First off, let me say that I am not a nurse (hopefully will be able to get back to school now that son is stable), but a mom to an 11 year old with the diagnosis of bipolar. I'd like to share my story with you and maybe offer a suggestion or two.
My son was diagnosed with bipolar last year. We tried many different medications, hospitalizations, and even thought we would have to place him into long term care. Things were bad. He was very violent, hallucinating, not sleeping...it was just awful.
He wasn't getting anywhere. His psychiatrist was baffled by him and on the verge of referring him to another psychiatrist. I was getting desperate. I started researching trying to find out what was wrong with this kid. I looked into Autism. I looked into Aspergers. If it was a disease or disorder, I was reading about it.
Finally, I asked for a CAT Scan. I wish I had done that years ago. The psychiatrist called me a little later to tell me that he had calcification in the left temporal lobe of his brain. She referred us to a neurologist and after a few MRI's and several EEG's, we had a new diagnosis. My son had had a stroke around the left temporal lobe area and this brought on his bipolar disorder. He also had a mass around his left temporal lobe referred to as an angioma. In his case, Dr's 'think' it is a Venous Angioma and that he was more than likely born with it. He also picked up the diagnosis of epilepsy. He is now being treated with Lamictal and Abilify and doing much better than he has ever done. We still have problems, but I never thought he would be doing as well as he is right now. There is hope! Don't give up.
My suggestion would be to think about getting some kind of testing done like this just to be on the safe side. I wish I had done it sooner. It didn't change anything, but allowed me to understand why he was the way he was.
I'd also like to direct you to a website from the Childhood and Adolescent Bipolar Foundation at this address: www.cabf.org
This place was a Godsend to me when my son was so unstable. This is a very busy site and you will read about lots of things that sound all too familiar. You will even meet many parents whose children have several disorders such as Autism and Aspergers as well as bipolar.
I hope this will be helpful to you. I understand your desperation.
Blessings to you and your family.