So we have finally had the dr.'s appts. we have been waiting for. The paediatrician was on Saturday and not only did I appreciate him seeing my child on a Saturday but he spent quite a lot of time with us and never seemed rushed to leave - only focused on the situation at hand. difficult child was very belligerent and oppositional towards the pediatrician. throughout most of the appointment.. He was so rude it was embarrassing but I know it gave the doctor a glimpse of what he can be like. It was nowhere near what he's like at home but it was a glimpse. Paediatrician confirmed Tourette's and ADHD are accurate and he added clinical depression and then he mentioned ODD. I know how many feel about an ODD diagnosis so I took that one in stride. The other three I already figured on anyway. Today we saw the psychiatrist. 9:30 - 12:30. She comes highly recommended and I can see why. She took a good detailed history of our family. Asked many questions and gave husband and I an Autism Spectrum Disorders (ASD) screening questionnaire (DSM). She spoke with all three of us for about 1.5-2 hours then with difficult child alone for about 30-40 minutes. The DSM questionnaire came up VERY UNLIKELY for Autism Spectrum Disorders (ASD) so that was a good thing. Her diagnosis is clinical depression - moderate. She is also looking at the possibility of emerging bipolar. The bipolar wasn't an instant diagnosis because the only bipolar diagnosis in our family is a cousin of mine. Lots of addiction and depression and anxiety in my family but only the one bipolar diagnosis that I know of. So many of my mother's siblings don't speak to each other so I have no idea what the situation is with any other cousins - I wouldn't even know where to find them. She was looking at bipolar because of his sleep issues. He can sometimes go days without sleeping more than a couple of hours a night and maintain high energy and function. Also he can be very irrational and angry for no reason. The anger could be part of the depression or ADHD so she wants to hold off and see what SSRI's do for him. We are looking at the following for medication. Ciprolex to start. Possibly introducing lithium, adhd medication and risperdal. She wants to treat the depression first to see if it will alleviate the anger. And if he is bipolar we will likely see the manic phase show up within a month (geez I hope not) and can then introduce lithium as a mood stabilizer. (What are your opinions on this???) We didn't get a prescription today because difficult child was diagnosed with Vaso-vagal syndrome 2 years ago. Basically he has a low heart rate and low blood pressure which can cause fainting/blacking out upon standing or sitting up from a prone position. His ECG's, Echocardiogram and Holter monitor test all came back clear but the psychiatrist wants the paediatrician to verify that the medications won't cause any problems for difficult child. So after the appointment I went into the pediatrician.'s office and gave the note to the secretary. She will consult with the pediatrician. and get back to me. We will either have a follow up with the paediatrician or he will just write a prescription for the SSRI and we can start there. So difficult child is a little disappointed that he didn't get immediate help in the form of a prescription. I think we are all starting to feel a little desperate at this point. But we are all hopeful that we are making progress in the right direction. It's a bit of a relief and sadness - relief that we have a diagnosis and sadness that this could be a permanent challenge in his life. I also have a call into our family doctor because my husband is very worried about me. I'm having trouble sleeping, trouble eating, have the shakes and have been having panic attacks lately. So, I guess I need to get some help too.