Bipolar Disorder treatment in Texas
Telehealth psychiatric care for adults — based in Austin, serving patients statewide.
Bipolar disorder is a treatable mood condition characterized by episodes of mania or hypomania alternating with episodes of depression. It exists on a spectrum: Bipolar I involves at least one full manic episode (often with severe consequences if untreated); Bipolar II involves hypomanic episodes (less severe but still impairing) along with one or more major depressive episodes; and cyclothymic disorder involves chronic, lower-intensity mood swings that nonetheless interfere with daily life. Diagnostic clarification matters: bipolar depression is treated very differently than unipolar depression, and getting that distinction right is often the single most important clinical decision in your care.
Many adults are misdiagnosed for years — sometimes treated for unipolar depression with antidepressants alone, only to experience worsening mood instability, mixed states, or a manic episode triggered by treatment. If you have a family history of bipolar disorder, depressive episodes that did not respond predictably to SSRIs, periods of unusual energy or productivity that felt good but caused damage in retrospect, or cycles that seem tied to seasons or sleep loss — bipolar deserves to be on the differential. We'll take that history carefully and treat what is actually present.
Signs you may benefit from treatment
- Distinct episodes where mood is unusually elevated, expansive, or irritable
- Decreased need for sleep — feeling rested after only a few hours
- Racing thoughts or pressured speech that others struggle to follow
- Increased goal-directed activity — projects, spending, sexual activity, or risk-taking
- Inflated self-esteem or grandiosity that is out of character
- Heightened distractibility — starting many things, finishing few
- Periods of severe depression with low energy, hopelessness, or suicidal thoughts
- Mixed states where depressed mood and high energy coexist (often the most dangerous phase)
- Sleep that drives mood — staying up late often triggers shifts
- Irritability or anger that surprises you and the people around you
- Cycles that may follow seasons, sleep changes, or hormonal shifts
- Family history of bipolar disorder, depression, or suicide
How Eki Mental Health PLLC treats bipolar disorder
Diagnostic clarification comes first. Bipolar disorder is often missed because patients usually seek care during depression — the part of bipolar that hurts most — while hypomanic or manic episodes feel productive and pass without coming up in the interview. We use a structured mood history, the Mood Disorder Questionnaire (MDQ), family history, and a careful review of any prior antidepressant response to map what your mood actually does over time. When indicated, we incorporate input from family members or a partner who has watched you across episodes — with your consent.
Once we agree on the picture, treatment is built around mood stabilization — protecting against both manic and depressive extremes — rather than just treating whichever episode you are in today. That means medications with proven prophylactic benefit, attention to sleep and routine as biological stabilizers, and a long-arc partnership: bipolar disorder is a chronic condition, and the goal is years of stability, not just acute symptom relief.
Treatment options
1. Mood stabilizers
Mood stabilizers are the foundation of bipolar treatment. The most evidence-supported options:
- Lithium — the gold standard. Reduces both manic and depressive episodes, has unique anti-suicide evidence, and remains the most effective long-term prophylaxis. Requires periodic blood monitoring (level, kidney, thyroid).
- Valproate (Depakote) — strong for acute mania and for rapid cycling. Requires blood-level and liver monitoring; not first-line for patients who can become pregnant due to teratogenic risk.
- Lamotrigine (Lamictal) — strongest evidence for bipolar depression maintenance. Slow titration is required to minimize rash risk.
- Carbamazepine — useful in specific presentations, with closer monitoring needs.
2. Atypical antipsychotics
Several second-generation antipsychotics have strong evidence in bipolar disorder for acute mania, mixed states, and as adjuncts in bipolar depression — used either short- term during episodes or long-term for maintenance:
- Quetiapine (Seroquel) — works across mania, depression, and maintenance.
- Lurasidone (Latuda) — strong evidence for bipolar depression with fewer metabolic side effects.
- Aripiprazole (Abilify), olanzapine (Zyprexa), cariprazine (Vraylar), risperidone (Risperdal) — each has its own profile; we match to your symptom picture and side-effect tolerance.
3. What we are careful about
Antidepressants alone — without a mood stabilizer — can destabilize bipolar disorder and trigger manic or mixed episodes. If antidepressants are part of your plan, they are added thoughtfully, on top of an established mood stabilizer, and monitored closely.
4. Sleep, rhythm, and lifestyle
Sleep is biology. For bipolar disorder, sleep stabilization is a clinical intervention, not a wellness suggestion. We will protect your sleep window, talk through shift work or travel that destabilizes you, and use targeted strategies (and, when indicated, short-term sleep medications) to keep your circadian rhythm steady.
5. Therapy and supports
Evidence-based therapies for bipolar disorder include Interpersonal and Social Rhythm Therapy (IPSRT), CBT, and family- focused therapy. We coordinate with a therapist if you have one or refer you to an Austin colleague who works with bipolar adults. Peer-support resources like DBSA (Depression and Bipolar Support Alliance) are also valuable for many patients.
What to expect at your first visit
Your first visit is a comprehensive 60–90-minute evaluation. We will map your mood history carefully — including any episodes you may not have called “manic” or “hypomanic” at the time — using a structured timeline and the MDQ. We will also review any prior medication trials, family history, sleep patterns, substance use, and current life stressors.
If you are in an acute episode (severe depression, mania, or a mixed state with suicidal thoughts), please call 988 (Suicide & Crisis Lifeline) or 911 immediately, or go to your nearest emergency room. Telehealth is not the right level of care for acute crisis — but I can be part of your stabilization plan once safety is established.
Optional: GeneSight pharmacogenomic testing
If you'd like, we can order GeneSight at your first visit — a simple cheek-swab genetic test that analyzes how your body metabolizes psychiatric medications and provides a clinician-facing report to guide prescribing.
Benefits:
- Reduces medication trial-and-error by predicting which medications you're likely to tolerate well
- Identifies medications you may metabolize too quickly (less effective) or too slowly (more side effects)
- Especially useful if you've had a hard time tolerating medications in the past or first-line options haven't worked
- Covers 60+ psychiatric medications — antidepressants, antipsychotics, mood stabilizers, anxiolytics, ADHD meds
- One-time test — your genes don't change, so results stay relevant for life and follow you to future prescribers
- Non-invasive cheek swab; results typically return within 2–3 days
Entirely optional — we only order it if you want it. Insurance coverage varies; we'll review cost and coverage with you before ordering.
Insurance & cost
In-network with Aetna and UnitedHealthcare / Optum; most insured patients pay $20–$60 per visit after benefits. Self-pay rates: $400 initial evaluation, $250 standard follow-up. Superbill provided for out-of-network reimbursement. Full pricing & insurance details →