You can all say "I told you so," now. After giving the psychiatrist an update, he was speechless. He agreed that difficult child sounded depressed and on the spectrum, but added that he felt he was in the middle of a soap opera. He said difficult child's behavior was more like a 15-yr-old than an 18-yr-old, and that he was shooting himself in the foot. He added, "And Mom, I'd try to stop putting everything onto a diagnosis like bipolar and start talking about irresponsibility and just plain being a teenager." difficult child, for the first and only time, did not text during the session. Because he has a borrowed phone that only works on WiFi. He had to listen to the entire thing. I used to get on his case about texting during mtngs, but the psychiatrist let it slide. Ticked me off royally. Not today. So, today, difficult child took the bus to school, showed up for first period, and was called to the office for ISS. He had skipped out on too many classes and they had his number. Or so they thought. He left class, and kept on walking, all the way home! He woke me up around 9 and told me he'd overslept, and could I take him to school? Sure. And could he have a Starbucks? Sure, I'm in the mood, too. Sounds good. I got an angry ans machine msg from the school attendance office a few hrs later. Arrrrrggh! psychiatrist also said that if he ever talked to his mom the way difficult child talks to me, he'd--hhmm, can't remember, but something like he'd have been kicked to Mars. "But you have different parents." He also said that what I was seeing was not so much ADHD/impulsivity, as it was flat-out defiance. I agree. difficult child is being upped to 300 mg lithium 2x a day, continuing to titrate with Strattera, and if things only improve slightly, psychiatrist will introduce an atypical antidepressant. But he wants to make sure difficult child is at a higher dose of lithium before that. He said in the meantime, no more skipping ISS to pay for ... skipping. (He slapped his forehead at the irony. I have to say, that today is the first time in maybe forever that the psychiatrist "got it." Did he hear all of you talking???) Even after all this, difficult child had the gall to ask me to pick him up a steak for dinner at the grocery store! I'm speechless. No, I made chicken and rice and edamame and difficult child didn't want it, so he opened a can of soup. (Guess what kind of soup? Chicken and rice!) Fine. husband, difficult child and I sat at the table together and ate, and went over difficult child's history homework. It was almost normal. Scary normal.