometimes they will adopt the “uniform” of social groups that profess depression or despondency as a way of life. They often become much more emotional “at every little thing.” Often there is an increased sensitivity to rejection in love relationships as well.

Which reminds me of a Cornell University study that reported that the leading cause of teenage depression was breaking up with a boyfriend or girlfriend. And that the younger the teen was in this relationship, the more likely the breakup would lead to depression.

Teenage boys will often become aggressive with their parents or peers, seem more agitated around the house, and get into more trouble at home, at school, or with the law.

Teenage girls will sometimes become preoccupied with themes of death or dying, and become decreasing concerned about how they look. Think black – black hair, nails, clothes, lips.

Suicidal thoughts are common in depressed teens. Some studies suggest that 500,000 teens attempt suicide each year, and 5,000 are successful. That would be 10% of depressed teens. Other studies suggest that the number is 15% of depressed teens ending their life via suicide.

By the way, another study notes that of all the teenagers that commit suicide each year, only seven percent were receiving mental health treatment at the time of their death.

Poor self-esteem is common with teenagers, but especially with those who are depressed, and there is often an increase in “self-destructive behaviors” such as alcohol abuse, drug abuse, and sexual promiscuity.

Parents are often confused and frustrated when their teens begin to act like this. Sometimes parents become stern disciplinarians, or even put the teen down, which only serves to increase feelings of guilt and depression. Other times, parents feel helpless, and stand by waiting for adulthood to arrive. Of course neither course is the right one to take.

From 2001 to 2006, the use of ADHD medicines prescribed to girls was up by nearly 75%, and the use of antidepressant medications was up by nearly 10% in girls.

Black Box Warning Label

No doubt you have seen recent news headlines about a federal panel that recommended to the FDA that anti-depressant medications carry the strongest possible warning label for use in children and teenagers. This recommendation to the FDA shook the medical community, especially those who work with depressed young people, and now the FDA does mandate that antidepressants used to treat adolescent depression carry the “black box” warning label.

The warning label reads:

Suicidality in Children and Adolescents

Antidepressants increase the risk of suicidal thinking and behavior (suicidality) in children and adolescents with major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of [Drug Name] or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. [Drug Name] is not approved for use in pediatric patients except for patients with [Any approved pediatric claims here]. (See Warnings and Precautions: Pediatric Use)

Pooled analyses of short-term (4 to 16 weeks) placebo-controlled trials of nine antidepressant drugs (SSRIs and others) in children and adolescents with MDD, obsessive compulsive disorder (OCD), or other psychiatric disorders (a total of 24 trials involving over 4400 patients) have revealed a greater risk of adverse events representing suicidal thinking or behavior (suicidality) during the first few months of treatment in those receiving antidepressants. The average risk of such events on drug was 4%, twice the placebo risk of 2%. No suicides occurred in these trials.

The biggest problem from the treatment community's point of view was not the recommendation for the warning label, but the way that the media portrayed the panel's recommendation. The panel reported that 2% to 4% of children and teens that were given anti-depressants for the treatment of depression had suicidal thoughts, or made suicidal attempts of one kind or another. None of the 4,000 children and teens studied committed suicide.

What the media did not report well is the fact that 10% to 15% of children and teens with depression that receive no treatment will commit suicide. These 10% to 15% will not just think about it, but will actually kill themselves.

So what are we to do? If the media had their way it seems that no teens with depression would receive anti-depressants. As a result the suicide rate for those who could be using the medication would rise from nearly zero percent to about fifteen percent, which is the suicide rate for depressed teens who are untreated.

While there actually are young people, and adults, who have become suicidal only after beginning treatment with an anti-depressant, and some have in fact gone on to take their own lives, which is absolutely tragic and heart-breaking, so is the fact that untreated depression is potentially a fatal disease. As many as fifteen out of one hundred young people with depression take their own lives unless they receive treatment. These young people should be allowed to receive a treatment that will lower the suicide rate dramatically, and without any stigma attached to it by the media.

