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ADHD Chatter Podcast

7 Newly Discovered Types Of ADHD (After 300,000 brain scans!)

What if everything you thought you knew about ADHD was only part of the story? In this episode of ADHD Chatter, world-renowned psychiatrist and brain imaging specialist Dr Daniel Amen reveals his controversial theory of 7 different types…

Alex PartridgehostDr. Daniel Amenguest

Nov 10, 202653mWatch on YouTube

Summaries, chapters, transcripts, and FAQs on this page are made by uListen, not YouTube.

CHAPTERS

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Chapter summaries

Why “ADD/ADHD” isn’t one condition: Daniel Amen’s scan-based view
Dr. Daniel Amen explains how his psychiatric work—especially with children—pushed him from thinking ADD was a single condition to believing it has multiple biological patterns. He also shares why he prefers the term ADD and how naming changes in diagnostic manuals affected public understanding.
- •Dr. Daniel Amen describes his background as a psychiatrist and child psychiatrist and how common ADD/ADHD is in his practice
- •He explains his frustration with the shift in terminology toward “ADHD” and why he prefers “ADD”
- •He describes early expectations about what ADD would look like in the brain versus what scans actually showed
- •He introduces the idea that different people show different activity patterns (e.g., decreased vs increased activity, over-focus, trauma-related patterns)
- •Alex Partridge frames the conversation around why understanding different “types” matters
Hyperactive vs non-hyperactive presentations—and what that means for girls
Alex asks whether girls may suppress hyperactivity due to conditioning, and Dr. Amen disagrees based on his experience. He illustrates the contrast using personal stories about his two daughters—one clearly hyperactive, the other inattentive and missed until later.
- •Alex raises the idea that hyperactivity may be suppressed and internalized in girls
- •Dr. Amen says that explanation doesn’t match what he’s seen clinically
- •He shares a vivid example of intense early hyperactivity in one daughter
- •He contrasts this with his other daughter whose struggles weren’t recognized until tenth grade
- •He describes how identifying the inattentive pattern and treating it changed her academic outcomes
How repeated criticism trains the brain to expect rejection
Alex describes the accumulation of comments, eye rolls, and dismissals that many girls with ADHD report, and asks what it does to brain chemistry. Dr. Amen says it heightens emotional reactivity and increases sensitivity to rejection, adding that their brains can become tuned to spot negative cues faster.
- •Alex describes the “tsunami” of negative feedback and nonverbal rejection many people report growing up with ADHD
- •Dr. Amen says late diagnosis often means negative self-talk is already entrenched
- •He links frequent correction (especially for hyperactive kids) with chronic stress and trouble
- •He says this experience heightens the emotional brain and increases rejection sensitivity
- •He describes a clinic test where patients recognize negative faces faster, suggesting learned vigilance for what’s wrong
Rejection Sensitivity Dysphoria (RSD) and the over-focused pattern
Alex introduces RSD and asks if Dr. Amen recognizes it. Dr. Amen agrees it’s real and argues certain scan-based types—especially an over-focused subtype—are more vulnerable because rejection-related thoughts can loop repeatedly and intensify.
- •Alex outlines RSD as heightened pain from perceived criticism or rejection and perfectionism/people-pleasing patterns
- •Dr. Amen says some ADD/ADHD types are more prone to this, especially an over-focused subtype
- •He describes the “gear shifter gets stuck” profile: rigid, inflexible, worried, argumentative, and unable to let go
- •He explains how a single negative comment can replay dozens of times internally
- •He notes stimulants can worsen spinning/obsessive thinking in this subtype, which shapes why medication experiences vary
Relationship fallout: mind-reading, projection, and pushing people away
Alex asks how intense rejection sensitivity can play out romantically. Dr. Amen describes how it can erode both partners’ self-esteem, create chronic stress, and lead to projection dynamics that push others away, while also noting how misinterpreting cues can fuel conflict.
- •Dr. Amen says rejection sensitivity can push partners away and make them feel they can’t do anything right
- •He shares partner-side stress and the challenge of perceived “mind-reading” in relationships
- •He emphasizes that negative cues may have nothing to do with the person interpreting them
- •He teaches the “18, 40, 60 rule” as a reframing tool for social worry
- •He introduces “projective identification,” describing how projecting rejection expectations can shape others’ behavior and strain relationships
Sponsor break: Tiimo
Alex briefly pauses the conversation for a sponsor message about Tiimo. He describes it as a tool to offload tasks and visualize a day plan to reduce the mental load of remembering everything.
- •Alex describes the mental exhaustion of tracking tasks with ADHD
- •He presents Tiimo’s AI co-planner for turning thoughts into tasks and smaller steps
- •He highlights the value of a visual planner for seeing the day clearly
