L.
M.,
First things first, get a second opinion. I belive many teens are misdiagnosed (I have worked with many types of teen populations) either because of Psychiatrists placing their own misconceptions into the diagnosis or manipulation by the teen, or rebelling to going to a psychiatrist in the first place.
Secondly, any Rx that is handed out should be researched first. Make sure the medication is ok for teens, many psychotropic medications are not and will actually aggrevate any actual symptoms.
If it is bipolar, this is something that will have to be treated his whole life, and many bipolars go off their medications because they like their "ups" so much. Make sure, if it is bipolar, that he stays on any safe medication that is prescribed, otherwise he could fall into suicidal danger.
As a psych. nurse, you know that the most dangerous time of a bipolar's cycle is the upswing from down to up. This is the time period that most suicides happen. I would, if you could, chart his cycle, so that you know when this period is and keep a closer eye on him.
Other diagnoses that may mimic or manipulation could be a symptom of are, Borderline Personily Disorder, Depression (singular no bipolar), or early onset schizophrenia (onset is usually early twenties but can occur earlier).
It is a tough road, and if it is bipolar, he is going to be struggling with this his whole life. I am sure there are support groups, but teens are not usually willing to go.
I cannot stress enough, however, to get a completely second opinion. I know that many psychiatrists are "whollier than thow" and often diagnose without the proper time spent with the patient, or without careful consideration. I think bi-polar is one of the "trendy" diagnosises for psychitatirsts for teens. Find a psych. that HE likes, and maybe that will help as well. Sorry I could not have been more help. If you need more info, you can reach me at ____@____.com