With proper diagnosis and treatment a depressed teen, or adult, can be greatly helped. If someone close to you is suffering from depression, first please understand that depression is a very emotionally painful condition. Please take the situation seriously.

If you know of a teen whose behaviors have changed to look like what has been described above, let the parents know that there is help available, and encourage the family to seek help from a professional.

Women with ADHD : More Severe Symptoms than Men?

Let’s begin by pointing out that we have recently written about ADHD and Depression in Teenage Girls, and have even produced a brief internet video on the topic. As reported in that article, females with ADHD tend to have the “inattentive” type of ADHD (what we refer to as Winnie the Pooh type), where males tend to have the “impulsive-hyperactive” type or a “combined type” of ADHD (what we refer to as Tigger type ADHD).

As a result, males tend to have more behavioral problems that go along with their ADHD, which leads to referrals from the classroom teacher to a physician where he can receive a diagnosis and treatment. Their female counterparts, however, tend to be inattentive in the classroom, without the behavioral problems, and as less likely to get a referral which might lead to a diagnosis and treatment.

As children mature into adolescence, the human brain matures. But the interesting thing about the brain is that the brain tends to mature from the back of the brain to the front of the brain, and the frontal lobes and pre-frontal cortex mature last. These brain areas are most associated with the “executive functions” of the brain, and their delays in maturity are associated with “inattentive ADHD.”

Since the female brain tends to achieve its full growth and maturity in the early 20’s, we see many females who had been diagnosed with inattentive ADHD seemingly “outgrow” it in young adulthood.

But what about those who don’t “outgrow” their ADHD? And what about those females who started off with “impulsive-hyperactive type” ADHD, or “combined type” ADHD? What is observed in adult years with these women?

What we know is that during the teenage years these girls with ADHD are at a much higher risk of developing depression, anxiety disorders, and eating disorders, than their peers without ADHD. And during the adults years, these problems remain.

Fred Reimherr, MD, is a professor of psychiatry at the University of Utah in Salt Lake City, where he heads up their Mood Disorders Clinic, and is active in research. He is also quite an outdoorsman and conservationist. He led a study on the effectiveness of Strattera on adult subjects, which was funded by Eli Lilly and Company, and some of his results were startling. At least until the research on adolescent girls with ADHD recently became available.

One of the “side note” findings of Reimherr’s team was that there seemed to be a lot of women with ADHD combined type out there who did not “outgrow” their symptoms, and were still greatly bothered by their ADHD.

Through the assessment process it was found that these women’s scores on various inventories were much higher, and much more severe, than were the scores found with men. These adult women with ADHD had more severe emotional symptoms, including much higher levels of anxiety and depression. The study did not report on eating disorders, but other studies on female adolescents have noted higher levels of eating disorders in young women with ADHD.

Dr. Reimherr noted that when physicians (and mental health professionals) are working with women who are being treated for either anxiety or depression (or we would add eating disorders), if they show symptoms that are not entirely consistent with anxiety or depression, such as displaying more irritability or mood instability than might be expected, the physician should at least consider the possibility of ADHD being at the root of the problem.

ADHD with Depression

ADHD with Depression

This is our old page on ADHD and Depression. Please see our new page for the latest information on ADHD and depression.

Depression in adults often appears as great sadness, difficulty sleeping or eating, not caring for how one looks, and not caring at all. But in children, and in teenagers, depression may look very different. There may be much more anger and social withdrawal. Depression with ADHD is another story altogether too.

It is estimated that 25% of children and teens with ADHD are also mildly or moderately depressed.

Teen Suicide Rates Increase as Prescriptions Decrease

A lot of teenagers, and even children, are prescribed antidepressants, somewhere from 1% to 1.5% of the population. At one point studies estimated that as many as 1.66% of children or adolescents were prescribed antidepressant medication, but after the FDA required a "black box" warning label for the medications in 2005, the prescription rate has dropped. The warning label states that the use of antidepressants among children and teenagers is associate with an increased risk of suicial thoughts, and suicial behaviors. So physicians have backed off of prescribing the medications.

