Your description of your son sounds very much like my 5 year old son. He is a great kid and generally quite mature, but he can be very moody/intense. There are times when it seems like "normal" kid reactions and times when I can tell it is different. The "different" times tend to be when we have recently increased his Cortef, when he is in the heat, when he is getting hungry and about 5 hours after a dose. When we combine 2 or more of these factors we are in trouble!

Like Janet, we recently switched his dosing schedule. I know it isn’t necessary for everyone, and isn’t an option many want to look into, but for us it has been a very positive switch. (I have a newborn so I am up at 3 am anyway). 

Almost immediately we noticed two very positive things from the dosing change. (1) His weight gain slowed dramatically - essentially stopped. Weight gain has been an issue with him for years and (2) His moods leveled out considerably. Come to think of it, I don’t believe he has had a "really intense" moment since we switched the schedule. I don’t know if it is better due to the 3 am dose or if it is just the fact that he gets four doses a day instead of three.  

I am not positive that all his intensity can be chalked up to the CAH. I too am very intense/emotional and had to work quite hard to learn to control my emtions. But, I do believe the meds affect his emotions. Our goal is to help him out as much as we can with the meds, while teaching him coping techniques and setting firm boundaries in terms of behavior. We don’t expect any less of him in terms of behavior. He tends to get weepy, but also can get aggressive. We go for zero tolerance on the agression.

For me this has been one of the difficult things about this condition - what can you attribute to CAH/meds, what can’t you.