View Full Version : Ring of Fire


mbj0680
02-22-07, 11:54 AM
Does anyone out there know anything about the 'Ring of Fire' ADHD subtype? I have ADHD subtypes 1,2,3,4, and 6. The Ring of Fire is type 6. I haven't heard much about that one. Can someone lead in the right direction for more research please. I would appreciate any help or advise.

Thanks,

-Mark

lurker
02-24-07, 10:12 PM
Hey Mark, the subtypes you mention are from Dr Daniel Amen's own model of ADHD. I find it a useful way of understanding ADHD especially since it covers symptoms that are not always given enough attention (pun not really intended) in the DSM etc, but as far as I know no one else uses it so there isn't much out there apart form his own literature
The ring of fire subtype:
Individuals with "Ring of Fire" often do not respond to psychostimulant medication. Sometimes these medications will make symptoms worse. Symptoms include oppositional behavior, irritability, temper problems, mood swings and distractibility.

Andrew
02-24-07, 10:41 PM
Try this thread that discusses subtypes
http://www.addforums.com/forums/showthread.php?t=31774&highlight=ring+fire

mbj0680
02-26-07, 10:02 AM
Thanks Andrew and Lurker. I appreciate the info. I have seen two seprate doctors. One was a psychologist and the other a psychiatrst. They both used Dr Amen's materal as standard. Is Dr Amen the standard for ADHD?

-MJ

jeaniebug
02-26-07, 12:10 PM
Thanks Andrew and Lurker. I appreciate the info. I have seen two seprate doctors. One was a psychologist and the other a psychiatrst. They both used Dr Amen's materal as standard. Is Dr Amen the standard for ADHD?

-MJHe's been considered "fringe" for quite some time. However, in his latest book, Hallowell (Delivered from Distraction) went to visit Dr. Amen and had his own brain scanned. He found he had early signs of pre-alzheimers condition, which he is getting treatment for. Hallowell also said his group would be partiipating in an upcoming clinical study jointly with the Amen clinic. So I would say this is a huge leap forward into the "standard."

Dr. Amen has always approached ADD from a very different starting place, the SPECT scan, and he has done so many thousands of scans at this point, and had good success with diagnosis and treatment, the ADHD world has been forced to acknowledge that his methods and findings are valid.

There has been lots of controversy. His (Dr. Amen's) book "Healing ADD" is great, and he discusses all the politics and controversy he stirred up (although not intentionally) in a straight forward manner. Plus his book has lots of pictures of brain scans, which I think are cool. "This is your brain on ADD, this is your brain on (the correct) medication. And a picture is indeed worth a thousand words.

I think reading work from many different doctors has advantages, though. So while I like Amen's stuff, I still look at other sources as well.

mbj0680
02-26-07, 01:02 PM
jeaniebug,

Great input. What other sources would you suggest? I am a researcher and want to look deeper into all of this. I was not aware that my version of ADHD was this bad. Bad maybe the wrong term, complex might be a better word to use.

-MJ

jeaniebug
02-26-07, 04:12 PM
jeaniebug,

Great input. What other sources would you suggest? I am a researcher and want to look deeper into all of this. I was not aware that my version of ADHD was this bad. Bad maybe the wrong term, complex might be a better word to use.-MJI'm glad you liked it. I have also read Hallowell Rateys "Driven to Distraction" and "Delievered from Distraction." Both Hallowell and Ratey are Harvard educated Doctors and both of them have ADHD.

Here is a little excerpt from Amen's book re: Ring of Fire. I think members of my family may have this, and this is from a PM I shared with another member. Remember not everyone with Ring of Fire ADHD has all of these symptoms:

(quote) p. 143. "Jarred" s a textbook example of ring of fire (ROF) ADHD. He has all the hallmark symptoms, including irritability, hyperactivity, excessive talking, overfocus, extreme oppositional behavior and cyclic periods of calm alternating with intense aggressiveness.

Stimulants such as Ritalin make ROF paitents more worried, more irratible and more negataive. ROF ADHD is often helped with either anticonvulsant medication or new antipyschotic medications such as Risperdal or Zyprexa. A high protein, low carb diet is often helpful. THe amino acid GABA often has an overall calming effect. SSRI antidepressants like prozac or zoloft often make this type much worse.

THis is the most intense type of ADHD. .... Ring of fire ADHD can be difficult to differentiate from bipolar disorder. Bipolar tends to be cyclic, ROF tends to have problems on a more consistent basis. .... People can have both....

RX: Dr. Amen prescribes Risperdal and ritalin, sometimes together, in another case, Depakote and adderall. He also mentions zyprexa.

Core symptoms: angry, aggressive, inflexible or rigid, insists on having their own way, insensitive, unpredictable, possible grandiose "larger than life" thinking, etc. etc. (end quote)

I don't know if this sounds like you or not. As he said, ROF can be hard to distinguish from bipolar. Since I myself am bipolar, I might disagree with those comments, since I am not angry, aggressive or insensitive, inflexible or rigid. I do not insist on having my own way either. Perhaps he is talking about bipolar type I.

On Dr. Amens' ADHD test, I scored as a type 2 (inattentive) and a type 5 (limbic).

