Bipolar disorder is complex — but with the right psychiatric team, effective mood stabilization and a high quality of life are absolutely achievable. We specialize in comprehensive, long-term bipolar care.
Bipolar disorder is a chronic mood disorder characterized by distinct episodes of mania or hypomania (elevated or irritable mood, decreased need for sleep, increased energy and activity, impulsive behavior) alternating with episodes of depression. It affects approximately 2.8% of American adults and is one of the most disabling conditions worldwide.
There are several subtypes. Bipolar I disorder involves full manic episodes, often with psychotic features, that frequently require hospitalization. Bipolar II disorder involves hypomanic episodes (less severe than full mania) and major depressive episodes — and is often misdiagnosed as unipolar depression. Cyclothymia involves chronic mood instability that doesn't fully meet criteria for mania or major depression but still causes significant impairment.
Accurate diagnosis is critical. Treating bipolar disorder as if it were unipolar depression — for example, prescribing an antidepressant without a mood stabilizer — can trigger mania or rapid cycling. This is why psychiatric expertise matters so much in bipolar care.
Get an Expert EvaluationBipolar disorder requires a carefully calibrated treatment plan — different for each phase of the illness and for each individual's unique presentation.
Lithium, valproate, lamotrigine, and carbamazepine form the backbone of bipolar pharmacotherapy. Each has a different profile — lithium is the gold standard for classic bipolar I; lamotrigine is preferred for bipolar depression and bipolar II. We manage dosing, labs, and long-term tolerability.
Second-generation antipsychotics (quetiapine, lurasidone, aripiprazole, olanzapine) are FDA-approved for acute mania, bipolar depression, and maintenance. We select and monitor them carefully based on your metabolic profile and history.
Treating the depressive phase of bipolar disorder is challenging — standard antidepressants can destabilize mood. We use evidence-based agents like quetiapine, lurasidone, and lamotrigine, and may recommend Spravato® or ketamine for treatment-resistant bipolar depression.
Long-term bipolar management involves regular lab work (lithium levels, thyroid, renal function), metabolic monitoring, and mood tracking. We coordinate with primary care to ensure nothing falls through the cracks.
Antidepressants must be used very cautiously in bipolar disorder. They can trigger manic episodes, rapid cycling, or mixed states when used without an adequate mood stabilizer. Most guidelines recommend against antidepressant monotherapy in bipolar disorder. We take a highly individualized approach based on your specific bipolar subtype and history.
For most people, bipolar disorder is a lifelong condition requiring ongoing management. However, many people with bipolar disorder lead extremely full, successful lives with proper treatment. Long-term stability is the rule, not the exception, when treatment is maintained consistently.
Diagnosis requires a comprehensive psychiatric evaluation including detailed personal and family history, review of past mood episodes, and assessment of current symptoms. There is no blood test for bipolar disorder — diagnosis is clinical. Because bipolar II is frequently misdiagnosed as unipolar depression, a thorough evaluation is essential.
Yes. All major insurance plans cover psychiatric evaluation and medication management for bipolar disorder. We accept Aetna, BCBS, Cigna, United Healthcare, Humana, Medicare, and TRICARE.
Expert bipolar disorder care in San Antonio and Boerne. Schedule your comprehensive evaluation today.
Mental Health Associates San Antonio is a proud member of Privia Medical Group — a high-performance physician network committed to coordinated, patient-first care across San Antonio and beyond.