Knowledge of the natural history of an illness is critical to understanding its origins and to optimizing its management. Over the past 15 years, data have been accumulating steadily on the course and outcome of juvenile affective conditions. This chapter begins with an account on the risk of recurrence of juvenile depression. This is followed by the mechanisms involved in continuity and recurrence. Prospects for recovery and the natural history of other juvenile affective disorders are discussed with a focus on bipolar disorder. Finally, a discussion of some of the clinical implications of these research findings is presented. There has recently been interest in milder forms of bipolar disorder in adolescents, such as bipolar II disorder (episodes of major depression and hypomania) and cyclothymia (chronic mild states characterized by symptoms such as irritability, decreased need for sleep, and so on).