Bipolar Disorder Psychiatrists: In Person & Online

What is Bipolar Disorder?

Bipolar disorder is a complex mental health condition characterized by intense shifts in mood, energy, impulsivity, and activity levels. Individuals may experience periods of elevated or irritable mood and increased energy, followed by episodes of depression, fatigue, and emotional lows. These changes can disrupt work, relationships, sleep, and everyday responsibilities. Understanding the symptoms of bipolar disorder is the first step toward finding effective bipolar disorder treatment and long-term mood stability. Formerly known as manic depression, bipolar disorder affects millions of adults in the United States and commonly begins in early adulthood.

If you or someone you love may be experiencing symptoms of bipolar disorder, early intervention can make a significant difference. With personalized bipolar disorder treatment, many individuals are able to stabilize their moods, improve daily functioning, and reduce the frequency and severity of mood episodes. At Rittenhouse Psychiatric Associates, our experienced providers offer comprehensive evaluations, accurate diagnosis, and evidence-based bipolar disorder treatment both in person and online. Contact our team today to begin your path toward recovery and emotional wellness.

What are the Symptoms of Bipolar Disorder?

The symptoms of bipolar disorder involve noticeable changes in mood, energy, behavior, and activity levels that differ from a person’s baseline emotional state. These episodes may include mania, hypomania, and depression, each affecting daily functioning in different ways. These mood states must not occur solely due to substance use or another medical condition. Identifying these patterns early can help individuals receive the right bipolar disorder treatment and support.

Mania and hypomania are among the most recognizable symptoms of bipolar disorder. These episodes can involve elevated energy, increased motivation, racing thoughts, rapid speech, impulsive decisions, reduced need for sleep, heightened confidence, and unusually irritable or euphoric moods. Manic episodes are more severe and may include psychosis, hospitalization, or dangerous behaviors, while hypomanic episodes are milder but still disruptive. Recognizing these symptoms early is essential for effective bipolar disorder treatment and long-term symptom management.

Hypomania is difficult for providers and patients to recognize because it does not impair functioning and is not distressing. In fact, individuals experiencing hypomanic symptoms often only recognize that they feel great, productive, and confident.

Depression is the most common and longest-lasting phase of bipolar disorder. Depressive episodes can include persistent sadness, low energy, hopelessness, loss of motivation, difficulty concentrating, low libido, poor self-confidence, and other symptoms. Because depressive symptoms may resemble major depressive disorder, many individuals seek help without recognizing or reporting past symptoms of bipolar disorder such as hypomania or mania. A thorough psychiatric evaluation is essential to ensure the most effective bipolar disorder treatment plan is provided.

Even a single manic or hypomanic episode can lead to a bipolar disorder diagnosis rather than major depressive disorder. Because these symptoms may have occurred years earlier, many individuals do not realize how important they are to disclose during treatment. Sharing a complete mental health history helps providers accurately identify the symptoms of bipolar disorder and avoid treatments that could unintentionally worsen mood instability. At Rittenhouse Psychiatric Associates, our specialists conduct comprehensive evaluations to create personalized bipolar disorder treatment plans tailored to each patient’s needs.

Symptoms of Mania or Hypomania

Symptoms of mania and hypomania include:

• A distinct period of time during which an individual experiences uncharacteristically elevated, expansive, or irritable mood and increased activity or energy that lasts most of the day, nearly every day

Plus several of the following symptoms:

• Significantly increased confidence, self-importance, or grandiose feelings
• Decreased NEED for sleep (not just difficulty sleeping)
• Talking excessively or feeling pressure to keep talking
• Subjective feeling that thoughts are racing, which can manifest as continuous speech about loosely related topics, one after another
• Distractibility, being drawn to unimportant details
• Increase in activity. Sometimes the activity is productive, such as taking on lots of projects, making a lot of social plans, getting a lot of tasks done around the house, increased sexual activity, and partaking in a lot of creative endeavors. Sometimes the activity is not productive, such as excessive pacing, rearranging of things without a specific reason, hand-wringing, fidgeting, inability to sit still
• Reckless behavior that can result in serious consequences (uncontrolled shopping sprees or gambling, indiscriminate sexual behaviors or affairs, suddenly or impulsively quitting a job or moving).

In some cases, depressive symptoms can occur at the same time as manic or hypomanic symptoms, making the diagnosis and bipolar disorder treatment process more complex.

Here is an example of a patient describing a period of hypomanic symptoms. “My mood was better than usual, and it felt like everything was finally coming together in my life. I was way more outgoing and made a ton of plans with my friends. A lot of people told me to slow down because I was talking and moving fast. I only needed 4 or 5 hours of sleep and felt totally refreshed. Usually I need at least 8 hours of sleep. I got way more work done than I usually do.”

