Psychiatry is the practice of assigning probable mental-health diagnoses to individuals in need. It is far from an exact science and is predicated upon educated attempts to pin down the intangible. There is no one psychiatrist who can state, with complete authority, the precise mental-health experience of any given individual. This is because the experience is unique to each individual, so it may manifest with a number of variations. Any capable mental-health clinician will endeavor to make an educated best guess based upon diagnostic experience and professional expertise. The clinician does this by interviewing and observing clients, consulting clinical documents such as the Diagnostic and Statistical Manual (DSM), and, in some instances, seeking a second opinion from a colleague. The goal is to distill all the information into a diagnosis based upon a series of symptoms, that is,—what the client reports of experiences and how the client appears during the interview.

The best place to start in exploring your child's mental health is with your pediatrician. Your pediatrician is an excellent first resource; however, this physician may not be in a position to make a bipolar diagnosis. Perhaps such a diagnosis is outside this doctor's area of expertise, or perhaps your pediatrician has limited experience with children's mental-health concerns. Your child's doctor should volunteer helpful information, but you will probably have to ask for a referral to an experienced pediatric psychiatrist or psychologist. Your doctor or nurse practitioner can point you in the right direction toward accessing a local pediatric mental-health clinician.

In metropolitan areas, you may have a multitude of qualified doctors from which to choose, which may prompt your need to narrow your range of selections. You may want to start by asking your clinician about any other patients who have been pleased with particular diagnosing physicians. Your pediatrician will most likely not be able to share this information directly but may be able to alert other patients to your request for information. Those patients can either contact you care of your doctor's office or follow up with you directly.

If you reside in a rural area, you should still ask your pediatrician for a referral to a mental-health clinician experienced in diagnosing bipolar disorder in kids. Just be aware that the doctor is less likely to know of a specialist in your area. You may have to travel a great distance to access a reputable and established medical center with a pediatric psychiatry department.

You may also be able to locate a pediatric psychiatrist by contacting the nearest college or university with a child psychiatry department; someone there may offer you leads in locating a capable clinician. Another source of leads may be any local or Internet parent's group that convenes to discuss bipolar issues in kids. (The Web resources in Appendix B may be a starting place.) If your child does not regularly receive health care from a pediatrician, or if you do not have medical insurance for your child, please persist in seeking adequate mental-health treatment for your child by networking with your child's child-care provider, school psychologist or guidance counselor, or by calling your county's human services office. You can find that phone number in your telephone book.