Healing ADD: The Breakthrough Program that Allows You to See and Heal the 7 Types of ADD

by Daniel G. Amen

dysfunctions and treatments Type 1—Classic ADD—Inattentive, distractible, disorganized, hyperactive, restless, and impulsive. Type 2—Inattentive ADD—Easily distracted with low attention span, but not hyperactive. Instead, often appears sluggish or apathetic. Type 3—Overfocused ADD—Excessive worrying, argumentative, and compulsive; often gets locked in a spiral of negative thoughts. Type 4—Temporal Lobe ADD—Quick temper and rage, periods of panic and fear, mildly paranoid. Type 5—Limbic ADD—Moodiness, low energy. Socially isolated, chronic low-grade depression, frequent feelings of hopelessness. Type 6—Ring of Fire ADD—Angry, aggressive, sensitive to noise, light, clothes, and touch; often inflexible, experiencing periods of mean, unpredictable behavior and grandiose thinking. Type 7—Anxious ADD—Anxious, tense, nervous, predicts the worst, gets anxious with timed tests, social anxiety, and often has physical stress symptoms, such as headaches and gastrointestinal symptoms, conflict avoidant.

Directions If you have attention deficit disorder (ADD), also known as attention deficit hyperactivity disorder (ADHD), I know you are not likely to read this entire book. I have been working with

Hahahaha he really does know us

BIOLOGICAL ADD TREATMENT SUMMARY Here Is a Summary of the Major Treatments for Each Type. ADD Type Diet Natural Supplements Medications Type 1. Classic ADD higher protein, lower carb Rhodiola, green tea, ginseng, L-tyrosine, zinc, grape seed or pine bark (abbreviated stimulating supplements) Stimulants such as Adderall, Vyvanse, Ritalin, or Concerta Stimulants or Provigil, Nuvigil Type 2. Inattentive ADD higher protein, lower carb stimulating supplements Stimulants or Provigil, Nuvigil Type 3. Overfocused ADD lower protein, higher smart carb 5-HTP PLUS stimulating supplements Serotonin and norepinephrine enhancing meds such as Effexor or Cymbalata; or a serotonin enhancing med, such as Zoloft, Paxil, Prozac, Celexa, or Lexapro, PLUS a stimulant Type 4. Temporal Lobe ADD higher protein, lower carb, maybe “ketogenic diet” GABA, gingko, vinpocetine, huperzine A, ALC, PS, NAC, and ALA PLUS stimulating supplements If mood instability, consider anticonvulsants such as Neurontin, Lamictal, Trileptal or Depakote, PLUS a stimulant Type 5. Limbic ADD higher protein, lower carb SAMe PLUS stimulating supplements Stimulants such as Adderall, Vyvanse, Ritalin, or Concerta Type 6. Ring of Fire ADD higher protein, lower carb GABA, 5HTP PLUS stimulating supplements Anticonvulsants together with a serotonin enhancing med and then if needed a stimulant. Guanfacine or clonidine can also be used. Type 7. Anxious ADD higher protein, lower carb L-theanine, Relora, Magnesium, Holy Basil, PLUS sti...

think of effective treatment for ADD like glasses for people who have trouble seeing. The glasses do not change people, they just make their vision more effective. This book will give you a completely new perspective on ADD. You’ll see actual ADD brain images (many before and after

back to church, but left her at home. I went to pray for a healing. I believe in healings. At the time I knew that 30 percent of three-year-olds look hyperactive, while only 5 to 10 percent of four-year-olds are hyperactive. So the first time you can really diagnose ADD with confidence is about four years old. I lit candles at church, and even put an extra fifty dollars in the offering, trying to bribe God. I wrote to the Pope and asked him to send a blessed picture that I could put by her bed. But he must have had a secretary with ADD because no one wrote

activity “I used to hate school, Dad, because I had trouble learning. A one hour class seemed like it went on all day long. It was painful. Now, I can pay attention, and that same class seems like it goes by in twenty minutes and I love it because I can do it.” That statement is critical. Many

