Steadier ground is possible.
Bipolar disorder causes unusual shifts in mood, energy, activity level, and the ability to carry out day-to-day tasks, ranging from manic or hypomanic episodes to depressive ones. It is a medical illness, and it is highly treatable with the right care.
Types
- Bipolar I: manic episodes lasting at least seven days, or severe enough to need hospital care, usually with depressive episodes as well.
- Bipolar II: a pattern of depressive episodes and hypomanic episodes, without full mania.
- Cyclothymic disorder: periods of hypomanic and depressive symptoms lasting at least two years, without meeting criteria for a full episode.
What it can look like
During mania: unusually high energy, racing thoughts, little need for sleep, and risky behavior. During depression: deep sadness, low energy, trouble concentrating, and loss of interest. Some episodes mix both.
How we treat it
Diagnosis starts with a full psychiatric and medical evaluation to rule out other causes. Treatment combines medication (mood stabilizers, sometimes atypical antipsychotics or carefully chosen antidepressants) with psychotherapy such as cognitive behavioral therapy, family-focused therapy, or interpersonal and social rhythm therapy. Consistent follow-up is the key to long-term stability, and we build that into your plan.
Common questions
What's the difference between bipolar I and bipolar II?
Bipolar I involves at least one full manic episode, which lasts a week or more or is severe enough to require hospital care. Bipolar II involves depressive episodes plus hypomania, a milder high that doesn't cause that level of disruption. Bipolar II is not a milder illness overall; the depressive episodes are often the harder part, and it's frequently misdiagnosed as plain depression.
Why does it matter if my depression is actually bipolar?
Because the treatment is different. Antidepressants on their own can trigger mania or rapid cycling in someone with bipolar disorder. A careful history, including any periods of unusually high energy, little need for sleep, or impulsive decisions, helps us choose a mood stabilizer or other medication that treats the whole illness.
Will I have to take medication for the rest of my life?
Bipolar disorder is a long-term condition, and most people do best staying on a maintenance medication even when they feel well, because stopping is the most common reason for relapse. The goal is the lowest effective dose with the fewest side effects, reviewed at every visit, so the medication fits your life rather than the other way around.
Can bipolar disorder be diagnosed in teenagers?
Yes, though it takes care, because irritability, mood swings, and risk-taking can have many causes in adolescence. Dr. Shaikh directed an adolescent inpatient unit and led adolescent and young adult programs at The Menninger Clinic, so this is familiar ground. A parent or guardian joins every visit for patients under 18.
How often will I need to be seen?
More often at the start, while we find the right medication and dose, then less frequently once your mood is stable. Routine visits include a check on sleep, mood, side effects, and lab work when a medication calls for it. Consistent follow-up is the single biggest factor in long-term stability.