Here is an example of a provider describing a patient with mania: The patient was sleeping 1-2 hours per night for days on end and reported “chain smoking” day and night. She was hardly eating or drinking. The patient was speaking very quickly and jumped from topic to topic, each with little connection to the last. She was pacing around her house frequently and would constantly shift positions if she sat down. The patient ended up outside in the middle of the night, shouting at the neighbors’ windows about problems she had found out about going on in the government. When someone tried to talk to her to see if she was OK, they could not get a word in. She was eventually picked up by the police and taken to the local crisis response center for psychiatric evaluation.

Symptoms of Depression

Depression symptoms do not differ in bipolar I disorder, bipolar II disorder, or major depressive disorder. The symptoms of a depressive episode last for 2 or more weeks, and the symptoms are present most of the day nearly every day. The symptoms include:

• Depressed, sad, blue, empty mood and/or loss of interest in almost all activities most of the day nearly every day

Plus several of the following symptoms:

• Unintentional weight gain or loss, or appetite increase or decrease
• Difficulty sleeping or sleeping excessively
• Being more restless or slow to the point that others notice
• Fatigue or loss of energy
• Lower self-esteem or excessive or inappropriate guilt
• Difficulty concentrating, difficulty thinking, or difficulty making decisions
• Recurrent thoughts about one’s own death, suicidal thoughts with or without a plan, or a suicide attempt

Sometimes, some symptoms of mania are mixed into the same period as a depressive episode. This adds additional complexity to the diagnosis of bipolar disorder.

Here is a patient describing a depressive episode: “I felt really sad and was crying almost every day for a couple of weeks. I didn’t like doing my favorite things anymore. I stopped responding to texts and phone calls. I was sleeping 12 or 14 hours a day, but never felt rested. I was really down on myself and thought the world would be better off without me. I didn’t care if I woke up the next day or not. My apartment was a mess because I just couldn’t motivate myself to clean up. I even showered less than usual.  I also had a hard time focusing at work.”

Types of Bipolar Disorder

Bipolar I Disorder

Psychiatrists or other qualified providers diagnose bipolar I disorder if a person experiences one or more manic episodes. Manic episodes, at times, require hospitalization to manage and keep the individual safe. Mania is a psychiatric emergency.

Although most individuals with bipolar I disorder also experience depressive episodes, depression is not a necessary part of the diagnosis. A person with bipolar I disorder can also have hypomanic episodes and times of feeling neutral (“euthymic”).

The majority of individuals who have bipolar I disorder have a history of 3+ mental health disorders. The most common are: anxiety disorders, alcohol use disorder, other substance use disorder, and attention-deficit/hyperactivity disorder.

Bipolar II Disorder

Bipolar II disorder is diagnosed if an individual has experienced one or more hypomanic episodes, AND one or more depressive episodes. There can be neutral (“euthymic”) periods as well. If at any point the individual experiences a manic episode, the diagnosis is changed to bipolar I disorder.

Bipolar I vs. Bipolar II Disorder

Cyclothymic Disorder (Cyclothymia)

Cyclothymic disorder is a mood disorder within the bipolar spectrum of illnesses. Like bipolar I and II disorders, there are mood fluctuations that do not fall within the realm of normative. However, the elevations are not severe enough to meet the full criteria for hypomania. Similarly, the lows are not severe enough to meet the full criteria for a depressive episode. The symptoms of subthreshold ups and downs occur more often than not, and are still disruptive to functioning or are distressing. For a diagnosis of cyclothymic disorder to be made, the mood episodes must occur for 2+ years in adults (1+ years in children). There must be no symptom-free periods that last longer than 2 months.

It is important to be aware that individuals who have cyclothymic disorder have a 15-50% chance of developing bipolar I or II disorder later on, and the sooner a mood disorder is treated, the better the overall prognosis.

How Does Rittenhouse Psychiatric Associates Treat Bipolar Disorder?

Effective bipolar disorder treatment requires a personalized approach tailored to each individual’s symptoms, lifestyle, medical history, and overall mental health needs. Because bipolar disorder affects everyone differently, treatment plans may include varying combinations of medication management, therapy, lifestyle support, behavioral modification and ongoing monitoring. At Rittenhouse Psychiatric Associates, our providers carefully evaluate all contributing factors to develop customized treatment strategies that support long-term emotional stability and improved quality of life.

Your First Visit for Bipolar Disorder

When a patient comes to a provider at Rittenhouse Psychiatric Associates, the first steps are building a relationship with the patient while comprehensively evaluating the patient’s concerns and history. Evaluations include listening to the patient’s story, a thorough review of medical problems, current medications, past medications taken along with associated results or problems, safety assessment, cultural background, family history of medical and mental health problems, social history, educational history, substance use history, and circumstances of the patient’s upbringing. The evaluation may include ordering bloodwork and/or referrals to other specialists in some cases to rule in or rule out other possible diagnoses.

