Ring of Fire ADHD is one of the seven types of ADHD identified by Dr. Daniel Amen. This type of ADHD is characterized by a pattern of overall heightened brain activity, which has been identified on brain SPECT imaging. Symptoms of ring of fire ADHD include typical symptoms of ADHD and feeling overwhelmed by thought or emotion, rapid speech, racing thoughts, and irritability.
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What Is Ring of Fire ADD?
Dr. Amen is a psychiatrist who has used brain SPECT imaging to name seven types of ADHD, including ring of fire ADHD. Using this imaging, Dr. Amen observed increased activity in many parts of the brain, which looks like a ring on SPECT imaging.1 Dr. Amen describes this type of ADHD as having sensory sensitivities, irritability, rapid and increased speech, and racing thoughts.
Here are Dr. Amen’s seven types of ADD:
- Classic ADD
- Inattentive ADD
- Over-Focused ADD
- Temporal Lobe ADD
- Limbic ADD
- Ring of Fire ADD (“ADD plus”)
- Anxious ADD
Ring of Fire ADD Vs. Ring of Fire ADHD
When describing the seven types of ADHD, Dr. Amen uses the term ADD instead. According to Dr. Amen, not all types of ADHD have hyperactivity, which is why ADD is used instead.1 ADD is an outdated term because the current diagnostic manual, the DSM-5, uses the term ADHD. Most people in the mental health field use ADHD as the most up-to-date term.
How Is the Ring of Fire Detected?
Ring of fire ADHD was defined by the ring pattern noted on SPECT scan. A SPECT scan is a nuclear imaging test that uses a radioactive tracer that can reveal the level of blood flow in various organs.2 Using a SPECT scan on the brain and looking at this blow flow can evaluate parts of the brain that are underperforming, overperforming, or working as they should.3
Dr. Amen believes that by using SPECT imaging, treatment can be more targeted by tailoring it to the specific subtype of ADHD that an individual has. Using brain imaging to diagnose ADHD is still cautioned against by many professionals, and a thorough evaluation of symptoms is needed to diagnose ADHD correctly. One reason for this is that other mental health concerns may overlap with what is observed on brain imaging; for example, depression may also lead to deficits in attention.4
Ring of Fire ADD Symptoms
Individuals with ring of fire ADHD have heightened activity in many parts of the brain, according to brain imaging SPECT scans completed by Dr. Amen. Symptoms of this type of ADHD include more common symptoms of ADHD as well as symptoms specific to this subtype. This type of ADHD is sometimes referred to as “ADD plus” due to being “the most intense of the 7 types of ADD”.5
Common symptoms of ring of fire ADD include:
- ADHD racing thoughts
- Sensory overload
- Rejection sensitive dysphoria
- Emotional dysregulation
- Impulsivity
- Irritability
- Rapid speech
- Times of increased talkativeness
- Inflexible thinking
- Appearing anxious
Ring of Fire ADD Causes
Many people describe ADHD as a type of neurodivergence. Dr. Amen, however, believes ring of fire ADHD may be due to allergy, infection, or inflammation in the brain.1 Further research needs to be done to investigate this stance and confirm the role that inflammation may play in ADHD.
Some research indicates that having ADHD may cause someone to have a lower threshold for stress, therefore increasing inflammation as a result of stress. Whereas other research makes the case that inflammation has a negative impact on brain structures that then leads to the development of ADHD.10 Whether inflammation is the cause or the consequence of ADHD, it is well established that reducing inflammation helps prevent many diseases.
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Ring of Fire ADD Vs. Bipolar
Ring of fire ADHD and bipolar disorder may appear to have an overlap in symptoms, but there are key differences between the two. Some of the commonalities between them are racing thoughts, rapid speech, impulsivity, and mood changes. Differences between ADHD and bipolar disorder can be observed both in brain imaging data and symptom presentation.1
Behavioral difficulties tend to remain consistent with ring of fire ADHD whereas with bipolar, these symptoms cycle in correlation with mood. Bipolar disorder is also characterized by manic or hypomanic episodes, which is not present in ring of fire ADHD. It is possible for an individual to have both; recent data has revealed that 1 in 13 adults with ADHD also had bipolar and 1 in 6 adults with bipolar were also diagnosed with ADHD.8
Is Ring of Fire ADD an Official Diagnosis?
Ring of fire ADHD is not an officially recognized diagnosis by the medical and mental health community. Although Dr. Amen has identified 7 types of ADHD; they are not recognized as formal diagnoses in the current DSM-5, which lists criteria for diagnosis. The currently recognized diagnosis is ADHD and its 3 subtypes: inattentive, hyperactive/impulsive and combined. If an individual has the symptoms of ring of fire ADHD, they would most likely meet criteria for ADHD and would need to be evaluated by a mental health professional to determine this.
Ring of Fire ADHD Treatment
Treatment for this type of ADHD is tailored to the specific needs that arise from their symptoms. For example, stimulant medication is often used for ADHD but Dr. Amen believes that stimulant medication alone can make ring of fire ADHD worse, due to the brain already being overstimulated.9 Treatment recommendations for this type of ADHD include supplements, exercise, certain medications as needed, and therapy to challenge automatic negative thoughts.5
Treatment options that Dr. Amen recommends for ring of fire ADHD include:
- Elimination diet: Because this type of ADHD is believed to be due to an allergy or inflammation, an elimination diet can help identify the allergen, according to Dr. Amen.
- Supplements: A variety of supplements are recommended by Dr. Amen, such as L-tyrosine, 5-HTP, and GABA, to boost the neurotransmitters serotonin and GABA.6 Omega-3 fatty acids may also be recommended as they have been shown to be helpful for some ADHD symptoms.7
- Exercise: Exercising for 30-45 minutes daily is recommended to individuals with ring of fire ADHD.5
By incorporating exercise and being active regularly, the goal is to use physical activity to decrease hyperactivity. - Medication: Dr. Amen recommends anticonvulsants and blood pressure medications, as he believes they help “calm overall hyperactivity”.5
Treatment options for severe combined ADHD include:
- Cognitive behavioral therapy (CBT): CBT for ADHD can help with negative thinking patterns that an individual may have, as well as behavior modification such as learning time management, organization skills, social skills, and more.
- Medication for ADHD: A variety of medications for ADHD may be used, with stimulants being the most widely prescribed for ADHD. Stimulants work by acting on the neurotransmitter dopamine and norepinephrine in the brain and helping to regulate attention. Other medications such as non-stimulants and antidepressants may be prescribed as well.
- Natural remedies for ADHD: Some individuals may choose natural remedies for ADHD as well, such as supplements, exercise, mindfulness, or dietary changes.
When to Seek Professional Support
No matter the type of ADHD an individual has, seeking professional support is important in helping manage symptoms of ADHD. A professional can help you sort out which treatment route you would like to take, whether it be medications, therapy, or natural remedies. Using an online therapist directory or online therapy platform can help you start your search, by filtering for providers who specialize in ADHD. Searching for someone who specializes in ADHD can help you find a neurodiverse affirming therapist who is well-versed in both the challenges and strengths that come with ADHD.
In My Experience
In my experience, finding a trusted support team who can help you overcome the challenges that come with ADHD is an important step, no matter the type of ADHD. By working with a team of professionals, they can help tailor treatments to what you need specifically, as described above with ring of fire ADHD. Life with ADHD can be fulfilling, manageable, and enjoyable, even if things seem overwhelming right now.
Additional Resources
To help our readers take the next step in their mental health journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy is compensated for marketing by the companies included below.
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