Different Types of ADHD

Douglas Cowan Psy.D. MFT's picture
Share it now

The Different Types of Attention Deficit Hyperactivity Disorder


The diagnosis of "Attention Deficit Hyperactivity Disorder" is very broad, including several different types of ADHD. This is the reason that one child with ADHD may look much different than another. One may be quiet and inattentive, while the other is loud and hyperactive - but both are diagnosed with 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.

Daniel Amen and Healing ADHD bookDr. 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.

Dr. Daniel Amen - What You Need to Know About ADD

Best selling author, Dr. Daniel Amen on ADD - as seen on The Wellness Hour with Randy Alvarez

Here at the ADD ADHD Information Library 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.

  • Winnie the Pooh Type - Inattentive, distractible, disorganized. He's nice, but lives in a cloud.
  • Tigger Type- Inattentive, impulsive, hyperactive, restless, bouncy.
  • Eeyore Type - Inattentive, with chronic low-grade depression.
  • Piglet Type - Trouble shifting attention, excessive worry, easily startled.
  • Rabbit Type - Trouble shifting attention, inflexible, argumentative.
  • Troubled Type ADHD - Irritable, aggressive, impulsive, defiant, disobedient. Learning problems.

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

ADHD Inattentive Type

Winnie the Pooh has ADHD

inattentive-adhd-type-jpgWinnie 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 Inattentive ADHD are:

  • Easily distracted
  • Have short attention spans to a task that is not interesting, or is hard
  • Daydreaming when others are talking to him/her
  • Always looking for things that they have just put down somewhere...
  • Always late
  • Easily bored

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 bouncy-hyperactive-adhd-jpg

  • Inattention
  • Impulsivity
  • Hyperactivity
  • Restlessness
  • Disorganization

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.

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:

  • May worry a LOT, even over things that don't really matter much
  • Can be very oppositional to parents
  • May like to argue
  • May be somewhat compulsive about the way things ought to be done
  • Will have a very hard time shifting from one activity to another
  • Always wants to have his way

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 what treatment intervention you choose.

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.

nervous worried anxious adhd like PigletBut he is always worried, nervous, and startles easily . Sometimes he is so nervous that he stutters. So it is with some kids with ADHD. In fact some estimate that 25% of kids with ADHD also have symptoms of anxiety or are excessively worried.

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 graphic of Eeyore"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:

  • Inattentive
  • Have a chronic sadness or low-grade depression
  • Seem to be negative, or apathetic
  • Have low energy levels
  • They just do not seem to care
  • They often feel worthless, or helpless, or hopeless.

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:

And to find an experienced therapist who provides counseling in Tehachapi for ADHD please give my office a call at (661) 972-5953.

Douglas Cowan, Psy.D., M.S. is a licensed Marriage and Family Therapist in Tehachapi, CA who has been a skillful counselor to children, teens, and adults helping them to overcome ADHD, find relief for depression or anxiety, and solve other problems in life since 1989. He served on the medical advisory board to the company that makes Attend and Extress from 1997 through 2011, and he is the Editor of the ADHD Information Library online resource. His weekly ADHD Newsletter goes out to 9,500 families. Visit his website at http://DouglasCowan.me for more information on achieving greater health, personal growth, Christ-centered spirituality, stress management, parenting skills, ADHD, working out the stresses of being a care-giver to elderly parents and also being a parent to teenagers, or finding greater meaning in retirement years, Dr. Cowan can be a valuable resource to you.

Douglas Cowan, Psy.D., MFT
27400 Oakflat Dr.
Tehachapi, CA 93561
(661) 972-5953

Share it now