The difficult child's had their quarterly check-in with the psychiatrist yesterday. When he was finished chatting with the boys, he excused them from the room so he could ask me how husband was doing since he added Lamictal to the mix. After I told him things were going much better, that husband is participating in family activities more, being more productive here at home, much less negative and coping with life much better overall, the psychiatrist told me how husband was VERY hypomanic at his last appointment (pre-Lamictal). His speech was fast, pressured and he was very intrusive -- sitting too close to strangers in the waiting room and striking up conversations even though anyone could see they didn't want to be bothered. psychiatrist actually seemed surprised to have seen him this way, and it was all I could do to keep from laughing. He also said husband had absolutely NO idea, NO awareness of his own behavior. Yep, welcome to my world! I also let psychiatrist know that husband's neuro (who really doesn't seem to see the psychiatric piece of husband's picture) was making noises about taking husband off Trileptal since she didn't think he needed TWO AE's to control his seizures. psychiatrist said that the Trileptal was likely helping the manic piece (though not as effectively alone as when combined with Lamictal) and he told me to caution husband about making any medication changes without talking to psychiatrist first. So I sent husband a text when he asked how the boys' appointment went, and told him that psychiatrist would have to adjust Lamictal dose if he wanted to change the Trileptal at all. I still don't understand why the psychiatrist doesn't just come right out and tell husband that he's cyclothymic. Maybe he's intimidated by him. Maybe he doesn't think husband is receptive to that info yet. I flat out told husband on our NOLA trip that the last superbill stated he was cyclothymic, but he didn't know what that meant. And when I explained it, he dismissed it as not possible. Whatever. I guess it doesn't matter what he thinks, as long as he keeps taking his medications and going to his appointments!