Bipolar Disorder

Bipolar disorder is a lifelong mood disorder that requires careful, ongoing management — and with the right treatment, people with bipolar disorder can and do live stable, fulfilling lives. Greater Boston Psychiatric Services provides psychiatric evaluation and ongoing medication management for bipolar disorder, by telehealth or in person at our office in Medway.

What Is Bipolar Disorder?

Bipolar disorder is a mood disorder characterized by episodes of depression alternating with episodes of mania or hypomania — periods of abnormally elevated mood, energy, and activity. It's a distinct condition from major depressive disorder, because treating bipolar depression with a standard antidepressant alone, without a mood stabilizer, can sometimes trigger a manic episode. Getting the diagnosis right is central to getting treatment right.

Types of Bipolar Disorder

• Bipolar I Disorder — at least one manic episode, often — though not always — with depressive episodes as well; manic episodes can be severe enough to require hospitalization

• Bipolar II Disorder — at least one depressive episode and at least one hypomanic episode (a less severe form of mania), without a full manic episode

• Cyclothymic Disorder — chronic, fluctuating mood instability with numerous periods of hypomanic and depressive symptoms that don't meet the full criteria for bipolar I or II

Signs & Symptoms

• Depressive episodes: persistent sadness, low energy, loss of interest, sleep and appetite changes (see our Depression page)

• Manic or hypomanic episodes: elevated, expansive, or irritable mood

• Decreased need for sleep without feeling tired

• Rapid, pressured speech or racing thoughts

• Increased impulsivity — spending, risk-taking, or decision-making that's out of character

• Inflated self-esteem or grandiosity

• Increased goal-directed activity or agitation

• Distractibility

Causes & Risk Factors

• Strong genetic component — bipolar disorder tends to run in families

• Differences in brain structure and neurotransmitter regulation

• Significant stress, sleep disruption, or major life changes, which can trigger episodes in someone predisposed to the condition

• Substance use, which can trigger or worsen mood episodes

How It's Diagnosed

Bipolar disorder is diagnosed through a detailed clinical evaluation that looks not just at current symptoms but at your full mood history — including whether you've ever had a period of unusually elevated mood, energy, or impulsivity, even briefly. Because bipolar disorder is often misdiagnosed as depression (patients seek help during a depressive episode and may not recognize past hypomanic periods as symptoms), a thorough history is essential to getting the diagnosis — and the treatment — right.

Treatment Options

Bipolar disorder is treated primarily with mood-stabilizing medication (such as lithium or certain anticonvulsants) or atypical antipsychotic medications, sometimes combined with an antidepressant under careful supervision. Because mood stabilizers often require blood-level monitoring, our electronic connection to local labs means you can complete bloodwork near home, with results routed directly to us. Treatment is ongoing rather than short-term, and consistent follow-up is central to preventing relapse.

When to Seek Help

If you've experienced depressive episodes along with periods of unusually elevated mood, energy, or impulsivity — even if those periods felt good at the time — it's worth discussing with a clinician, especially before starting antidepressant treatment alone. If you or someone you know is in the middle of a manic episode involving risk to safety, seek emergency care.

Insurance & Self-Pay

We're in-network with Blue Cross Blue Shield, Aetna, Harvard Pilgrim Healthcare, Optum, Tufts Health Plan, Wellpoint, United Healthcare, HPI, Mass General Brigham, Carelon, UMR, and UniCare. Self-pay options are available. We are unable to bill Medicare, Medicaid, or supplemental plans.

Frequently Asked Questions

How is bipolar disorder different from regular mood swings?

Everyone's mood fluctuates day to day. Bipolar disorder involves distinct episodes — lasting days to weeks — of clearly elevated or depressed mood that represent a real change from a person's normal functioning, often affecting sleep, judgment, and behavior in ways that are noticeable to others.

Can bipolar disorder be treated with therapy alone, without medication?

Medication is generally considered the foundation of bipolar treatment, because mood stabilizers address the underlying biological pattern in a way therapy alone doesn't. Therapy is a valuable addition for coping strategies and relapse prevention, but it isn't typically used as the sole treatment.

Will I need medication for life?

Bipolar disorder is generally a lifelong condition, and most patients benefit from long-term mood-stabilizing treatment, even during periods when they feel well, since stopping medication is a common trigger for relapse. Your clinician will discuss your specific situation with you.

What if I was previously diagnosed with depression, but I think it might actually be bipolar disorder?

This is a common and important situation to raise in an evaluation. If you've ever had a period of unusually elevated mood, energy, or impulsivity, tell your clinician — it can change the treatment approach, since some antidepressants can worsen bipolar disorder if taken without a mood stabilizer.

Do mood stabilizers require regular blood testing?

Some do — lithium in particular requires periodic blood-level monitoring to stay within a safe and effective range. We coordinate this through local labs near you, with results sent directly to our office.

Can I still live a normal life with bipolar disorder?

Yes. With consistent treatment and monitoring, many people with bipolar disorder maintain stable careers, relationships, and daily lives. Ongoing medication management — rather than treatment that stops once symptoms improve — is usually key to that stability.

Related Conditions We Treat

Bipolar Disorder often overlaps with, or can be mistaken for, other conditions. We also provide evaluation and medication management for Depression, Mood & Emotional Regulation Concerns, Sleep Disturbance.

Get Started

If you're experiencing symptoms of bipolar disorder, the first step is a comprehensive psychiatric evaluation, available by telehealth or in person at our office in Medway. Schedule an appointment or view our full list of conditions we treat.