It's the last week of January, and there's a whole lot of crazy goin' on. In Bob's case, particularly, he is climbing up his usual mid-winter spiral into mania. It's frustrating. Throw in some miscommunication among treatment providers and it becomes downright maddening.

Last week, I received an email from Bob's teacher, filling me in on his first week back at school following winter break. It was about what I expected--he's been pretty hateful and nasty to his peers, unwilling to follow directions, and sneaking around in order to get his way without getting in trouble. In short, not much different than how he's been acting at home for the past couple of weeks. Once again, I ask myself the question--is it time for talk therapy?