In this issue we tackle a range of challenges, including differentiating ADHD from bipolar disorder, understanding suicide risk in college students, managing assertions about the safety of weed, and assessing and treating violent behavior in our patients.

Early into the evaluation of a 10-year-old boy, you note the following symptoms: inattention, hyperactivity, impulsivity, sleep problems, racing thoughts, and moodiness. The boy’s parents came to your office convinced that their son has ADHD, but thinking through the case, you recognize that the same symptoms could signal bipolar disorder (BD).

School shootings keep happening in the US, and most of us have wondered at times whether one of our patients might carry out a violent act, shooting or otherwise. This article will help you assess and treat violent youth and advise families who are grappling with these issues.

Do antidepressants actually cause children to be suicidal? If so, how do we detect it, and what should we do about it? In this article, we’ll give you a brief review of the most recent findings on antidepressant-induced suicidality (AIS) in children and adolescents, and then move on to some practical tips for how to evaluate and prevent this problem.

The issue of emergent suicidal thinking has weighed on us since the 2004 black box warning—amplified by the re-analysis of the now infamous study 329, which found the emergence of previously under-reported suicidal thinking. How do we offer hope for effective use of medication while balancing the potential risks? Dr. Danella Hafeman has made a close study of it all and sheds light on the problem.

Recently, CCPR presented the following hypothetical case to leading child and adolescent development authority Calvin Colarusso, MD, for his advice on how to help a young man presenting with a possible major depressive disorder (MDD).

One of our biggest in-office challenges is how to enhance teen resilience, the process of adapting to and recovering from stressful life experiences. Some neuroscientists hypothesize that resilience is related to the limbic system, which plays a vital role in emotion processing, motivation, and learning.

You are evaluating a 16-year-old boy referred for mandated substance use treatment by his high school, where he was found drinking alcohol and smoking cannabis with a friend in the restroom.

Since they already often seem two steps ahead of us, with adolescents it can be really helpful to use direct routes. Be very specific in your questions. For example, don’t just ask, “Do you smoke?” Ask, “Are you using any nicotine products? What are you using in your vape?”