How do you approach the treatment of anxiety disorders in children with a significantly family history of bipolar disorder?  

First, I always question the validity of a family history of bipolar disorder and clarify as best as possible bipolar 1 vs. 2. Nine times out of ten, it is "mood swings" that with further clarification were never formally diagnosed and were anger outbursts/irritability.  If there is bona fide ...

If the anxiety or OCD is severe and therapy is not doing much to help, medications should be on the table. Similar to adults, if there is a credible family history of bipolar (such as a close relative with suicide attempts and needing lithium or Depakote), but no signs that the patient is bipolar, ...