see that ADD symptoms have been present for most of a person’s life. Many hyperactive ADD children (Classic ADD) are noted to be overly active in the womb. One mother told me that her unborn child kicked her so hard during the eighth month of pregnancy that he broke her ninth rib! Many are also difficult from birth: A significant number are colicky, fussy eaters, have a difficult time being comforted, are sensitive to noise and touch, and have eating and sleeping difficulties. As toddlers, they’re often excessively active, mischievous, demanding, difficult to toilet train, and noncompliant with parental requests (like the terrible twos on overdrive). Most ADD children are not recognized as such until they go to school: In kindergarten or in first or second grade, schoolteachers often notice the difference between these children and others. Teachers have a large database of expected behavior,

study, which showed multiple areas of overactivity in her brain, which is why it is called the Ring of Fire (more on this pattern coming soon). As we will see, this pattern can have a number of causes, from food allergies, inflammation, or an early bipolar pattern. The goal of treatment was to eliminate anything that could be trouble for her and calm her brain. I put her on an elimination diet

studies have shown that the kids who spend the most time on the Internet have the poorest social skills. Balance and supervision are the biggest keys. I have become more concerned recently about a child’s exposure to how computer and TV screens flash (or refresh themselves). If you look at some computer monitors or television screens through a video camera, you will see black lines quickly roll across the screen. TV and computer screens flash at different speeds, up to thirty flashes or cycles per second. Interestingly, this speed of flashing is similar to a concentration brain state. Your brain gravitates to that rhythm, and you tune in to whatever is drawing your attention—forced focus, so to speak. “Entrainment” is the technical term of this phenomenon: Your brain picks up the rhythm in the environment. So if a light (or TV) flashes at a slow rate, one’s brain picks up the slow rate and that person feels sleepy. If it flashes at a fast rate, you may feel energized or anxious. If your brain picks up a concentration flashing rate, you will focus on the TV or computer screen, even though you may not be at all interested in what’s on it. Have you ever had the experience of watching TV even though you didn’t want to—the feeling of being mesmerized or compelled to watch, even though you were bored with what was on? I have. One example of mass entrainment occurred in late 1997 in Japan. Tens of thousands of Japanese children were watching the top-rated Nintendo cartoon Pokémon...

have also seen other factors involved in causing ADD. One of the most common is unrecognized head injury, especially to the front part of the brain. In my experience, many professionals and parents discount or ignore the impact of head injuries. They think that a person needs to have a significant loss of consciousness for a prolonged period of time in order for it to do damage. Our brain imaging work, as well as the work of others, is disproving this notion. More on head

OF OXYGEN OR TOXIC EXPOSURE When the brain is exposed to a lack of oxygen or some toxic substance, it is much more likely to show symptoms of ADD. Lack of oxygen can happen with premature babies who have underdeveloped lungs, babies born with the cord wrapped tightly around their necks, and individuals after a drowning accident. Lack of

MEDICAL PROBLEMS, MEDICATIONS Certain medical problems, such as thyroid disease, can look like ADD. An overactive thyroid gland may look like Type 1 ADD (feeling hyperactive and inattentive), while an underactive thyroid may look like Type 2 ADD (feeling lethargic and inattentive) or Type 5 Limbic ADD (sad, lethargic, and unfocused). Likewise, certain medications, such as asthma medications, can make people feel and

and judgment seem better. Love is a drug. Research studies have shown that romantic love works in the same part of the brain as cocaine and Ritalin, boosting dopamine availability. In my experience, when my ADD patients have a deep

www.saveonlabs.com. 1. Vitamin D, zinc, and ferritin (blood test). ADD is thought of as a lack of dopamine being released from brain cells to help nerve cell communication. Inadequate amounts of or poor messages from dopamine are felt to lead to the difficulties with inattention, hyperactivity, and impulsiveness. Many of the medications for ADD are thought to slow the body’s recycling of dopamine between neurons, and make more dopamine available for use. One step that limits the amount of dopamine that is made by cells is controlled by a protein (called an enzyme) called tyrosine hydroxylase. One thing tyrosine hydroxylase needs to function well is enough iron. Approximately 80 percent of the global population is iron deficient. Another thing needed to encourage DNA to make the tyrosine hydroxylase protein is vitamin D. In northern climates, vitamin D deficiency is being considered an epidemic. In addition, zinc is needed to help vitamin D bind to DNA and prompt production of the tyrosine hydroxylase

