Despite increasing evidence that bipolar disorders often emerge in adolescence, only about half of adolescents with a bipolar disorder receive mental health care. Research has shown that an early onset of a bipolar disorder, concomitant with a poor diagnosis and lack of treatment, can have lifelong devastating effects for the patient. Adults and younger people who initially exhibit symptoms only of depression may later develop bipolar disorder. The risk of depression turning into bipolar disorder is estimated at 10 percent or less in adults but appears to be as high as 20–40 percent in children and adolescents. In this episode, Dr. Neera Ghaziuddin answers many questions regarding how to better diagnosis and treat pediatric bipolar disorder, and depression with mixed features in the pediatric population. Optional CME Credits / Certificate Instructions: After listening to the podcast, to take the optional posttest and receive CME credit, click https://nei.global/POD20-PedBip Learning Objectives: After completing this educational activity, you should be better able to: Discuss challenges to diagnosing bipolar disorder in the pediatric population (e.g. adolescents) Define the concept of “mixed features” according to different diagnostic criteria Improve the differential diagnosis of depression with mixed features (DMX) in children and adolescents Utilize evidence-based therapies in the treatment of pediatric patients presenting with DMX Accreditation and Credit Designation Statements: The Neuroscience Education Institute (NEI) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. NEI designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. A posttest score of 70% or higher is required to receive CME credit. Nurses and Physician Assistants: for your CE requirements, the ANCC and NCCPA will accept AMA PRA Category 1 Credits™ from organizations accredited by the ACCME. The content in this activity pertains to pharmacology and is worth 0.50 continuing education hour of pharmacotherapeutics. Peer Review: The content was peer-reviewed by an MD specializing in pediatric psychiatry to ensure the scientific accuracy and medical relevance of information presented and its independence from bias. NEI takes responsibility for the content, quality, and scientific integrity of this CME activity. Disclosures: All individuals in a position to influence or control content are required to disclose all relevant financial relationships. Although potential conflicts of interest are identified and resolved prior to the activity being presented, it remains for the participant to determine whether outside interests reflect a possible bias in either the exposition or the conclusions presented. Interviewer Andrew J. Cutler, MD Clinical Associate Professor, Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY Grant/Research: Acadia, Aevi Genomics/Cerecor, Alder/Lundbeck, Akili Interactive, Alkermes, Allergan, Axsome, Biohaven, Daiichi Sankyo, Intra-Cellular, Ironshore, Janssen, Lilly, Lundbeck, Neurocrine, Novartis, Otsuka, Sage, Sunovion, Supernus, Takeda, Tris Consultant/Advisor: Acadia, Adlon, AiCure, Akili Interactive, Alfasigma, Alkermes, Allergan, Avanir, Cognitive Research, Intra-Cellular, Ironshore, Janssen, Lundbeck, Neurocrine, Novartis, Noven, Otsuka, Purdue, Sage, Sunovion, Supernus, Takeda, Teva Speakers Bureau: Acadia, Alfasigma, Alkermes, Allergan, Arbor, Avanir, Gedeon Richter, Intra-Cellular, Ironshore, Janssen, Lundbeck, Neurocrine, Otsuka, Sunovion, Supernus, Takeda, Teva, Tris Interviewee Neera Ghaziuddin, MD, MRCPsych Professor, Child and Adolescent Psychiatry Unit, Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI No financial relationships to disclose. Pre-Interview