However, the estimated suicide rate among American adolescents is about 16%.

So, as a result of fewer depressed teenagers receiving antidepressant treatment, the suicide rate among teenagers has gone up. See Hamilton B, et.al., Annual Summary of Vital Statistics: 2005. Pediatrics. Also see Greenhouse, J., et.al., Generalizing from Clinical Trial Data: A Case Study. The Risk of Suicidality Among Pediatric Antidepressant Users. Carnegie Mellon University.

Follow along with me here:

1. Antidepressants can increase suicidal thoughts and behaviors in children and adolescents who were not having any, or many, suicidal thoughts or behaviors, according to a study of 4,600 children and teens (and, by the way, no one in this group of 4,600 committed suicide). This was the basis of the FDA's black box warning label.

2. But in children and teens who ARE having suicidal thoughts or behaviors prior to treatment with medications, antidpressants LOWER the risk of suicide. Simon and his group studied 65,000 medical records and found that the highest risk of suicide among the depressed was the month PRIOR to beginning treatment, and that the risks greatly diminished after beginning treatment with antidepressants (Simon GE, et.al., Suicide risk during antidepressant treatment. Am J Psychiatry. January, 2006)

3. Other studies have found that the more often antidepressants are prescribed to children and adolescents who could benefit from them, the lower the suicide rates (Gibbons RD, et.al., The relationship between antidepressant medication use and rate of suicide. Archives of General Psychiatry. 2005)

So the bottom line is, black box warning label or not, if your child or teenager is not depressed and is not having suicial thoughts or behaviors, they are probably better off not taking an antidepressant medication.

However, if your child or teen is depressed, and is having suicial thoughts, or has made suicide attempts in the past, he or she is probably better off taking antidepressant medication.

What is the "Worst Type" of ADHD?

What is the worst "type" of ADHD to have? Can any of the "types" be treated alone with alternatives? If I do not wish to medicate my child, what is the best alternative to go with? Please reply, I'm working on reserch paper; as well as information for my own children.

Thanks for writing.

What is the worst "type" of ADHD to have? I guess the "worst type" would be what I call the "troubled type" or what Daniel Amen calls the "Ring of Fire" type. (Or else it would be whatever type YOUR child has ;-) Any "type" of ADHD can be serious, or slight. Any type can be just a mild problem, or a severe problem. Think "spectrum".

Can any of the "types" be treated alone with alternatives? Any of these types, except for the "troubled type" could be treated alone with alternatives. I just wouldn't recommend it for "trouble type ADHD" as the alternatives take longer to work, and typically this type needs to be stabilized as soon as possible.

If I do not wish to medicate my child, what is the best alternative to go with? I recommend (1) determining what "type" of ADHD is involved, (2) using our eating recommendations, (3) using the specific treatment recommendations with the VAXA formulas
for they "type" of ADHD involved. If people can afford it, I also like EEG Biofeedback training, with talented providers, as another effective alternative treatment. And, finally, homeschooling is a great alternative treatment option if families can do that as
well.

Good luck with your paper. Let me know if there are more resources that you might need, and feel free to use whatever is on any of our websites:
http://newideas.net
http://www.addinschool.com
http://www.add101.com

Doug Cowan

ADHD with Anxiety, Worry, Hypervigilance

Nervous, Anxious, Hypervigilant, and ADHD

Piglet is a great friend, but sure scares easily...

Piglet is that small, almost frail character from the Hundred Acre Wood. He is a great friend, and very loyal.

But he is always worried, nervous, and startles easily . Sometimes he is so nervous that he stutters. So it is with some kids with ADHD.

This style of ADHD is very similar to the Rabbit style, except that with "Piglet style" the child's mid-brain is so over-aroused that the child is hypervigilant and very easily startled.

He may be talking all of the time, and is probably touching everything in the room. And, this child is nervous or worried, or anxious. He has trouble shifting attention from one activity to another, and he frequently "gets stuck" in loops of negative thoughts.

He can be obsessive, and very inflexible.