TYPE 3: OVERFOCUSED ADD SPECT findings: At rest and during concentration there is increased activity in the anterior cingulate gyrus. During concentration there is also decreased activity in the underside of the prefrontal cortex, cerebellum, and basal ganglia. Primary symptoms: inattentive, trouble shifting attention, frequently get stuck in loops of negative thoughts or behaviors, obsessive, excessive worrying, inflexible, frequent oppositional and argumentative behavior. May or may not be hyperactive. This pattern tends to be seen more commonly in children and grandchildren of alcoholics. For personal reasons, families with alcohol-abuse histories were my research interest during training. This is a pattern I discovered within my first year of doing SPECT

5: LIMBIC ADD SPECT findings: At rest there is increased deep limbic activity (thalamus and hypothalamus). During concentration there remains increased deep limbic activity and now there is also decreased activity in the prefrontal cortex, cerebellum, and basal ganglia. Primary symptoms: inattentive, easily distracted, disorganized, chronic low-grade sadness or negativity, “glass half empty syndrome,” low energy, tends to be more socially isolated, and frequent feelings of hopelessness and worthlessness. May or may not be hyperactive. Some people say that Limbic ADD is really a combination of ADD and depression. That may be so, but we see this combination very frequently in our ADD patients and it leads us to specific treatments that seem best for this type.

RING OF FIRE ADD SPECT findings: At rest and during concentration (often worse during concentration) there is patchy increased uptake across the cerebral cortex with focal areas of increased activity, especially in the left and right parietal lobes, left and right temporal lobes, and left and right prefrontal cortex. In addition there is often increased activity in the cingulate gyrus. Primary symptoms: inattentive, easily distracted, irritable, overly sensitive, cyclic moodiness, and oppositional. May or may not be hyperactive. Many of our younger “difficult cases” had this pattern in the brain. Initially, I thought it was related to perhaps an early bipolar pattern. While that may be true, it is more complex and it can also be related to infections, allergies, or inflammation. It is important to note here that young children naturally have very busy brains and this pattern has to be adjusted for age.

CHAPTER 6 Type 1: Classic ADD Common symptoms include: Being easily distracted Difficulty sustaining attention span for most tasks in play, school, or work Trouble listening when others are talking Difficulty following through (procrastination) on tasks or instructions Difficulty keeping an organized area (room, desk, book bag, filing cabinet, locker, etc.) Trouble with time, e.g., is frequently late or hurried, tasks take longer than expected, projects or homework are “last- minute” or turned in late Tendency to lose things Making careless mistakes, poor attention to detail Forgetfulness Being restless or hyperactive Trouble sitting still Being fidgety, in constant motion (hands, feet, body) Being noisy, having a hard time being quiet Acting as if “driven by a motor” Talking excessively Being impulsive (doesn’t think through comments or actions before they are said or done) Having difficulty waiting his or her turn Interrupting or intruding on others (e.g., butts into conversations or games). When

on the brain. She injected these substances tagged to a radioactive isotope and watched where they worked in the brain. Both methylphenidate and cocaine worked in the same area of the brain: the head of the caudate nucleus in the basal ganglia (a structure deep in the brain). This is the same area found to be underactive in a number of ADD studies and may be one of the reasons many ADD adults abuse cocaine and methamphetamines. Dr. Volkow concluded in her study that the reason cocaine is addictive and methylphenidate is not is that cocaine is taken up very quickly in the basal ganglia, has a much more powerful effect in releasing dopamine (a high sensation), and is gone quickly (leading to withdrawal). Methylphenidate, on the other hand, is taken up much more slowly, has a weaker effect, and stays around longer (no withdrawal). The caudate nucleus appears to be an important brain structure in psychiatry, and is involved in motivation, attention shifting, and anxiety control. When it is overactive, people have a tendency to be overfocused or obsessive. When it is underactive, people have trouble paying attention. There are many connections between the basal ganglia and prefrontal cortex. When there is low basal ganglia activity, there is not enough dopamine being produced to drive the prefrontal cortex. The result is primary ADD symptoms. As I

