Explore the signs and causes of seven types of attention deficit hyperactivity disorder (ADHD), and how you can help your child or teen manage the symptoms.
If you see your child struggle with academic performance, focus, and impulsivity, the question of ADHD may have crossed your mind. If it has, know that you’re not alone. Data suggests roughly 5-9% of children and 3-5% of adults across Canada are affected by ADHD [1].
ADHD has been linked with higher rates of job terminations, car accidents, relationship problems, and poor academic performance [2], so it’s fair to wonder whether there’s anything you can do to support your loved ones.
What is ADHD?
Attention deficit hyperactivity disorder is a neurological disorder. Its trademark characteristics involve:
- Hyperactivity
- Impulsivity
- Difficulty maintaining focus and attention
- Challenges with emotional regulation
- Challenges with time management and organization
- Difficulty self-regulating and self-monitoring
- Challenges with working memory and processing speed
- Decreased flexibility or increased rigidity
ADHD is NOT a disability, nor is it a learning disorder. People with ADHD often first show symptoms between the ages of 3-7 years old. Some people find their symptoms fade as they grow up, however, this is not always the case. Regardless of whether people “outgrow” their ADHD, many find their ADHD symptoms shift as they age.
What Causes ADHD?
Although the exact origin of ADHD remains a mystery, research over the past two decades has led to exciting advancements in our understanding of ADHD. These advancements have helped us to understand that ADHD isn’t just one disorder. Rather, ADHD can be divided into several distinct subtypes, each with its own effects on the brain and subsequent effective treatments.
7 Types of ADHD + Their Causes, Signs, and Symptoms
Previously, ADHD was believed to be a mental disorder that resulted from dopamine deficiency and dysregulated executive function and control. ADHD was divided into three main types: hyperactive, inattentive, and impulsive. We also used to distinguish between Attention Deficit Disorder (ADD) and ADHD — over time, these have merged under the umbrella term of ADHD.
In general, ADHD impacts three neurotransmitters (GABA, dopamine, and serotonin), across six areas of the brain. The brain regions involved in ADHD include [3]:
- The prefrontal cortex and cerebellum (controls executive functions of attention, impulse control, planning, judgment, and organization)
- The anterior cingulate cortex(supports the brain’s ability to notice mistakes and switch between tasks)
- The temporal lobes (supports memory, emotions, mood stability, learning, and visual processing)
- The basal ganglia (a large structure responsible for dopamine production)
- The limbic system (responsible for bonding and emotional and behavioural reactions)
In recent years though, work from psychiatrist and brain imaging specialist Dr. Daniel G. Amen has shed light on the existence of seven unique types of ADHD, each with its own unique effects on the brain.
#1 Classic ADD
Caused by: decreased blood flow between the prefrontal cortex, cerebellum, and basal ganglia; dopamine deficiency. Shows lower brain activity during concentrated tasks.
Symptoms: impulsive, hyperactive, inattentive and easily distracted, and disorganized.
#2 Inattentive ADD
Caused by: reduced prefrontal cortex activity; dopamine deficiency.
Symptoms: easily distractible, short attention span, procrastinates, disorganized, may daydream, may present as more introverted. Not impulsive or hyperactive. *Present as much or more so in girls than boys.
#3 Overfocused ADD
Caused by: overactivity in anterior cingulate gyrus (makes flexibility difficult); deficiencies in dopamine and serotonin.
Symptoms: symptoms of Classic ADD; difficulty shifting attention from thought to thought or changing tasks; gets stuck in negative cycles of behaviours and/or thought patterns.
#4 Temporal Lobe ADD
Caused by: decreased prefrontal cortex activity; abnormal functioning in the temporal lobe.
Symptoms: symptoms of Classic ADD; learning and memory issues; behavioural problems like aggression, mild paranoia, and quick anger.
#5 Limbic ADD
Caused by: decreased prefrontal cortex activity (both while concentrating and at rest); overactivity in the limbic center (which controls mood).
Symptoms: symptoms of Classic ADD; chronic low self-esteem, chronic low levels of sadness (not depression), low energy, moodiness, and frequent feelings of intense guilt or helplessness
#6 Ring of Fire ADD (also known as “ADD Plus”)
Caused by: a ring of hyperactivity throughout the entire brain, particularly with too much activity across the cerebral cortex.
Symptoms: periods of especially mean behaviour; unpredictable behaviour; fearfulness and anxiety; speaking very fast; sensitivity to touch, light, and noise.
#7 Anxious ADD
Caused by: High activity in basal ganglia.
Symptoms: Symptoms of Classic ADD, alongside feeling tense and anxious; physical symptoms of anxiety-like stomachaches and headaches; catastrophizing; freezing in high-anxiety situations (especially if they feel judged).
Diagnosing ADHD in Children and Teens
Although each type of ADHD has its own unique presentations, symptoms can also vary by age and gender. A child with ADHD will often present differently than an adult with ADHD, and men and women with ADHD also tend to showcase different symptoms.
Diagnosis Criteria for ADHD
- Children/Teens (2-16 years): must have experienced 6+ symptoms for at least 6 months
- Adults (17+ years): must have experienced 5+ symptoms for at least 6 months
- Symptoms must have been present before the age of 12
- Symptoms must interfere with the individual’s ability to function in 2+ settings
- Symptoms have significantly impacted the quality of life (work, social, school)
- Symptoms are inappropriate given the individual’s age and developmental stage
- Symptoms cannot be explained by another condition
How You Can Support Children and Teens with ADHD
There are many ways you can help support children and teens struggling to manage ADHD.
Medications for ADHD
There are many ADHD medications available, with the most popular being stimulants, such as methylphenidate and amphetamines like Adderall. Non-stimulant options can also offer support, such as monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), and more. Every person is different, so your healthcare practitioner can guide you further and answer any medication-specific questions.
Therapies and Added Support for ADHD
Therapies that have proven helpful in managing ADHD symptoms for children and teens include neurofeedback, cognitive-behavioural therapy (CBT), and parent training.
Neurofeedback
Neurofeedback involves giving real-time feedback on mental states that can help people strengthen certain skills, such as concentration and attention. For children and teens who may have deficiencies in those areas, getting moment-to-moment feedback on when their focus strays can help them learn to manage their concentration and control impulses more easily.
Cognitive-Behavioural Therapy
Cognitive behavioural therapy is an incredibly popular and effective therapy that helps people identify and shift patterns of thoughts, which then impacts their behaviours and emotions. In CBT, children and teens learn to replace bad habits with more helpful ones, strengthen emotional regulation, and rewrite negative patterns of thinking and poor self-image.
Parent Training
When working with children and teens to manage ADHD symptoms, parent training can prove quite helpful. Parent training involves helping parents understand what’s happening in their children’s brains and gives them the tools to help their loved ones navigate challenging and emotionally distressing moments.
Attention deficit hyperactivity disorder can be tough on both children and parents alike. If you’re looking for support and guidance as you navigate your child or teen’s ADHD, reach out.
With clinical psychologists, registered psychotherapists, and registered social workers, we at Bhatia Psychology would love to support you and your loved ones on your healing journey. Learn more about our assessments and testing services for kids and teens.