In spite of some critics' decrying a lack of progress in the field and the lack of a need for DSM-5, much research and clinical experience have informed the proposed changes, and I believe these changes will help patients and clinicians. One example has been the controversy regarding the rapidly increasing rates of bipolar diagnoses in children. The rise has stemmed, in part, from the way some investigators have applied current diagnostic criteria, particularly substituting irritability for elation when the usual episodic nature of bipolar disorder is absent. One proposed diagnosis for DSM-5 is a temper dysregulation disorder and the re-emphasis on severity of impairment for receiving a diagnosis. Recent research has indicated that these children are at low risk for developing adult bipolar disorder; rather, as they grow up, they have depression, anxiety, and/or intermittent explosive disorder.