What you describe was my son on Vyvanse and Adderall. There are two types of ADHD stimulants: amphetamine (Adderall, Vyvanse, Evekeo…) and methylphenidate (Ritalin, Concerta, Quillivant…). Almost everyone does well on one type or the other, but not both. That said, before chasing other reasons for these behaviors, I’d ask his prescribing doctor to try a methylphenidate (of course, I’m not a physician, but that’s what I’d personally do with the knowledge I have on this). My son was angry and aggressive and moody on amphetamines, but doesn’t have those side effects with methylphenidates. He’s also a naturally sweet and kind kid.
If these behaviors are all related to sensory processing issues (SPD), you would be able to correlate them to sensory stimuli when they happen. Things like disregarding house rules and poor self-esteem are probably not SPD related. Talk to his OT about what could be related to sensory issues — that’s their area of expertise.
A lot of kids with ADHD, especially the younger ones, tend to say a lot of extreme criticisms of themselves. I think it has a lot to do with poor emotional regulation and not having the skills to handle disappointment and frustration better. That comes with time. My son was the same way, and didn’t show signs of any self-awareness and self-regulation until age 9. At 15, he still says those things on occasion, but pretty rarely now.
On tantrums, consider that they may actually be meltdowns. They’re two very different things, and should be responded to very differently. A tantrum is within the child’s control and can be stopped instantly if they get their way. A meltdown, however, is not within their control and has to cycle out. I equate a meltdown to their brains being hijacked, or like a record stuck in a scratch.
ADDitude Community Moderator, Author & Trainer on Parenting ADHD, Mom to teen w/ ADHD, LDs, and autism