Have you completed his checklist at your doctor's office?

http://www.addresources.org/article_checklist_amen.php (http://www.addresources.org/article_checklist_amen.php)


I also love Dr. Thomas Brown's little video clips:

http://www.drthomasebrown.com/resources/index.html (http://www.drthomasebrown.com/resources/index.html)


Good luck! :p

mbj0680
02-26-07, 05:05 PM
On Dr. Amens' ADHD test, I scored as a type 2 (inattentive) and a type 5 (limbic).

Have you completed his checklist at your doctor's office?
Yes, I am a 1,2,3,4, and 6. Kinda funny. The doctor asked me if I had ever had any head injuries before...

We are trying some meds now and will see how they go.

-MJ

inquisitive
02-27-07, 11:36 PM
someone once said something about someone they knew having the "Ring of Fire" ADHD to me, and I assumed they were using it as an expression for their ADHD being of a really 'bad' case.

thank you for posting this as it has cleared it up for me too :)

xbeejx
03-12-07, 06:10 AM
I got sucked right in from that book, all he is doing is applying labels to labels that already exist that are themselves essentially meaningless

http://www.quackwatch.org/06ResearchProjects/amen.html

astroellij
03-12-07, 11:14 AM
I found reading Dr Amens stuff very helpful, I came across a summarized version which I will paste up.

In "Healing ADD” Dr. Amen lists the six types of ADD as 1) Classic hyperactive, 2) Inattentive, 3) Over focused, 4) Temporal, 5) Limbic, and 6) Ring of Fire.

Each of these types has much in common, but also differences in symptoms and treatment.

All of the types of ADD have as their primary feature periodic impairment of the prefrontal cortex of the brain and dopamine involvement.

Classic ADD is characterized by both hyperactivity and inattentiveness. It is usually quite easy to treat by a combination of a high protein diet, aerobic exercise, a stimulant such as Adderall or Ritalin, and possibly the supplement of L-Tyrosine. Often an anti-depressant is used as well.

Inattentive ADD lacks the hyperactivity, but people who suffer from it have a difficult time focusing and are often very scattered. As with the classic type the prefrontal cortex is involved. The treatment for inattentive ADD is usually exactly the same as the classic type.

Overfocused ADD exhibits the same problems and symptoms of prefrontal cortex as with classic and inattentive ADD, but the difference is that the sufferer of over focused often cannot break away from a thought or behavior. This is because the cingulate system of the brain is overactive and often locks a person into self-destructive, negative, or repetitive behavior. Often a stimulant will cause temper problems if used alone. Therefore, it is usually helpful to have the person take an anti-depressant first and only later to add the stimulant. Another possible treatment is to use St. Johns Wort, a natural herbal anti-depressant, but it is important not to use both a traditional and an herbal anti-depressant at the same time. The other forms of treatment such as diet and exercise is the same as the first two types of ADD.

Temporal ADD is still characterized by problems with the prefrontal cortex, but the temporal area of the brain is often affected. This could be from a previous head injury, but not necessarily. All the symptoms remain the same, but often extreme bouts of anger are also included. The treatment for this type is usually a stimulant and an anti-convulsant such as Depecote. All other treatment is the same except the following supplements can be used: GABA, Ginkgo Biloba, or Vitamin E.

Limbic ADD is when the limbic area of the brain is also affected in addition to the prefrontal cortex. This type of ADD has the symptoms of inattentive ADD, but a significant amount of depression is also present. A stimulant and an anti-depressant are indicated. Aerobic exercise is needed, but often a complex carbohydrate and protein mixed diet is indicated. The following supplements are used: SAMe or L-tyrosine.

Ring of Fire ADD is a very disorganized and severe form of ADD that is a combination of all the other types. The entire brain is lit up on a SPECT scan. In addition to the standard treatment of a stimulant and an anti-depressant, an anti-psychotic like Respiridal is often called for. Dietary and exercise treatment is the same as in inattentive type. The following supplements are possibly needed: GABA or Omega-3. Other supplements that have been found helpful with ADD in general are Zinc, Flax seed oil, and Serephos.

mbj0680
03-13-07, 11:58 AM
astroellij,

Thanks for the info. Lots of good stuff.

-MJ

watt_the?!
12-26-07, 02:13 AM
im textbook ROF ADD. ive been trying dex for 3 weeks now and all i find is that its a great sleeping agent...in doses up to 25mg at a time... ive had to endure this yoyo effect for this time and now, since its very difficult to get authority for more than 30mg/day dex here, my doc has decided ritaln might be worth a try.

i hope someone here can respond to this and perhaps offer additional insight?

Tim

watt_the?!
12-26-07, 02:19 AM
Yes, I am a 1,2,3,4, and 6. Kinda funny. The doctor asked me if I had ever had any head injuries before...

We are trying some meds now and will see how they go.

-MJi have 3,4,5,6...

im interested in the treatments used especially ones that remove that impulsivity and aggression/opposition.

anyone?

Tim

jamcat95
07-09-08, 02:07 AM
I just got off bn.com and found a book on the 6 types of adhd, don't know it will help.