Ring of Fire ADD is a proposed subtype of ADHD characterized by a distinctive “ring of fire” pattern of increased brain activity seen on SPECT scans.
Single-photon emission computed tomography (SPECT) imaging is a type of imaging test used to identify variations in brain activity and blood flow.
For people with attention deficit hyperactivity disorder (ADHD), SPECT imaging can play an important role in identifying distinct brain activity patterns and aiding in diagnosis and treatment planning.
Dr. Daniel Amen, a well-known psychiatrist and brain imaging specialist, has used SPECT imaging to categorize ADHD into seven distinct types. One of these types is Ring of Fire ADD, characterized by widespread and persistent overactivity in the brain.
Ring of Fire ADD is one of seven distinct types of ADHD, as proposed by Dr. Daniel Amen, a psychiatrist and brain imaging specialist.
It’s named after the distinctive brain activity pattern observed in SPECT scans, resembling a “ring of fire.”
Ring of Fire ADD is characterized by a wide range of severe and often unpredictable symptoms stemming from generalized overactivity across the brain. Symptoms include:
- sensitivity to sensory stimuli (noise, light, touch)
- rapid speech
- often challenging behaviors
The 7 types of ADD
Amen details the seven types of ADD in his book “Healing ADD.” The seven types based on brain SPECT scans are:
- classic ADD
- inattentive ADD
- over-focused ADD
- temporal lobe ADD
- limbic ADD
- ring of fire ADD
- anxious ADD
It’s important to note that Amen’s classification system for ADHD is a subject of debate within the academic community. More research is needed to validate these subtypes.
Why use ADD instead of ADHD?
Amen uses the term “ADD” to emphasize the inattentive aspect of the condition, recognizing that not all subtypes of attention-related disorders involve hyperactivity. This approach allows for a more nuanced classification of different patterns of symptoms and brain activity.
However, it’s worth noting that most medical professionals and diagnostic criteria now use “ADHD” to encompass both inattentive and hyperactive-impulsive presentations, recognizing that symptoms can vary across individuals.
Ring of Fire ADD is not an officially recognized subtype of ADHD in mainstream psychiatry. It could not be diagnosed when following the gold standard of diagnostic criteria, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
Diagnosing ADHD typically involves clinical evaluation based on established diagnostic criteria, and these subtypes aren’t part of the standard diagnostic process.
According to Amen’s description, Ring of Fire ADD is characterized by a broad range of severe and often unpredictable symptoms.
Some of these symptoms may include:
- unpredictable and challenging behavior
- sensitivity to touch, noise, light, or clothing
- cyclic mood changes from high to low and back
- rigid, inflexible thinking
- oppositional defiance
- periods of behavior that may include mean, nasty, or insensitive comments, increased talkativeness, or increased impulsivity
- demanding things be a certain way
- grandiose thinking
- rapid speech and racing thoughts
Ring of Fire ADD can sometimes be mistaken for bipolar disorder due to similar symptoms, particularly in children.
Both conditions can involve irritability, impulsivity, and aggressiveness. However, they differ in the consistency of these symptoms over time.
Bipolar disorder often presents with episodic, intense changes in mood, with periods of extreme symptoms followed by more typical periods. In contrast, Ring of Fire ADD symptoms tend to be more consistent.
It’s possible for someone to have both disorders simultaneously, but it’s crucial to distinguish between them to provide appropriate treatment tailored to each condition.
The “ring of fire” pattern observed on SPECT scans has been associated with increased brain activity throughout the cerebral cortex and various brain regions.
According to Amen Clinics, this overactivity is believed to be linked to inflammation, infection, or allergies. Ring of Fire ADD may also be related to bipolar disorder.
Possible contributors include prenatal factors like:
- viral infections
- maternal smoking
- maternal obesity and gestational diabetes
- nutrient deficiencies
- alcohol exposure
According to Amen, traditional stimulant medications can worsen symptoms of Ring of Fire ADD.
Treatment often involves:
Ring of Fire ADD is one subtype of ADHD identified by psychiatrist Dr. Daniel Amen. It’s characterized by a pattern of overactivity throughout the brain, leading to a range of challenging symptoms.
None of Amen’s subtypes are currently recognized in the DSM-5-TR and require more research. However, his approach highlights the complexities of ADHD and the need for personalized treatment strategies.