spiraling downward


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Since we stopped the Daytrana 15mg, difficult child has become increasingly out of control. On the Daytrana he was hypersensitive and irritable. He is not irritable now, but is over the top hyper and impulsive. psychiatrist has been on vacation, was supposed to be back in today, but he has not returned my emails from last week yet. He is usually good about this, so I am guessing he is buried in communications from patients/parents. I want to try the Daytrana 10 mg again. It has also been a really tough last few days as husband was in the hospital, so this could be contributing to the issue. husband is home now and doing much better, and I saw the symptoms before husband was in hospital.

How do you tell the difference between hyperactivity and hypomania? I would think they could look very similiar.


I was looking for examples of differences, but didn't have any luck. They sound so similar on paper, that I like to get examples to understand the differences. Will share what I found, but doubt it will help....


Hyperactivity - Excessively active. A hyperactive child usually has difficulty sticking to one task for an extended period and may react more intensely to a situation than a normal child.

Hypomania - A stage of the manic-depressive cycle, characterized by mild mania.

Mania - Characteristic of Bipolar Disorder, defined by insomnia, hypersexuality, rapid alternation between happiness and touchiness, and scattered thought patterns.


Hypomania (Hypomanic Episode)
Hypomania is a less severe form of mania. People in a hypomanic state feel euphoric, energetic, and productive, but their symptoms are milder than those of mania and cause less impairment to functioning. Unlike manics, people with hypomania never suffer from delusions and hallucinations. They are able to carry on with their day-to-day lives. To others, it may seem as if the hypomanic individual is merely in an unusually good mood. But unfortunately, hypomania often escalates to full-blown mania or is followed by a major depressive episode.


Active Member
thanks for trying. I am not really sure what we are seeing, as far as I can tell it could be either. With Cyclothymia, you see more hypomania than actual mania. difficult child is very hyper, but not happy all the time. His mood seems normal, not overly giddy. Maybe just hyperactive.


Active Member
Yea, at least for us, with mania we definitely see the pressured speech, the grandiose thinking, the suicidal ideation, the rages, and the compulsion to buy things, (it does not matter that he has no money - he will badger me to death about a coke, new game, or a new stereo - just something). Also, it is not just insomnia, but staying up for days on end that is a tell tale sign of mania vs hyperactivity.

Good luck getting in touch with the psychiatrist. My guess is that your son is also reacting to the stress of his dad being in the hospital., coupled with his medications just not being quite right.


Active Member
Sequoia- I have seen pressured speech, semi grandiose thinking (he is better than anyone else at whatever he is doing) and maybe a few rages. Cyclothymia is milder than bipolar.

this is just such a hard time to have problems, but we were starting to have issues before.

psychiatrist wrote a scrip for Daytrana 10 mg (next dose down). Maybe this will help.

I will also email psychiatrist about hyperactivity vs hypomania


New Member
I don't understand why your psychiatrist keeps trying to stabilize your difficult child's ADHD when your difficult child has a mood problem. I think, if memory serves me right, you've had this problem for a long time.

It doesn't matter what your child's diagnosis "technically" is, in my opinion, your difficult child has a mood disorder. THAT, before anything else, should be tamed.

I found this site ~ if you have the time and patience to read through it, it may give you some light:


ADHD is almost always co-morbid with Bipolar. My son, Dylan, is ADHD with the BiPolar (BP). But you know what? The ADHD can't be treated. He cannot handle stimulants. Ever. With that being said, I'd rather have a stable Bipolar child that is in a more structured classroom and gets extra help with school work, over an unstable Bipolar child that might be able to pay attention now and then. I think you are going to have to weigh what, exactly, you want to "fix" the most, and take it from there. If it's Bipolar (or Cyclothmic, whichever) symptoms, you're not going to be able to use a stimulant.

I have a child that is BiPolar (BP) and I have a child that is ADHD, Combined Type. There is an enormous difference in J's lack of focus/inattentive/hyperactive behaviors compared to Dylan's hypomania. J needs to be redirected alot, yes, and is hyper, yes, but on the Concerta, that all is tamed within 20 minutes. When the medication wears off, he goes back to being inattentive and hyperactive, but he is not angry or aggressive. He does not talk wildly or at such a fast pace that what he says makes no sense as Dylan does when he's manic. J can sit still, even without medications, where when Dylan is manic, he cannot. He cannot fall asleep, he cannot function properly, and everything and anything triggers problems. My Bipolar son is NOTHING like my ADHD son, and for sure, if I, a big nobody but a mom, can see differences, your psychiatrist should definately be able to as well.


New Member
How long was he on the Daytrana in total? I ask because Seb's doctor said that it might take him a few weeks to adjust to the medication-- his comment though was in the contect of my concern about sleep and appetite which he said can improve after a few weeks of consistently being on the medication. I wonder, however, if this notion of adjustment period is more global- affecting other possible reactions.

As I've told you in the past, I suspect that Seb like your son is clyclothymic. Your question about hyperactivity vs. hypomania is a good one and I am eager to hear how people weigh in.

Let us know how you procede and what your doctor's feedback is!


Active Member
I had a great response and my wifi went out.

We are treating the mood disorder with lamictal, but psychiatrist wants to see if C can tolerate stims while he is on mood stabilizer. ADHD symptoms are very intense. The only thing he can concentrate on is playing Zoo Tycoon on the computer. He is loud, talks incessantly (has always done this and makes sense once he slows down enough so I can understand him), has to be in charge. He plays well with children younger than him, but does not get along with kids his own age.Since on the Lamictal I have seen no irritability or tearfullness except for 2 weeks after we started 15mg of Daytrana. He was on 10mg of Daytrana for 1 week, and then 15mg for 2 weeks and then mood went down.

Cody has never broke anything out of anger, he has thrown toys away out of frustration. He has never hit me out of anger or frustration. He does not rage at the word no,though he has thrown a fit or two but I see that as a kid thing. He has been in a few bad fights at school, where he hurt other kids.

I am frustrated now, as with husband not doing well, I should have difficult child go somewhere, but 1st of all I cannot afford day care, and difficult child has been kicked out of Boys & Girls club. Even if I got them to accept him again, he would get kicked out again. He gets so wound up and in "show off mode" and just cannot stop. He hit another boy with a pool cue one time.

The problem is at home he is completely different than he is anywhere else. Maybe I compensate and make sure he is in a good situation. The problem with school is that his IEP is for speech therapy as he has no educational impact. He is at and above grade level at everything. We have behavior things built into his IEP, but once he graduates from speech, we will not have that option. He will be out of speech soon, and probably should be now, but the school district has been good about doing what may help him. I think his speech problems are associated with his ADHD.

psychiatrist described hypomania as a mood disorder, pressured speech, grandiose feelings, a definant change in mood, not like the short lived irribality of ADHD or its short fuse

Sorry to ramble. In a nutshell, I know he cannot tolerate stims alone, but we want to see if he can tolerate them while on a mood stabilizer. Guess that was all I needed to say