A negative self-esteem with self-destructive beliefs and feelings of despair is very common among children and adolescents with ADHD. This can be a consequence of failures caused by disturbed attention, impulsive reactions and behaviour and rejection by classmates or even their teachers. These children have problems to integrate in groups and are very prone to be excluded from common social activities. Usually they have to go through years of failure at school and rejections before someone thinks about a possible diagnosis of ADHD. Even if a successful medication with psychostimulants might improve the cognitive possibilities of the child the low selfesteem remains for a much longer period. Often secondary depression or social phobia can interfere with a successful change.

So special psychotherapeutic help and social reintegration may channel new behaviour into new experiences of success. But this takes a hard time both for the children and their relatives.