Hi, Bug's neuropsychologist raised the possibility of bipolar disorder recently and I'm trying to learn as much about it as I can. Right now, his diagnoses are Tourette Syndrome, ADHD, Obsessive Compulsive Disorder (OCD), Generalized Anxiety Disorder (GAD), and Sensory Integration Disorder (SID). He also shows some signs of NLD. He is almost 7 yo. Bug has always been a very hyper child, even before he was born. I swear, he was trying to find the exit months before he was born. He has never slept well (Naps? What are those?) and has always had trouble with self-regulation. He started having tics at 3.5 and they got much worse when he started kindergarten last year. He had done well in a wonderful preschool program, but kindergarten was a disaster (lots of tantrums, violent language, parents wanting him kicked out...). He now has an IEP, an has a one-on-one aide, social skills therapy, Occupational Therapist (OT), and adaptive PE through the school. He takes clonidine, Prozac, and imipramine (a tryicyclic antidepressant). So, I'm wondering if Bug's hyperactivity could be hypomania. Our neuropsychologist says that he sees two warning signs for BiPolar (BP): 1) Zoloft was EXTREMELY activating for Bug. He took two doses of 12.5 mg over two days and was the most hyper I have ever seen him. Our pediatrician said it could have been much worse...Bug was in the early days of taking clonidine then and it was still causing a lot of sedation, so presumably that took some of the edge off the hyperactivity. 2) Bug is very irritable, in addition to hyperactive and impulsive. I would say that the irritability is the most difficult symptom for our family to deal with and it also has a serious impact on his interactions with peers. He is currently on a very low dose of Prozac and imipramine and a fairly high dose of clonidine. He started with 6.25 mg of imipramine and did well. The first time we tried to increase imipramine, he became very hyper so we lowered the dose again. The second time we tried increasing it, he seemed sedated. We have maintained the original dose now for about a month and I'm not sure what to think about it. Last week, he had several days of extreme hyperactivity, coupled with extreme irritability. He had periods of calm where he played happily with his sister, but then he would return to being hyper and irritable. He did very well at school during this time. The problems were only at home. This extreme hyperactivity/irritability passed after about 5 days and he returned to his usual levels of hyperactivity and irritability. Overall, Bug is a very loving little boy. He is extremely bright (most likely "gifted") and creative. We know that he loves us dearly (as we do him), but that sometimes his emotions overwhelm him and he lashes out, both physically and verbally. He adores his sister and has several close friends. Last year, he did not make many friends in kindergarten, but this year is going much better. He has a "modified day" and leaves school after lunch and recess and is doing very well on the playground. Right now, our neuropsychologist and pediatrician have us watching Bug closely and keeping track of his mood and other symptoms. We are also trying to get him into a child psychiatry clinic through a nearby medical school. I would appreciate your thoughts.