I hope you are taking your son to an experienced, qualified psychiatrist. If you are concerned about self esteem get the boy appropriate treatment which includes a combination of a single stimulant medication, prescribed by a psychiatrist who monitors the medication closely in the beginning, making adjustments as needed and will then monitor the boy at least monthly. When he is functioning better his self esteem won't be at risk. Self esteem issues are exagerated. Unfortunately if the behavioral symptoms of the disorder are severe, constant arguing, purposefully ignoring directions, or worse overt oppositional and defiant behavior he have the additional diagnosis of Oppositional/Defiant Disorder which would be ADHD/ODD. Legitimate scientific research, not some alternative med scammers view, has establish the effectiveness and safety of using stimulant medication for children. You have undoubtly been influence by non-professional people you come across who have no stake in your's or your son's lives but are not reluctant to share their expertise with a doubting, confused and vulnerable parent. These message boards are full of them. They don;t know what it is like in your home and don't experience your challenges and daily, disappointments possible guilt feelings because you can't help your son. ADHD is not fatal, but can have severe consequences affecting your child's ability to get educated and have a chance at a decent life. I have met many, many parent's who have a child in high school doing poorly, their hopes and ambitions for their child's future disintegrating and prospects for college diminishing with each report card that comes home. At ages 15, 16 and 17 desperate for help to save their child's futture. They all, one and all say these exact words, "We wish we had let him be put on medication when he was younger." You are lucky, your child is eight, but you should give very serious consideration to allowing your child to be treated by a competent clinical professional in the field with training, background and experience with treating this disorder. Who else should you seek help from? I have never heard of kid's self esteem being damaged by taking meds. They conceal it rather well from school mates and play mates and are in denial about having a disorder anyway. They will say they don't need and it makes no difference. Fine don't argue, but your observations and the doctor's consultation will be the determinants. You are an adult ,responsible parent, the decision maker and decide what is best for your family, not all the so-called experts who never hesitate to thow in their two cents worth. But they don't live in your house.