In this type of ADHD some stimulants, and too much use of L-Tyrosine to increase dopamine production can actually make the problem of over-focus worse. So be careful.

Alternative Treatment Strategies for Piglet style ADHD

adhd specific treatment strategy ordering chart

In addition, we recommend for Anxious, "Piglet" style ADHD the following for adults. Children can take less:

Together these two products give the best combination of homeopathic medicines, amino acids, vitamins and minerals, essential fatty acids, lipid complexes, and more, for the alternative treatment of Piglet style ADHD.





Order ATTEND and EXTRESS here on the secure shopping cart directly from the manufacturer - online. Adjust the quantities of the products according to your needs.

Or phone VAXA directly at 1-800-248-8292 during business hours on the east coast. They are located in Florida. Ask for Daniel, the supervisor in customer service. He is a friend who will give you great service. Tell him that Dr Cowan said "hello."

When you order directly from the manufacturer (VAXA International), either online or by phone, you get the freshest product (it hasn't been sitting in somebody's garage for a year or so), which means that the product will be the most powerful available. The order is professionally processed and shipped out to you quickly. Plus you get VAXA's 1 year money back guarantee!

Try Attend Risk Free! VAXA offers a great guarantee of satisfaction. Attend either works for you, or you get your purchase price back. See the details of their money back guarantee here.

Blood Test for Anxiety Disorders?

When the Detroit Tigers placed pitcher Dontrelle Willis on the disabled list last Sunday (3/29/2009) with the diagnosis of "anxiety disorder" it was very interesting to me for two reasons:

First, because my nephew Casey Fien was trying to make the Tigers as a pitcher and we had just recently returned from a trip to spring training to follow the Tigers and watch Casey pitch (Casey was just assigned to AAA Toledo a few days ago), and we have started following the Tigers very closely; and

Secondly, because of the reports that although Willis had not reported any symptoms of an anxiety disorder, he was diagnosed solely through the results of a blood test, according to news reports.

I must confess that I had never heard of a blood test for anxiety disorder, so I began looking around the internet for information to see if this was true, or if the Tigers were just trying to find a reason to put Willis on the DL so that they wouldn't have to pay all of the $11 million owed him for this season.

Here is what I discovered, and it may be helpful to you if you or your child with ADHD also has symptoms of anxiety, panic, rigid thinking, or OCD...

While WebMD doesn't know about any blood tests for anxiety disorder, they write: "Although there are no laboratory tests to specifically diagnose mental illness, the doctor may use various tests to make sure something else isn't causing the symptoms. If no other illness is found, you may be referred to a psychiatrist or psychologist, mental health professionals who are specially trained to diagnose and treat mental illnesses."

Our local family practice doctor doesn't know anything about a blood test for anxiety disorders either.

However, over three years ago (January, 2006) a research team from Hebrew University in Israel announced the development of a blood test for anxiety disorders. The blood test looks for abnormally high levels of the neurotransmitter Acetylcholine (ACh) by measuring the levels of related enzymes. According to the website, "(the) team found more than a 90% correlation between people who were diagnosed with higher than usual anxiety by a psychologist and people with abnormal AChE, BChE and PON levels."

The entire 2006 article is here: http://www.isracast.com/article.aspx?ID=45 and it is worth the read. There is also a 2005 report on the research here: http://blogs.zdnet.com/emergingtech/?p=47

Hebrew University, through Yissum Research Development Company, which is the technology development company of the University, then applied for a patent on the blood test in April of 2006. They were just awarded the patent on February 24, 2009, which would mean that the test would be commercially available soon if not already.

The patent award is here: http://www.pharmcast.com/Patents200/Yr2009/Feb2009/022409/7494783_Anxiet... and it gives very detailed information about the test. How do you buy stock in this?

As of March, 2007, the University of Iowa was also developing a blood test for anxiety disorders based on the genetic profiles of individuals that they hoped would be commercially produced. Their study was publishes in the American Journal of Medical Genetics, and according to reports, "The team compared gene expression in lymphoblasts (immature white blood cells) culled from 16 participants with panic disorder and 17 participants without the disorder. The study found many genes were more expressed in people with panic disorder than in people without the condition. Similarly, the study found many genes were less expressed in people with panic disorder."

