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Three types of symptoms emerged as powerful predictors of whether a youth with one parent with bipolar disorder will go on to develop the disorder, according to a study of 391 at-risk youth, funded by the National Institute of Mental Health (NIMH). The findings offer a much more specific roadmap than previously available for assessing risk of bipolar disorder early in at-risk youth, and one that is based on symptoms, not traditional psychiatric diagnoses. The symptoms identified—related to anxiety/depression, affective lability (unstable mood, including irritability), and low-level manic symptoms—also provide insight into what may be a high-risk syndrome or “prodrome” preceding the onset of bipolar spectrum disorder.