In a world where circumstances continue to put our patients and families into overdrive, in this issue we look at several kinds of amped-up situations. Dr. Ann Van Meter talks with us about assessment of bipolar disorder and the use of a practical nomogram to help predict whether a patient’s history and symptoms are likely to lead to bipolar disorder. Dr. Joseph Blader reviews his research on more effective and safer treatment of aggression in the context of ADHD. Dr. Rafael Pelayo offers us a more sophisticated approach to sleep problems. We also include a collection of research updates that look at preliminary studies in a variety of overdriven situations: DASH diet treatment of ADHD, treating agitation in the ED, self-injury with ADHD, and IVIG for PANS. For a bit of relief, expert colleagues also get together to give us a picture of the pastoral beauty and broad application of equine-assisted psychotherapy. As always, we welcome your feedback and suggestions.