Because of their hyperactivity and impulsive actions, children with ADHD often have difficulty making and keeping friends. They can annoy other children because they often find it hard to follow normal social customs and interactions. The subsequent rejection they receive can lead to poor self-esteem and depression.

While Ritalin and other medications can be an important component of treating ADHD, it should not be the only treatment. It's essential that children with ADHD be managed on two other levels:

• Educational therapy -- This should address weak areas and provide successful classroom strategies to make sure the child is learning appropriately.

• Psychological therapy -- Counseling can help children sort through any issues about being rejected by their peers, or being different from other kids. There are even counseling groups available for children with ADHD to help them learn social skills and other techniques to improve their self-control.

Your description sounds rather serious; I recommend that you consult with a child psychologist or psychiatrist as soon as possible. While the symptoms you describe could certainly all be associated with ADHD, it's important to reassess your son's initial diagnosis. Problems such as learning disabilities, depression, anxiety disorders, and post-traumatic stress disorder can at times be misdiagnosed as ADHD. Also, it sounds as though the educational strategies that your son's school has tried have not been very successful. At this point, it's necessary to re-evaluate his educational plan.