CHAPTER 7 Type 2: Inattentive ADD Common symptoms include: Being easily distracted Difficulty sustaining attention span for most tasks in play, school, or work Trouble listening when others are talking Difficulty following through (procrastination) on tasks or instructions Difficulty keeping an organized area (room, desk, book bag, filing cabinet, locker, etc.) Having trouble with time, for example, frequently late or hurried, tasks take longer than expected, projects or homework are last-minute or turned in late Having a tendency to lose things Making careless mistakes, poor attention to detail Being forgetful Daydreaming excessively Complaining of being bored Appearing apathetic or unmotivated Being tired, sluggish, or slow moving Appearing spacey or preoccupied The second most common type of ADD is Type 2: Inattentive ADD. Unfortunately, many of these people never get diagnosed. Instead they are labeled slow, lazy, spacey, or unmotivated.

CHAPTER 8 Type 3: Overfocused ADD ADD core symptoms plus: Excessive or senseless worrying Oppositional, argumentative Strong tendency to get locked into negative thoughts, having the same thought over and over Tendency toward compulsive behaviors Tendency to hold grudges Trouble shifting attention from subject to subject Difficulties seeing options in situations Tendency to hold onto own opinion and not listen to others Tendency to get locked into a course of action, whether or not it is good for the person Needing to have things done a certain way or you become very upset Others complain that you worry too much

anterior cingulate gyrus a certain cognitive inflexibility is present. This can present as many different symptoms, but the underlying mechanism, trouble shifting attention, remains. The symptom list at the beginning of the chapter is a compilation of what we have seen in these patients. The anterior cingulate area of the brain is heavily innervated with serotonin neurons. We have also found that serotonergic medications seem to be the most helpful in this disorder.

going to improve. Given her poor prior response to medication, the parents and I initially decided to try an herbal approach to treatment. I placed her on St. John’s Wort (a serotonin booster) and had her engage in a daily exercise program. In addition, her parents had to learn to be very firm and prevent her from arguing or opposing them. It took two months for all of the interventions to work together, but they had a significant positive impact on her behavior and academic ability. Mark

4: Temporal Lobe ADD ADD core symptoms plus: Memory problems Learning problems Auditory processing issues Irritability Periods of quick temper with little provocation Misinterprets comments as negative when they are not Irritability tends to build, then explodes, then recedes, often tired after a rage Periods of spaciness or confusion Periods of panic and/or fear for no specific reason Visual changes, such as seeing shadows or objects changing shape Frequent periods of déjà vu (feelings of being somewhere before even though you never have) Sensitivity or mild paranoia Headaches or abdominal pain of uncertain origin History of a head injury Dark thoughts, may involve suicidal or homicidal thoughts

5: Limbic ADD ADD core symptoms plus: Moodiness Negativity Low energy Frequent irritability Tendency to be socially isolated Frequent feelings of hopelessness, helplessness, or excessive guilt Lowered interest in things that are usually considered fun Sleep changes (too much or too little) Chronic low self-esteem Type 5: Limbic ADD is where ADD and depression intersect each other. The ADD core symptoms are present in addition to negativity, moodiness, sadness, low energy, and decreased interest in life. On SPECT we see decreased prefrontal cortex activity both at rest and during a concentration task and we see too much activity in the deep limbic or emotional center of the brain. Depression on SPECT

center of the brain). Barry was placed on DL-phenylalanine and L-tyrosine, the amino acid building blocks for norepinephrine and dopamine, the two neurotransmitters