After gathering and considering the above information, the provider will develop a treatment plan that is customized for that individual patient. For bipolar disorder, this does typically include medication recommendations. The plan may also include therapy options, management of sleep and wake patterns, management of problematic substance use, mood tracking, stress management, exercise, and more. As bipolar disorder is complex, the provider and patient might meet a couple of times to discuss all of the details and options.

Therapy for Bipolar Disorder

There are many options for therapy when it comes to bipolar disorder, and different approaches may be beneficial for different individuals. Cognitive behavioral therapy (CBT) is a modality often used for treating mental health problems, including bipolar and mood disorders. CBT can help an individual manage thoughts, feelings, and behaviors that contribute to or exacerbate mood episode symptoms. Other benefits of CBT for bipolar disorder include: learning skills to better manage symptoms, improved ability to cope with the challenges of the disorder, learning to recognize when episodes are starting as early as possible, improving functioning, managing co-occurring conditions (anxiety, substance use, ADHD), building habits that keep an individual stable and healthy, and more. CBT is not appropriate for managing mania.

Another therapy modality option is dialectical behavior therapy (DBT). DBT is based on four core principles: emotional regulation, distress tolerance, mindfulness, and interpersonal effectiveness. Patients learn skills to enhance these abilities in themselves, which can in turn help reduce symptoms of bipolar disorder and reduce distress caused by the symptoms of bipolar disorder. It is also potentially helpful for reducing suicidal behavior, which is of significant concern with this mood disorder.

Psychotherapy with a Rittenhouse Psychiatric Associates provider is available in most states.

Medication Management

Medications are an essential part of managing bipolar I and II disorder symptoms. It is also common for a patient with bipolar disorder to need 2 or more medications for symptoms to fully remit. There are nuanced reasons why one medication may be chosen over another. A psychiatry specialist, such as a psychiatrist or psychiatric nurse practitioner, should guide patients in this process, monitor for problematic side effects, and modify treatment when necessary. Some of these medications require careful monitoring. At Rittenhouse Psychiatric Associates, we believe in using the least amount of medication necessary to achieve adequate improvement and stability of the conditions we treat.

Options available to manage mania, hypomania, and depression include mood stabilizers and antipsychotics. (Of note, a more accurate name for antipsychotic medications is “serotonin-dopamine antagonists,” as they are not solely used for treating psychotic symptoms). While the mechanisms by which these medications work are extremely complex, they can be thought of as evening out abnormal brain activity by changing how brain cells communicate and/or by modifying levels of chemical messengers in the brain.

At times, other categories of medications are called upon to help manage symptoms. These can include anti-anxiety medications, insomnia medications, and antidepressants (with caution, as antidepressants can worsen bipolar disorder symptoms in some situations).

Despite the popular belief that medications for bipolar disorder will make people “flat,” or “feel like a zombie,” or make people “tranquilized,” the right medication(s) at the right dosage(s) for an individual can help them to feel like themselves again, and bring one’s mood within a normative range. People who take medications for bipolar disorder can be successful, active, creative, and maintain a normative range of emotions.

Bipolar Medication Management with RPA Available in these States:

• Delaware
• Florida
• New Jersey
• New York
• Pennsylvania

How to Choose a Bipolar Disorder Treatment Provider

There are several ways to find a psychiatrist or psychiatric nurse practitioner specializing in bipolar disorder treatment. The process can seem overwhelming, but finding a provider is similar to seeking any medical specialist.

• Talk to your doctor about psychiatrists near you who treat bipolar disorder.
• Call local hospitals and teaching institutions for recommendations.
• Call your insurance carrier and ask about bipolar disorder treatment near you.
• Search online for psychiatrists who specialize in bipolar disorder.
• If you have family or friends who have seen local psychiatrists who specialize in bipolar disorder treatment, it may be reasonable to ask if they would recommend (or not recommend) a certain doctor or psychiatrist.
• Utilize national mental health resources for additional guidance.

Rittenhouse Psychiatric Associates In-Person Bipolar Disorder Treatment Locations

• Wilmington, DE
• Collingswood, NJ
• Manhattan, NY
• Center Valley, PA
• Paoli, PA
• Philadelphia, PA
• Pittsburgh, PA

Discover Rittenhouse Psychiatric Associates on YouTube

Learn more about bipolar disorders on the Rittenhouse Psychiatric Associates YouTube channel:

• A Deeper Look at Bipolar I Disorder
• A Deeper Look at Bipolar II Disorder