The entire 2007 article is here: http://psychcentral.com/news/2007/03/06/blood-test-for-panic-disorder/66...

Other blood tests focus on thyroid functioning and adrenal levels, both of which, if not functioning correctly, can cause anxiety related symptoms.

It will be interesting to see what 2009 will bring in the development of improved technologies to diagnose and treat anxiety disorders, as it will be interesting to follow the career of Dontrelle Willis. We wish him well.

ADHD and Anxiety - our old page

Worry and ADHD

This is our old page on this type of ADHD.

Please see our new page on "worry" "anxiety" and ADHD.

ADHD Information

ADHD with Over-Focused and Rigid Thinking

Over-Focused and Rigid Thinking in ADHD

Rabbit Tends to His Garden... and don't bother him.

The least flexible character in all of the stories of Winnie the Pooh and Christopher Robin has got to be Rabbit.

Oh, he can get a lot of things done, and he's the one character who will be prepared when winter comes, but he has a very hard time shifting from one activity to another. He is absolutely "task oriented" and is focused to whatever that task might be.

over focused adhdThe person with "Over-Focused ADHD" is much the same.

He has trouble shifting attention from one activity to another, and he frequently "gets stuck" in loops of negative thoughts.

He can be obsessive, and very inflexible. He can also be oppositional and argumentative to parents.

He may be like a "bull dog" and not give up until he gets his way, or until his worn-out parents finally say, "yes," to his 100th request for something. His parents are often worn-out, worn-down, fed-up, and ready to break.

Parenting a child like this is hard.

Someone with "Over-Focused ADHD" is like Rabbit, in that he:

The cause of this type of ADHD is an over-active Anterior Cingulate Gyrus. This part of the brain is over-active all of the time.

And, to make things worse, when a "work load" is put on the brain, such as school work or a chore to be completed, there is the common ADHD symptom of decreased activity level in the Pre-Frontal Cortex.

In this type of ADHD some stimulants, and too much use of L-Tyrosine to increase dopamine production can actually make the problem of over-focus worse. So be careful.


Alternative Treatment Strategies for Over-Focused ADHD

300 mg of St. John's Wort is recommended per day for these children, and 600 mg per day for adults, along with 5-HTP, and B Vitamins.

To provide this, and much more, we recommend for Over-Focused, or Rabbit style ADHD the following for adults. Children can take less.

ATTEND contains:

See the ATTEND ingredients list here.

EXTRESS contains:

DEPREX contains:

Together these three products give the best over-all combinations for the alternative treatment of "over-focused ADHD."

Order ATTEND, EXTRESS, and DEPREX here.

Or phone VAXA directly at 1-800-248-8292 during business hours on the east coast. They are located in Florida.

Ask for Daniel, the supervisor in customer service. He is a friend who will give you great service. Tell him that Dr Cowan said "hello."

Save about $15 off the list price when you order an "Attend Strategy Pac" with 1-Attend, 1-Memorin, and 1-Extress together for just $81.95.

When you order directly from the manufacturer (VAXA International) you get the freshest product (it hasn't been sitting in somebody's garage for a year or so), which means that the product will be the most powerful available. The order is professionally processed and shipped out to you quickly. Plus you get VAXA's 1 year money back guarantee!

Try Attend Risk Free! VAXA offers a great guarantee of satisfaction. Attend either works for you, or you get your purchase price back. See the details of their money back guarantee here.

Very Difficult ADHD: Temporal Lobe ADHD

Dark Moods, Anger, and ADHD

There is another, more difficult type of ADHD that you should be aware of.

There are no Winne the Pooh characters for this type of ADHD, as the creator of these children's stories would never have created a character with these challenging, difficult traits.

This type of ADHD can be very severe, and will require significant treatment, and great patience on the part of the parents.