6: Ring of Fire ADD ADD core symptoms plus: Sensitive to noise, light, clothes, or touch Cyclic mood changes (highs and lows) Inflexible, rigid in thinking Demanding to have their way, even when told no multiple times Periods of mean, nasty or insensitive behavior Periods of increased talkativeness Periods of increased impulsivity Unpredictable behavior Grandiose or “larger than life” thinking Talks fast Appears that thoughts go fast Appears anxious or fearful Irritability, especially when things do not go your way

7: Anxious ADD ADD core symptoms plus: Frequently anxious or nervous Physical stress symptoms, such as headaches Tends to freeze in social situations Dislikes or gets excessively nervous speaking in public Predicts the worst Conflict avoidant Fear of being judged Over the last thirteen years, I have noticed more and more the combination of ADD and anxiety symptoms running together; and when they do, the ADD symptoms become magnified. In looking at our large dataset of patients, it is very common to see the core ADD symptoms plus fear of being judged, predicting the worst, being conflict avoidant, and having physical stress symptoms, such as headaches and stomachaches. In addition, people with this type tend to freeze in anxiety-provoking situations, especially where they may be judged, such as in test taking.

clinic because we had seen her brother, who had the Classic ADD type. Clarice did very well on a combination of relaxation strategies, physical exercise, and the supplements magnesium and theanine,

brain. Using functional brain imaging studies, he looked at brain activity while people were thinking about something neutral, something positive, and something awful. The neutral thoughts did not change brain activity. The positive thoughts actually cooled overall brain activity, especially in the limbic area of the brain (certainly not good for ADD folks who have poor brain activity). The negative thoughts brought overall brain activation, especially in the limbic areas (making them more depressed) and in the prefrontal cortex (helping them focus). Clinically, I have seen that many ADD people seem to be experts at picking out the most negative thoughts possible and staying focused on them for prolonged periods of time. It is almost as if they need the negativity to have the mental energy to get work done. When I started

Make sure you get plenty of water every day. To know you are drinking enough water for your brain, a good general rule is to consume half your weight in ounces per day, unless there is significant obesity, and then usually not more than 120 ounces a day. Rule #3. Eat high-quality, lean protein throughout the day. Protein helps balance your blood sugar, helps you focus, and provides the necessary building blocks for brain health. Great sources of protein include fish, skinless turkey or chicken, beans, raw nuts, and high-protein vegetables such as broccoli

#4. Eat smart carbohydrates (low glycemic, high fiber). This means eat carbohydrates that do not spike your blood sugar (low-glycemic index), that are also high in fiber, such as vegetables, and fruits like blueberries and apples. Carbohydrates per se are not the enemy; they are essential to your life. But bad carbohydrates are the enemy, substances that have been stripped of

Focus your diet on healthy fats. Fat is not the enemy. Good fats are essential to your health. The solid weight of your brain is 60 percent fat (after all the water is removed). When the medical establishment recommended we remove fat from our diets, we got fat. However, bad fats, such as trans fats, are the enemy, and should be eliminated. Did you know that certain fats found in pizza, ice cream, and cheeseburgers fool the brain into ignoring the signals that you should be full? No wonder I used to always eat two bowls of ice cream and eight slices of pizza. Focus your diet on healthy fats, especially those that contain omega-3 fatty acids, found in foods like salmon, sardines, avocados, walnuts, flaxseed, chia seed, and dark green leafy vegetables. Rule #6. Eat from

Cook with brain-healthy herbs and spices to boost your brain. Here is a little food for thought, literally. Turmeric, found in curry, contains a chemical that has been shown to decrease the plaques in the brain thought to be responsible for Alzheimer’s disease. In three studies, a saffron extract was found to be as effective as antidepressant medication in treating people with major depression. There is good scientific evidence that rosemary, thyme, and sage help boost memory. Cinnamon has been shown to help attention and blood sugar. It is high in antioxidants and is a natural aphrodisiac. Garlic and oregano boost blood flow to the brain. Ginger, cayenne, black pepper—their hot, spicy taste comes from gingerols, capsaicin, and

