Identifying children with emotional or behavior disorders has long been problematic. In a general sense, those children who are most likely to be noticed by teachers and, therefore, referred for possible special education placement are those who exhibit externalizing behaviors, including physical aggression, noncompliance, and rule-breaking. It is often the children with internalized disorders who are overlooked. Children who suffer from mental or emotional conflicts may appear to be quiet and compliant in the classroom and, therefore, less likely to stand out to adults as needing supportive services (Flick, 2011). Children with bipolar disorder are among this population. Childhood bipolar disorder affects more than 750,000 children annually (Senokossoff & Stoddard, 2009) and is more common than childhood incidences of juvenile diabetes, cancer, AIDS, and epilepsy combined (Hellander, 2000). Educators, parents, and mental health professionals are just now beginning to recognize the seriousness of bipolar disorder in children. In this article, the author describes the difficulties related to both diagnosis of the illness itself and interventions that best improve the outcomes for children and adolescents with bipolar disorder.