The Temporal Lobes and ADHD

People with Temporal Lobe problems and ADHD can be very hard to live with.

They can have gigantic mood swings, get very angry for almost no reason, and be nearly impossible to live with on a daily basis. The key to look for with this type of ADHD is anger outbursts for little or no reason.

Decreased activity in the left temporal lobes causes problems with temper outbursts, aggressive behaviors, and even violence toward animals or other people.

Temporal Lobe ADHD is characterized by:

Individuals with this type of ADHD are often treated with a combination of stimulants, like Ritalin, and anti-convulsants.

You can see that this type of ADHD looks very much like Bipolar Disorder. See our discussion on ADHD vs Bipolar Disorder.

Research shows that about 15% of those diagnosed with ADHD actually have an early onset bipolar disorder. Physicians and therapists must be very careful in making their diagnosis. See our section on Differential Diagnoses of ADHD.

For someone who wanted to try an alternative treatment approach to this type of ADHD, or an "additional treatment" approach, we would recommend considering the following:

Using the VAXA nutraceutical product line, our recommended protocol would look like this:

Two capsules of the ATTEND contain GABA (33mg), and DL-PA (16mg) for mood stabilization, plus L-Tyrosine (67mg), Ginko (33mg), Phosphatidyl Serine (0.5mg) and other phosphatidyls (200mg) and DMAE (33mg) and Pregnenolone (8mg) for learning enhancement. There are over 70 total ingredients in ATTEND to help with learning, performance, and mood.

Four capsules of NEURAN contain GABA (240mg), and DL-PA (32mg) for mood stabilization. Children might take less. Consult your healthcare professional.

As you can see, using the Neuran along with the Attend can enhance the mood stabilization components without adding either St. John's Wort or Hypericum, two ingredients that some experts believe could make the problem worse.

Together the Attend and Neuran can also enhance learning and memory, and therefore school performance or work performance.

Order ATTEND, and NEURAN directly from the manufacturer - online - here. This link will take you to the VAXA shopping cart page. Adjust the quantities of the products according to your needs.

Or phone VAXA directly at 1-800-248-8292 during business hours on the east coast. They are located in Florida.

If you phone, ask for Daniel, the supervisor in customer service. He is a friend who will give you great service. Tell him that Dr Cowan said "hello."

When you order directly from the manufacturer (VAXA International) you get the freshest product (it hasn't been sitting in somebody's garage for a year or so), which means that the product will be the most powerful available. The order is professionally processed and shipped out to you quickly. Plus you get VAXA's 1 year money back guarantee!

Try Attend Risk Free! VAXA offers a great guarantee of satisfaction. Attend either works for you, or you get your purchase price back. See the details of their money back guarantee here.

ADHD Different Types Overview

The Different Types, or Styles, of ADHD

The diagnosis of Attention Deficit Hyperactivity Disorder is very broad, including several different types of ADHD.


What are these different types of ADHD?

And in each article we will discuss the best targeted alternative treatment strategies for each of these five types of Attention Deficit Hyperactivity Disorder.

Different Types, or Styles, of ADHD

Research literature, recent books, and common sense, all point to the fact that there are different types, or styles, of ADHD.

In the past we referred to Attention Deficit Disorder: Inattentive Type, or Impulsive/Hyperactive Type, or a Combined Type. Today the diagnostic differences are a bit less clear, but the reality doesn't change.

Dr. Daniel Amen has written a great book on the subject, titled "Healing ADHD:The Breakthrough Program That Allows You to See and Heal the 6 Types of ADD" where he uses his SPECT scans of patient's brain activity to help in making his six classifications.

His classifications include these "Types" ...

1. Classic ADD - Inattentive, distractible, disorganized. Perhaps hyperactive, restless and impulsive.

2. Inattentive ADD - Inattentive, and disorganized.

3. Over-focused ADD - Trouble shifting attention, frequently stuck in loops of negative thoughts, obsessive, excessive worry, inflexible, oppositional and argumentative.