- •He mentions a listener discount and returns to the episode afterward
When rejection feels like physical pain: catastrophic thinking and “killing the ANTs”
Alex shares a story where an ambiguous email triggered catastrophic thoughts, physical pain, and relapse into alcohol use. Dr. Amen connects emotional triggers to pain pathways and explains his method for identifying and challenging automatic negative thoughts to interrupt spirals.
- •Alex recounts a story where a vague request to “chat Monday” triggered panic, physical pain, and drinking
- •Dr. Amen says emotional triggers can activate suffering pathways tied to physical and emotional pain
- •He introduces “ANTs” (automatic negative thoughts) and how they link, stack, and attack
- •He describes a practice: write down the thoughts, then question whether they’re true using a structured set of questions
- •He frames relapse as something to learn from by walking through the process and building better mental management skills
Is RSD measurable—and how trauma history fits into ADHD discussions
Alex asks whether RSD can be seen on scans and whether it belongs in assessment. Dr. Amen says it’s real, suggests questionnaires can help, and links heightened emotional brain activity to adverse childhood experiences, emphasizing that ADHD conversations should include trauma exposure.
- •Dr. Amen says RSD causes significant suffering and is real
- •He says he’s unsure it can be directly identified on scans but suggests questionnaires may detect it
- •He references a large imaging study on childhood trauma showing higher emotional-center activity with higher trauma exposure
- •He argues ADHD discussions should include adverse childhood experiences scoring
- •He discusses heritability and shares an example of how parental ADHD traits can shape family dynamics and recognition
Loneliness, masking, and the broader mental health crisis among young people
Alex connects rejection sensitivity to masking and intellectual loneliness—feeling unseen even in a crowd. Dr. Amen says loneliness risk varies by type and then broadens to a societal issue, citing rates of persistent loneliness and sadness among young people and the role of modern choice overload and devices.
- •Alex describes how people may shift from pursuing their own happiness to trying to keep others happy, creating a mask
- •He defines “intellectual loneliness” as lacking someone to think and connect with authentically
- •Dr. Amen says certain types (over-focused and limbic) are more vulnerable to loneliness than classic presentations
- •He discusses loneliness as a public health crisis and connects it to devices and social media dynamics
- •He suggests untreated ADD can accelerate existing emotional issues even if broader societal factors are also at play
ADHD and suicide: hope, frontal lobe function, and the insula
Alex asks whether suicidal thinking is observable on scans. Dr. Amen describes findings from his published work: lower function in the front part of the brain, low hope scores, and low function in the insular cortex, which he links to agency and risk.
- •Dr. Amen says people in their suicide study tended to have lower frontal lobe function and low hope
- •He describes a HOPE questionnaire and how low scores correlate with low frontal function
- •He says the insular cortex relates to sensing the body and a sense of agency, and low function there increases risk
- •Alex asks what hope means, and Dr. Amen describes agency and pathways toward goals
- •They discuss heritability and modeling as factors in suicide risk
What brain scans can and can’t tell you—and how Amen Clinics assess ADHD
Alex asks what scans can’t reveal, then how a person’s assessment would work in Dr. Amen’s clinic. Dr. Amen explains scans show underlying biology (age, injury, toxicity, over/under-activity) rather than diagnostic labels, and outlines an evaluation combining interviews, questionnaires, cognitive testing, and scans at rest and during a focus task.
- •Dr. Amen says scans don’t directly label conditions like depression or anxiety but show biology and function patterns
- •He lists examples of what scans can suggest: injury, toxicity, over/under-activity, and how old the brain appears
- •He explains their assessment process: conversation, questionnaires, cognitive/emotional testing, and two scans (rest + concentration)
- •He emphasizes diagnosis requires a long-term life pattern, not just a bad day from stress or poor sleep
- •Alex asks about scan volume and standout cases, setting up a story about why looking matters
A standout case for “if you don’t look, you don’t know”
Dr. Amen shares a personal family case where a child’s sudden aggression had a structural brain cause rather than a purely behavioral one. He uses it to argue that imaging can reveal unexpected drivers of behavior that standard approaches might miss.
- •Dr. Amen recalls receiving intense criticism when he began scanning patients
- •He describes a nephew who attacked a child “out of the blue” and how typical care might have focused on medication and therapy
- •He says the scan revealed a cyst occupying the space of the left temporal lobe
- •He reports that draining the cyst normalized behavior
- •He concludes that without looking, clinicians may miss critical underlying causes
Most misunderstood ADHD realities: subtypes, stigma, and why treatments differ
