In the past decade, there has been a proliferation in the number of children and adolescents diagnosed with bipolar disorder. Except in rare cases, the young people who receive this diagnosis do not meet the strict diagnostic criteria for bipolar disorder I or II in the DSM-IV-TR. Many pediatric psychiatrists insist there are important development differences in the manifestation of bipolar disorder in childhood and adolescence. In place of clear-cut episodes of mania/hypomania and depression, they argue that younger people with the disorder experience chronic irritability, aggressive behavior, impulsivity, extremely rapid mood wings, hyperactivity, and severe temper tantrums. Given that many of the young people pose special challenges to the school system, the purpose of this article is to update school counselors on this controversial expansion of the diagnosis and treatment of bipolar disorder among children and adolescents.