My name is Mary and I am new to this web site. I have an 8 year old son with CAH. He is a salt-waster and was diagnosed at 2 1/2 weeks old.  His condition has been managed well up until recently.  About 1 1/2 years ago, Andrew began to gain weight and made a steep incline on the growth chart, while on dexamethasone.  He new endocrinologist did not feel comfortable managing him on dex anyway, and this gave him the opportunity to change him to Cortef.  He has been on the same dose this entire time.  This past summer, Andrew began to withdrawl, show signs of depression and anxiety, and has noticable pubic hair.  His behaviors intensified as did his mood swings.  I thought this might be a sign of early puberty and contacted his endocrinologist.  He informed me that his most recent lab work was within normal ranges and that we would keep and eye on him.  Andrew's behaviors greatly intensified with the start of school. He would cry for hours, then collapse in exhaustion; his sleep pattern was altered, he was tired and lethargic most of the time, anger outbursts, isolated himself from peers, refusal to go to school.  I was told by his endo. that these were not symptoms of CAH, but of depression and anxiety.  Andrew kept telling me that he didn't feel right, but could not put words to how he was feeling.  His symptoms got worse daily.  I was getting no help from any social worker, physician or counselor.  One told us to check into to the medical issues, while the other told us to confront his behaviors through traditional counseling techniques.  Finally, we thought about calling Dr. Rivkees.  (I know you don't like it when people name Dr's, but I credit him with figuring out Andrew's problem)  Dr. Rivkees was Andrew's endocrinologist when he was an infant.  He called me back right away.  To make a long story semi-short, he immediately increased Andrew's cortef and ordered a 24-hour urine.  The first increase showed no change in behaviors or moods.  After getting the results of the 24-hr. urine, he increased his Cortef.  By this time, Andrew had been put on xanax for the anxiety (it did nothing for him) and prozac for the depression.  (this made his sleep even more disturbed, so they took him off of the prozac)  His mood swings were so extreme and at times I had to physically restrain him so he would not hurt me or himself.  I thought for sure that he was going to end up on an inpatient psych unit.  Dr. Rivkees stated that if the second increase in Cortef was going to help, it might act like a light switch in about 2 weeks.  Things will just click and he will start acting like himself again.  He felt that we needed to bring Andrew under adrenal control first and then deal with the potential of early puberty.  One day shy of 2 weeks after the second Cortef increase, Andrew woke up singing, dressed early and ready to go to school.  Like his old self.  He stated he felt better and wanted to go to school.  Since that time 2 1/2 weeks now, he has not fought about going to school, gets excited about things, his coloring is better, he smiles, laughs, plays and is active again.  He states he feels like himself again, although he doesn't feel like he has quite as much energy as he used to. Thank God for miracles through Dr. Rivkees, to have the insight to see that Andrew's behaviors might be related to his CAH.  Have any of you out there had similar related stories? What did you experience about moods, behaviors and adrenal control?  What kind of support did you get from your endo.or pediatricians? What kinds of things helped you and your child through this difficult time?  Thanks for your feedback and help!    Mary