Juvenile bipolar disorder (JBD) poses a clinical conundrum, both diagnostically and therapeutically. In part, this could be ascribed to the developmentally-insensitive diagnostic criteria of our current classificatory systems, fairly common atypicality of presentations in this population, mixed psychotic ultra-rapid cycling course, high rates of comorbidities, and overall less-than-optimal response to medications [1]. Bipolar Spectrum Disorder (BSD), or Cade’s disease, stipulates a history of a depressive episode with ‘red flags’ that draw the clinicians’ attention to the possibility of underlying bipolarity for what clinically manifests as ‘pseudounipolar’ depression [2]. These are depicted in Table 1. And conceivably, this is of paramount importance with prognostic and therapeutic implications as antidepressants use in such cases could destabilize mood, induce manic shifts and/or accelerate cyclicity [3]. Hypergraphia, or graphorrhea, has been tied to organicity, e.g. interictal personality and stroke but also reported in schizophrenia and mania, where the patient has a compulsive tendency to write at a length. Mungas defined hypergraphia as a tendency to excessive writing that goes beyond any social, occupational, or educational requirements. This needs to be differentiated from organic automatic writing behaviour where writing perseveration without elaboration is evident [4-7].