I am a psychotherapist  but even I am confused when it comes to my 11 year old son.  He argues, constantly fights with his sister, gets bored and acts out at church, we have to force him to do any chores.  Yet, he does excellent at school - no problems with schoolwork (Principles honor roll) and he has had no behavior problems at school.  At home he gets mad at friends - accuses them of starting arguments, and at home he is always mad and irritable almost never calm.  He gets easily frustrated and if he loses things he blames it on us. Everything is someone else's fault.  He would much rather do computer or videogames than spend time with us.  We can't go to a restaurant or anywhere or it will be argueing.   I know he is oppositional, but I can't tell truly if it is ADHD (actually not much hyperactivity) and ODD (oppositional defiant) or if he has childhood bipolar.  I have read tons of info and am still confused.  Every since he was two he would have temper tantrums.

His primary care started him on Adderall four days ago (25 mg) but he couldn't sleep or eat so he lowered it to 10 mg yesterday.  So far he seems to be doing well, just some trouble eating. 

I will have him see a psychiatrist soon, but in all your experiences: does it look like ADHD with ODD or childhood bipolar?  Can a child have ADHD at home but have no trouble at school with concentration or behavior? 

I guess your child is trying to balance his self-control at school ?  My son would start blurting out words, annoying his sister, fidgeting non-stop in the car the minute i picked him up from school.  At school he had the usual symptoms/problems,....restless, lack of concentration, disorganisation, distraction BUT he would get into trouble because his teachers would yell at him (they never knew about the problem, they just reacted) and that would make him become easily irritated and off-balance.  We never knew about his condition as the teachers only talked about the symptoms (ignorant of add ?) and the family doctor dismissed my reports as 'boy-like' behavior.  It is that at the beginning of this year a friend told us about add and we started dealing with the situation.  My son was doing well at school until the age of 12 and then he just got lost and the symptoms fully exploded and became uncontrollable.

If he is alone without his sister my son is an angel[ but if his sister is around and when he becomes bored he starts annoying her and me.

Your son has to compensate for all that pent-up energy welling up in him and has to get rid of it somehow.  Maybe it's good he is not misbehaving and performing well at school.  You're on the right track for taking him to see a the psychoanalyst. 

We're having our son tested by a neuropsychologist next month to have a global assessment of his situation.

Good luck aand lots of patience !

DSM IV Criteria of ADHD.

From Eileen Bailey, Your Guide to Attention Deficit Disorder. FREE Newsletter. Sign Up Now!

A. Either (1) or (2)

(1). 6 (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:

Inattention

(a) often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
(b) often has difficulty sustaining attention in tasks or play activities
(c) often does not seem to listen when spoken to directly
(d) often does not follow through on instructions and fails to finish
schoolwork, chores, or duties in the workplace (not due to oppositional behaviour or failure to understand instructions)
(e) often has difficulty organising tasks and activities
(f) often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework).
(g) often loses things necessary for tasks or activities (e.g. toys, school assignments, pencils, books, or tools)
(h) is often easily distracted by extraneous stimuli
(i) is often forgetful in daily activities

(2) 6 (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level

Hyperactivity

(a) often fidgets with hands or feet or squirms in seat
(b) often leaves seat in classroom or in other situations in which remaining seated is expected
(c) often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
(d) often has difficulty playing or engaging in leisure activities quietly
(e) is often "on the go" or often acts as if "driven by a motor"
(f) often talks excessively

Impulsivity

(g) often blurts out answers before questions have been completed
(h) often has difficulty awaiting turn
(i) often interrupts or intrudes on others (e.g. butts into conversations or games)

B. Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years.

C. Some impairment from the symptoms is present in two or more settings (e.g. at school [or work] and at home).

D. There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.

E. The symptoms do not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and are not better accounted for by another mental disorder (e.g. Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder)

314.01 ADHD, Combined Type - if both A1 and A2 for at least 6 months
314.00 ADHD, Predominantly Inattentive Type
314.01 ADHD, Predominantly Hyperactive-Impulsive Type