Bipolar Disorders

The Problem

The highs - but especially the lows - keep returning. Some nights you can’t sleep, and maybe things are so distressing you feel like you’re crawling out of your skin. Sometimes you get the sense that you have to escape somehow. You might alternate between feeling like anything is possible and feeling heavy and full of despair.

I’m here to give you skills to get some stability and balance in your life, and relieve the pain you're experiencing.

Bipolar disorders (also called bipolar depression or manic depression) come in several types, and all are characterized by cycling between depressed states and the opposite - high energy states when you’re in either an elated or irritable mood. If you have bipolar I disorder, you’ve experienced mania - a “high” that’s too high, too fast, and too strong to control. It causes problems at work and in relationships, and may even require time in a hospital to recover. If you have bipolar II disorder, you’ve never experienced mania, but during times when you’re not depressed, you sometimes get hyper-energetic and do everything at once - working on projects, solving problems, channeling creativity, making plans, and having fun. This hypomania doesn’t cause problems for you (maybe it’s actually nice!) - but crashing back into depression again certainly does.

The Treatment

Bipolar disorders are closely related to our circadian (sleep/wake) rhythms. Episodes can also be prompted by stress and transitions. One evidence-based treatment we’ll use, called Interpersonal and Social Rhythm Therapy (IPSRT), focuses on:

  • Education about bipolar disorders

  • Creating daily routines that reduce mood instability

  • Considering important relationships in your life and how they can be enhanced to promote your recovery

  • Understanding your triggers and early warning signs so that you can act to reduce the risk of an episode

  • Coping with a difficult diagnosis and processing what it means for you

Another well-established treatment with early research support for bipolar is Dialectical Behavior Therapy (DBT). Areas we will work on include distress tolerance skills to get you through crisis situations and emotion regulation skills to help stabilize your moods.

Finally, if you’re struggling with a bipolar disorder, depression is part of that cycle. All focus areas listed on the depression page of this site can also be an important part of therapy for bipolar.

We’ll target the issues that are most critical for you, and work to get you healthy and stable again.