Alex asks what the public most misunderstands. Dr. Amen emphasizes that ADHD/ADD isn’t one thing and argues that taking medication isn’t a moral failure, comparing it to wearing glasses; he also stresses that medication isn’t the only lever and that modern devices can mimic or worsen attention problems.
- •Dr. Amen says two major misunderstandings are: it’s not one condition, and medication use doesn’t mean failure
- •He compares ADD treatment to needing glasses: a functional aid, not a character judgment
- •He says medication is never his first or only intervention
- •He references dietary changes as a factor he considers important and describes device use as influencing dopamine and attention
- •Alex highlights the mismatch between one diagnosis and varied brains, leading into a detailed explanation of the seven types
The seven types explained—and why stimulants help some people and harm others
Dr. Amen walks through seven scan-informed ADHD/ADD types and the hallmark symptom clusters he looks for. He then explains how stimulants can be beneficial for some types but can worsen others, describing distinct adverse reactions and why a one-size approach fails.
- •He defines hallmark symptoms: short attention span (for routine tasks), distractibility, disorganization, procrastination, and impulse control issues
- •He describes classic ADHD vs inattentive presentations and introduces over-focused, limbic, temporal lobe, “ring of fire,” and anxious patterns
- •He explains the “ring of fire” pattern as high activity and says stimulants often worsen it
- •He gives examples of how stimulants can intensify obsessiveness, rebound mood issues, hallucinations, or anxiety depending on type
- •Alex presses on medication differences and the implications for treatment matching
Sponsor break: Neuralis by HealthRestore
Alex pauses for a sponsor message about Neuralis by HealthRestore. He describes it as a personalized ADHD profiling tool involving a short questionnaire and a brief smartphone scan to explore strengths and challenges.
- •Alex shares his own late diagnosis and the variability of ADHD experience
- •He describes Neuralis as a profiling tool using a questionnaire plus a smartphone scan
- •He frames it as a way to explore an “ADHD operating system profile”
- •He gives a call to action via the link and returns to the discussion
Sex differences, changing types over time, and tailoring treatment by subtype
Alex asks whether certain types appear more often in men or women and whether types can change. Dr. Amen describes patterns he sees by sex, says types can shift with interventions, explains which type gets missed most, and contrasts approaches for classic vs ring-of-fire presentations with a family story of improvement.
- •Dr. Amen describes different subtype concentrations he sees in women versus men
- •He says types can change over time with interventions (e.g., becoming less obsessive or anxious)
- •He identifies the ring-of-fire type as commonly missed and often misdiagnosed when treatments make symptoms worse
- •He outlines shared foundations like diet, exercise, sunlight, and reducing device use, then diverges by type for supplements/medications
- •He shares a story about his niece improving after matching treatment to a ring-of-fire pattern
Common self-management mistakes, the role of exercise, and the grief after diagnosis
Alex asks what people get wrong when trying to manage ADHD alone and what emotions come after finally understanding decades of struggle. Dr. Amen warns about coping through substances and escapism, highlights intense aerobic exercise as a powerful regulator, and describes the mourning many feel for “what could have been” after diagnosis.
- •Dr. Amen lists common coping mistakes: relying on alcohol, marijuana, video games, and not treating it as a brain health issue
- •He uses a “Ferrari not properly tuned” metaphor for ADHD potential and noise
- •He describes intense aerobic exercise as a treatment approach and why it helps neurotransmitter balance
- •He notes people can become depressed when injury removes their exercise coping outlet
- •He explains post-diagnosis grief: relief followed by sadness about lost time and missed potential
Forgiveness, loving your brain, and a closing letter to a younger self
Alex asks about forgiving oneself and invites closing words for listeners struggling with loneliness and low self-worth. Dr. Amen emphasizes loving and caring for the brain, building hope through daily choices, and not believing every negative thought; the episode ends with a moving letter addressed to a younger self about being misunderstood and learning self-compassion.
- •Dr. Amen says self-forgiveness matters because decisions were made without full information
- •He describes the REACH model of forgiveness and how it can apply to oneself and others
- •He tells struggling listeners to start loving their brain and to ask whether actions are good or bad for brain health and whether they make the world better
- •He stresses hope as changeability: you’re not stuck with the brain you have and can improve it through multiple pathways
- •Dr. Amen reads a heartfelt letter to a younger self focused on being misunderstood, masking, loneliness, and the message that there was never anything “wrong” with her

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