4. Temporal Lobe ADD - Inattentive and irritable, aggressive, dark thoughts, mood instability, very impulsive. May break rules, fight, be defiant, and very disobedient. Poor handwriting and trouble learning are common.

5. Limbic System ADD - Inattentive, chronic low-grade depression, negative, low energy, feelings of hopelessness and worthlessness.

6. Ring of Fire ADD - Inattentive, extremely distractible, angry, irritable, overly sensitive to the environment, hyperverbal, extremely oppositional, possible cyclic moodiness.

We will be discussing these classification in more detail in this section.

Here our classifications are a bit different, and are based more on our clinical observation and experiences.

Our classifications are based on the classic children's stories of Winnie the Pooh and his friends in the Hundred Acre Wood.

Each of these types of ADHD (using either Amen's system or ours) will have different treatment needs and approaches.

ADHD Inattentive Type

Just Like Winnie the Pooh

Winnie the Pooh is the classic picture of Inattentive ADHD. Although Pooh is very lovable, loyal, and kind, he is also inattentive, sluggish, slow-moving, unmotivated. He is a classic daydreamer with brain fog. In other works we have called this "Space Cadet" style ADHD.

People with this type of ADHD are:

Inattentive ADHD Explained

Normally in the brain the prefrontal cortex will speed up activity when there is work to concentrate on. But with this type of inattentive ADHD the prefrontal cortex actually slows down when placed under a work load, like reading or doing homework.

This part of the brain looks normal when "at rest," but actually looks like it is starting to fall asleep when asked to "go to work." This makes it very hard to pay attention to school work, get homework done, listen to the teacher, clean your room, and so on.

We have actually observed this hundreds of times with subjects on an EEG. When at rest, the brainwave activity is pretty normal. But once the subject is asked to read, or to do a math worksheet, the subject's brainwave activity begins to look like the subject is falling asleep. And often times they do fall asleep! This sure makes school hard for these students!

Winnie the Pooh style inattention is seen more in girls than in boys.

It responds well to stimulants, such as ritalin and adderall, but other interventions like Attend and diet work well also, and without the side effects.


We have much more on Inattentive Type (Winnie the Pooh Type) ADHD for you, including an in-depth look at some alternative treatment strategies.

Classic Hyperactive ADHD

Tiggers Like to Bounce... Bouncin' is What Tiggers Do Best!

We call this bouncy type of ADHD "Tigger Type" for good reason. This classic form of ADHD is characterized by adhd with hyperactivity like tigger

This type of ADHD reminds us of Tigger from the Winnie the Pooh stories.

Dr. Daniel Amen refers to this type of ADHD as "Classic ADHD" for good reasons. When you think about someone who has Attention Deficit Hyperactivity Disorder, this is the classic picture that you think of.

Someone with this type of ADHD typically:

  • Is easily distracted
  • Has a LOT of energy
  • Is hyperactive
  • Can't sit still very long
  • Is fidgety
  • Talks a LOT, and can be LOUD
  • Is very impulsive, does not think before he acts
  • Has trouble waiting his turn in line, or in games
  • and more...

Tigger Type ADHD results from UNDER-ACTIVITY in the Prefrontal Cortex, both when at rest, and when performing concentration tasks.

This type of ADHD is most often seen in males, and can respond well to stimulants.


We have more in-depth information about ADHD with Impulsivity-Hyperactivity for you to learn, including alternative treatment strategies.

Learn more about each of the DIFFERENT TYPES OF ADHD:

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Types of ADHD (old)

The Different Types, or Styles, of ADHD

This page has moved.

We discuss the different types of ADHD using characters from Winnie the Pooh stories for easier understanding.
o "Inattentive Type": Just like Winnie the Pooh
o "Classic ADHD": Tiggers like to bounce...
o "Over-Focused ADHD": Rabbit tends his garden
o "ADHD with Anxiety": Piglet is nervous and worries...
o "ADHD and Depression": Eeyore says, "Thanks for noticing me..."

* What are the best treatment strategies for each of these types of ADHD?
* How you can find out more about the different types of ADHD?

ADHD Facts