Understanding bipolar disorder
Bipolar disorder involves episodes of depression and periods of mania or hypomania: elevated or irritable mood, decreased need for sleep, racing thoughts, increased energy and sometimes risky decisions. Many people are first treated for depression alone, because depressive episodes are often what brings them in.
Careful diagnosis matters
Getting the diagnosis right shapes everything else. Antidepressants alone can sometimes destabilize mood in bipolar disorder, while mood stabilizers can be very effective. A thorough evaluation looks at your full mood history, family history, sleep patterns, substance use and medical factors.
A whole-person approach
At Joy Integrative Psychiatry, the evaluation looks beyond a symptom checklist. We consider daily rhythms (which strongly influence mood stability), metabolic health and weight, and medication side effects, along with sleep, stress, physical health, current medications and what's happening at home, school or work. That fuller picture helps separate the true drivers of symptoms from things that simply look similar, and it leads to a plan that fits your life.
What treatment may include
- Mood-stabilizing medication, such as lithium, certain anticonvulsants or certain antipsychotic medications, chosen with you
- Lab monitoring appropriate to your medications, such as medication levels, kidney, thyroid, liver or metabolic labs
- Metabolic monitoring, since some mood stabilizers affect weight, blood sugar and cholesterol (see metabolic psychiatry)
- Sleep and routine protection as a core part of relapse prevention
- An early-warning plan so you and your family can recognize and respond to early signs of an episode
- Coordination with therapy and your primary care clinician
When telehealth isn't enough
Severe mania, psychosis or safety concerns may require urgent in-person or hospital care. If you or a loved one is in crisis, call 988 or 911.
Common questions
Can bipolar disorder be managed through telehealth?
For many people who are stable or moderately symptomatic, yes. Lab work is ordered to a local lab near you. Patients with severe symptoms may need in-person or higher-level care, and we'll help arrange it.
Will I need lab work?
Many bipolar medications require periodic blood tests. We'll order them to a convenient lab location and review the results with you.
I was diagnosed with depression but antidepressants made me feel worse. Should I be evaluated?
It's worth discussing. Some people experience agitation, sleeplessness or mood swings on antidepressants for different reasons, and a careful evaluation can help sort out why.