Bipolar Treatment at Feel August
Bipolar disorder affects approximately 2.8% of U.S. adults, and most go years before receiving an accurate diagnosis. The depressive episodes look like depression. The hypomanic episodes can feel productive. An accurate evaluation requires time, careful history-taking, and a willingness to look beyond the most recent symptom — which is exactly the kind of evaluation Feel August is designed to provide.
Understanding Bipolar Disorder
Bipolar disorder is a mood condition characterized by episodes of elevated, expansive, or irritable mood (mania or hypomania) alternating with periods of depression. Bipolar I includes full manic episodes; bipolar II includes hypomania (a milder elevated state) and depression. Cyclothymia is a chronic, lower-grade variant.
Bipolar is one of the most commonly misdiagnosed psychiatric conditions. People often present in a depressive episode and are diagnosed with major depression, then experience a hypomanic shift on antidepressant monotherapy that complicates their course. An accurate diagnosis requires a careful history of mood across the lifespan — not just a snapshot of the present moment.
Recognizing the Signs
- Distinct periods of elevated, expansive, or irritable mood lasting days or weeks
- Decreased need for sleep without fatigue during elevated periods
- Racing thoughts, rapid speech, or feeling "wired"
- Increased goal-directed activity or risky decisions during elevated periods
- Episodes of depression — sometimes severe — between elevated periods
- A family history of bipolar disorder
- Mood symptoms that worsened or shifted unexpectedly on an antidepressant
Our Approach
Treatment at Feel August
Bipolar treatment at Feel August begins with a thorough evaluation that looks at your full mood history — not just how you are feeling today. Your provider asks specifically about hypomanic and manic features, family history, and prior medication responses, because these are the data that distinguish bipolar from unipolar depression.
When bipolar disorder is confirmed, treatment centers on mood stabilizers (lithium, lamotrigine, valproate) and/or atypical antipsychotics with mood-stabilizing properties. Antidepressants are used cautiously and rarely as monotherapy. Lab monitoring is part of the plan when indicated. We track mood with structured charting at each visit and adjust the plan as needed.
What to Expect at Your First Appointment
Your first appointment is 60 minutes. Bring a comprehensive history of your mood across your lifetime — including periods that felt unusually energized, productive, or sleepless, even if they did not feel like a problem at the time. Family history is also important; bipolar disorder has a strong genetic component.
After the evaluation, your provider will share their assessment and recommend an approach. If lab work or further history-gathering is needed, that will be the next step. You will leave with a plan and a follow-up appointment.
Frequently Asked Questions
- How is bipolar different from depression?
- Bipolar disorder includes episodes of elevated mood (mania or hypomania) in addition to depression. Many people only present during a depressive episode and are misdiagnosed with major depression. The treatment approach is meaningfully different — antidepressant monotherapy can destabilize bipolar mood, so an accurate diagnosis matters.
- What medications are used for bipolar disorder?
- Mood stabilizers (lithium, lamotrigine, valproate) and atypical antipsychotics with mood-stabilizing properties are the foundation of bipolar treatment. The choice depends on the specific presentation, side-effect tolerability, and other clinical factors. Antidepressants are used cautiously — and rarely as monotherapy.
- Do I need lab monitoring?
- Some bipolar medications (lithium, valproate, certain antipsychotics) require periodic lab work to monitor levels and metabolic markers. Your provider will arrange this through a local lab and review results with you at each visit.
- Will I be on medication for life?
- Bipolar disorder is generally a long-term condition that benefits from ongoing treatment. Many people achieve excellent stability with the right medication regimen and continue treatment indefinitely. The specific plan evolves over time and is revisited regularly.
- Can online psychiatry treat bipolar disorder?
- Yes — for ongoing medication management with appropriate lab monitoring. Telehealth is well-suited to the regular follow-up visits bipolar treatment requires. If acute psychiatric stabilization is needed (severe mania, suicidal crisis), in-person or hospital-level care may be necessary first.
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