Hi, difficult child has been wild, absolutely wild, and defiant since Thanksgiving, after four months of positive steps. He's had a growth spurt and we decided on Thursday (along with the psychologist and pediatrician) to increase his imipramine, which in the past has helped a lot with his Obsessive Compulsive Disorder (OCD), leading to a generally calmer difficult child (we have not increased it yet). He is already at a high dose of clonidine and everyone involved is reluctant to raise it again. Also, his wildness goes way beyond ADHD. The psychologist and pediatrician think we should try Risperdal, but husband is adamantly against it. As for me, I say bring it on. We need help. ***Just to clarify, we have not made the medication increase yet*** Anyway, since the middle of the week his energy level has been ramping up. Yesterday we spent the afternoon at a friend's house and he and his friend had a very wild, but good and peaceful time. However, upon getting home, he continued to ramp up and told me that his "brain feels funny." I asked him what he meant and he said that it started at his friend's house. He was so wild all evening that I took easy child to her room to read just to keep her out of harm's way. He wasn't aggressive, but just flying around and unaware of how much "space" he was taking up. I went to bed at 9, when husband took difficult child upstairs to put him to bed. I woke up around 1:00 to them coming downstairs. Turns out that difficult child had not been able to sleep at all. He was still very wild, with flushed cheeks and a bright gleam in his eyes. He was happy and not aggressive, but could not control himself. He wanted to jump off furnture, make loud noises with our digital piano, and was talking in a very loud voice. husband was going to let him watch a video (out of pure exhaustion, I think), but I suggested we play a board game instead--seems more calming. So, husband dozed, while difficult child and I played games until about 3:00. He commented at one point, "My brain feels better now." And, he did get calmer, but was still spinning around on the hard wood floor between his turns and being a little "off." At about 3:00, easy child woke up and was very confused by all the ruckus. I took her back to bed and husband took difficult child upstairs, again. I don't know what time difficult child finally fell asleep. I know that he and husband made at least one more trip downstairs (woke me) sometime in the night for a drink. It is now almost 11 a.m. here and they are still asleep. It looks like husband finally gave up and slept in the guest room upstairs and that difficult child climbed into bed with him at some point. We were supposed to go out of town for the weekend, but I think that is off. I can't imagine putting difficult child into the car for a 3 hour drive after last night. easy child is going to be upset, but I think it will be for the best. We were going to increase the imipramine on Monday, but we can do that today if we stay home. We have an appointment with a new psychiatrist at the end of January (we are on the cancellation list, too) and in the meantime will continue to see the psychologist and pediatrician. But, we need more help. The psychologist has at times mentioned that we need to be on the look out for signs of early onset bipolar disorder. There is a history of Borderline Personality Disorder (BPD) in my family, as well as schizophrenia, and lots of alcohol and addiction issues. husband's family has some history of mental illness and addiction. Both of us have our depression and anxiety issues, but no addiction issues, and we do well, given the genetics in our families. It seems like all of this has come to roost in difficult child. The psychiatric says his big concern is that difficult child is so hyper and irritable, simultaneously. For the past 3 years, I would say that this has been his predominant state. As his tics have worsened, I would also say that he seems depressed at times. I've never felt like I see rapid cycling, though I'm not really sure I know what that looks like. However, he does seem to get stuck in "states." This period of high energy and defiance since Thanksgiving is one of those states. We have had a thorough neurpsych evaluation and he did not rise to the diagnostic level for an autism spectrum disorder. However, his social skills are bad and he often does not "get" it. He receives social skills therapy through the autism inclusion program at school and has a one-on-one aide. Thanks for your input.