FOODS WITH THE HIGHEST LEVELS OF PESTICIDE RESIDUES Celery Peaches Strawberries Apples Blueberries Nectarines Cucumbers Sweet Bell Peppers Spinach Cherries Collard Greens/Kale Potatoes Grapes Green beans SEVENTEEN FOODS WITH THE LOWEST LEVELS OF PESTICIDE RESIDUES Onions Avocado Sweet Corn (Frozen) Pineapples Mango Asparagus Sweet Peas (Frozen) Kiwi Fruit Bananas Cabbage Broccoli Papaya Mushrooms Watermelon Grapefruit Eggplant Cantaloupe Fish

and Seeds Almonds, raw—for protein, healthy fats, and fiber Brazil nuts—great source of zinc, magnesium, thiamine; high in selenium, healthy fat, and fiber Cacao, raw—loaded with antioxidants and high in flavonoids (substances shown to increase blood flow), magnesium, iron, chromium, zinc, copper, and fiber. Can help decrease cravings and balance blood sugar, plus it can make you happy by stimulating serotonin, endorphins, and phenylethylamine (PEA). (But eat only a small amount of dark chocolate or it will turn into fat) Cashews—rich in phosphorus, magnesium, zinc, and antioxidants Chia seeds—very high in plant-based omega-3 fatty acids, fiber, and antioxidants Coconut—high in fiber, manganese, and iron; low in natural sugars; high in medium chain triglycerides shown to be helpful for brain tissue Hemp seeds—high in protein, contain all essential amino acids and fatty acids; high in omega-3s and healthy 6s, including 6 GLA, which has anti-inflammatory properties; also high in fiber and vitamin E Sesame seeds—high in fiber, help stabilize blood sugar and lower cholesterol. Good source of calcium, phosphorous, and zinc Walnuts—of all nuts, contain the most omega-3 fatty acids to help lower bad cholesterol and may reduce inflammation. Great source of antioxidants, vitamin E, selenium, and magnesium Legumes (small amounts) Lentils—for fiber Chickpeas—for their high serotonin content (good for Type 3 [Overfocused] ADD) Fruits Acai berries—for fiber, omega-3s, antioxidants, min...

due to deficiencies of the neurotransmitter dopamine. I frequently prescribe the amino acid L-tyrosine in doses of 500 to 1500 milligrams two to three times a day for adults and 100 to 500 milligrams two to three times a day for children under 10. L-tyrosine is the amino acid building block for dopamine. It is reported to increase the level of phenylethylamine (PEA), a mild stimulant that is found in higher concentrations in chocolate. Many of my patients have reported that it is helpful for them. It is softer in its effect, but nonetheless they notice a positive effect. Because of absorption patterns, I recommend that they take it on an empty stomach (a half hour before meals or an hour after meals). I have not seen any side effects with L-tyrosine, except for mild weight loss. L-tyrosine does not work well by itself in treating Type 3 (Overfocused) ADD because it tends to increase the intensity of overfocused symptoms. Symptoms of tyrosine deficiency—which leads to low dopamine levels—include hypothyroidism, low blood pressure, low body temperature (cold hands and feet), and restless

(OVERFOCUSED) ADD This type of ADD seems likely due to a relative deficiency of both serotonin and dopamine. I have seen that a combination of St. John’s Wort and L-tyrosine is often very helpful. St. John’s Wort comes from the flowers of the St. John’s Wort plant (wort is Old English for plant). It got its name either from the fact that it blooms around June 24, the feast

John’s Wort seems to be best at increasing serotonin availability in the brain. The starting dosage of St. John’s Wort is 300 milligrams a day for children, 300 milligrams twice a day for teens, and 600 milligrams in the morning and 300 milligrams at night for adults. Sometimes I’ll go as high as a total of 1800 milligrams a day in adults. The bottle should say that it contains 0.3 percent hypericin, which is believed to be the active ingredient of St. John’s Wort. I have done a number of before and after

(LIMBIC) ADD Limbic ADD has many symptoms of mild depression, including negativity, sadness, feelings of hopelessness, and an overabundance of ANTs (automatic negative thoughts). Frequently I have seen stimulants make people who have this type of ADD more negative and moody. The supplements that seem to help this type of ADD best are DL-phenylalanine (DLPA), L-tyrosine, and S-Adenosyl-Methionine (SAMe). DLPA is the amino acid precursor for norepinephrine. In a number of studies norepinephrine and epinephrine (adrenaline) have been shown to be low in ADD and depression. The antidepressants imipramine, desipramine, and a new one, Reboxitine, work by increasing norepinephrine in the brain. DLPA, by boosting norepinephrine’s precursor, can have a positive impact on mood and focus. In fact, in a number of studies DLPA has been found to be helpful for depression, energy, and pain control. I have used it for fifteen years as a mild antidepressant in children, teens, and adults. It is more mild in its effect than prescribed antidepressants, but

have the enzyme that metabolizes it. I recommend doses of 400 milligrams three times a day on an empty stomach, half that

Another effective supplement for treatment of Type 5 ADD is SAMe. Involved with the production of many important brain compounds, such as neurotransmitters, SAMe’s unique chemical action (it’s called a methyl donor, a rare property) helps the brain to function properly. Normally, the brain manufactures all the SAMe it needs from the amino acid methionine. In depression, however, this synthesis has been found to be impaired. Supplementing the diet with SAMe increases the neurotransmitters involved with depression and improves cell membrane fluidity. SAMe is one of the best natural antidepressants available, and a number of recent studies have shown that it is as effective as antidepressant medication. SAMe has also been found helpful for people who suffer from fibromyalgia, a chronic muscle pain disorder. Fibromyalgia and ADD commonly coexist. I think the chronic stress associated with ADD is in part responsible for the

antidepressant, as all of the prescription antidepressants have that capability as well. The dosage of SAMe is between 200 and 400 milligrams two to four times a day, half that for children. TYPE 6 (RING

disorder. Stimulants tend to make it worse. However, we have seen that GABA, 5-HTP, and L-tyrosine, plus fish oil have a positive effect on Type 6 (Ring of Fire) ADD. As discussed, GABA has a calming

TYPE 5 (LIMBIC) ADD Wellbutrin is my favorite medication for Type 5 (Limbic) ADD. Researchers think it works by increasing dopamine. It has also been found to be effective in helping people stop smoking. When Wellbutrin was first released in the United States, a number of people developed seizures on it. It was then pulled from the market in the early 1980s. The manufacturer figured out the dosage pattern was wrong and the FDA allowed them to rerelease it with a different dosage regimen. Do not take more than 150 milligrams at a time of the regular release preparation or 300 milligrams of the slow release preparation. Imipramine is another option for this type. I also use it for anxiety disorders and bedwetting.

TYPE 6 (RING OF FIRE) ADD I typically start with supplements for this type, usually a combination of GABA, 5HTP and L-tyrosine. If I prescribe medication I typically start with one of the anticonvulsants listed under Type 4 ADD, and may add a stimulant medication later on. Stimulants by themselves often make this type worse. When used alone, serotonergic medication also seem to make this type worse. If the anticonvulsants do not seem to work, I may very cautiously use one of the novel antipsychotic medications, such as Risperdal. Often the dosages of the anticonvulsants or antipsychotic medications are much smaller than needed for seizure disorders or psychotic illnesses. In selected cases, the antipsychotic medications can be very effective. Some of my teenage patients have been kept out of the hospital or residential treatment centers using these medications. However, one of the problems with these medications is weight gain. I have a number of patients who have gained twenty to thirty pounds in less than a year. The amazing response to the medication is the only reason I persisted with the medication. The anticonvulsant Topamax is known to promote weight loss in some patients and I have used it successfully in some of my Ring of Fire patients. The blood pressure medicines guanfacine and clonidine can also be helpful. These tend to calm overall hyperactivity seen in this

ADD In Limbic ADD there is decreased activity in the left prefrontal cortex and increased activity in the deep limbic areas. Since the deep areas are too deep in the brain to do neurofeedback training, we have found that teaching the patient to increase beta activity over the left prefrontal