ED S. JESALVA, MD
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Bipolar Psychiatrist Insights: Treatment & Therapy Options

1/24/2024

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Bipolar disorder is a complicated mental health condition, and if you are one of the millions of Americans with some form of this disease, you are likely well aware of how difficult it can make life. As a bipolar disorder psychiatrist, however, I have seen many success stories with patients who can manage symptoms with effective treatment options. Let’s take a look at the types of therapy and treatments that may help.

Medication

Medication has long been prescribed to individuals with bipolar disorder, and many people successfully navigate life once the correct medications and the correct dosage have been established. This process can take some time, and it’s not always a quick fix, but it can be very beneficial for many patients. Some of the drugs we might use include:

  • Mood Stabilizers: Often the first line of treatment (e.g., lithium, valproate).
  • Antipsychotics: Used if symptoms persist despite mood stabilizer treatment.
  • Antidepressants: Sometimes used in combination with a mood stabilizer to manage depressive episodes.
  • Anti-Anxiety Medications: For managing anxiety symptoms, often on a short-term basis.

Psychotherapy

In general, the best approach always includes some type of therapy. As a bipolar psychiatrist, I can prescribe medication and recommend a course of treatment, but you will want to find a psychologist or therapist who specializes in bipolar disorder for your therapy.

  • Cognitive Behavioral Therapy (CBT): Helps identify and change harmful thought patterns and behaviors.
  • Dialectical Behavior Therapy (DBT): This type of therapy also can be used to help patients regulate emotions, which can be difficult with bipolar disorder.
  • Family-Focused Therapy: Involves family members in the treatment process to improve communication and support.
  • Interpersonal and Social Rhythm Therapy (IPSRT): Aims to stabilize daily rhythms such as sleeping, eating, and activity schedules. Sleep disruption is a huge component of bipolar disorder, which I will discuss below, but this is one reason why IPSRT can be beneficial.
  • Psychoeducation: Educates the individual and their family about bipolar disorder and its management. This is more important than you might think. It’s so helpful for both patients and friends/family to truly understand the best ways to manage this condition. Education can make a huge difference and boost the success of treatment. 

Electroconvulsive Therapy (ECT):

For severe episodes or when medication and psychotherapy do not work, ECT can be effective, particularly for depressive episodes and, in some cases, mania. ECT was formerly called shock therapy and it has a rather dubious reputation throughout the psychiatric community. However, multiple studies illustrate its success with major depression, severe bipolar disorder and schizophrenia.
 
Another option to consider might be Transcranial Magnetic Stimulation or TMS. This option is less invasive and, for lack of a better word, a bit less scary. The FDA has allowed its use as a treatment for bipolar depression as well as for treating major depressive disorder, OCD and even issues such as migraine headaches. As a side note, migraines are extremely common in patients with bipolar disorder, and TMS might be an option to treat both your depression and migraines.

What About Psilocybin?

Psilocybin, or magic mushrooms, as they are sometimes called, are gaining interest as a treatment option for some psychiatric disorders. However, because this substance has long been illegal federally, there have been few studies undertaken to gauge its safety or efficacy. It’s also worth noting that psilocybin is illegal in all but two states – Colorado and Oregon.
 
Having said that, there are a few studies that suggest psilocybin might be a good treatment for depression as well as PTSD. As a psychiatrist, I am intrigued by the idea of using psilocybin as part of therapy and look forward to more studies and research as I believe it may yield positive results.
 
However, it is important to understand that even in the states where it is decriminalized, it is being used at licensed facilities and not simply sold over the counter as you might purchase cannabis. People with bipolar disorder often self-medicate to alleviate symptoms, but I don’t recommend trying psilocybin on your own.
 
With bipolar disorder, there also is some anecdotal evidence to suggest that psilocybin might activate a manic phase, which is not a good outcome. Again, more research needs to be conducted, specifically with bipolar patients before I would feel comfortable recommending this as a treatment option although I truly feel it has great promise to help those with treatment-resistant depression and PTSD.

Additional Treatment Options

As a psychiatrist specializing in bipolar disorder, I recommend trying a multi-treatment approach to this disease. A combination of medication and different therapies tends to elicit the best results. However, the following tips have been shown to be helpful for patients with bipolar disorder as part of a combination approach.

Lifestyle Modifications Can Help

Changing your lifestyle can make more of a difference than you might think. For instance, regular exercise can help improve your mood and reduce depressive symptoms. A healthy diet that includes omega-3 fatty acids also has been shown to help. It is recommended that you avoid red meat and foods high in saturated fat and trans fat, such as “junk” food.
 
Creating a healthy sleep schedule is crucial, as sleep disruption can trigger both manic and depressive episodes. This is hugely important, and one step you can take is to create a sleep journal. Write down what you ate and when, and what you drank and when, as well as when you took medications, went to sleep, woke up, etc. This can help identify triggers that lead to poor sleep. I also recommend creating a sleep ritual that includes turning off electronic devices and perhaps winding down with some meditation, a warm bath and some relaxing music.

Try The Mindfulness Approach

These days, meditation is easier than ever before. For instance, many phone meditation apps can help you clear the mind and relax and de-stress, as well as classes in meditation and mindfulness. Deep breathing exercises also can be helpful and reduce stress and regulate your mood.

Consider A Support Group

Many people with bipolar disorder struggle with feelings of isolation and feelings that no one truly understands what they are going through. Finding a support group can be a great way to feel less alone and isolated.

Need A Psychiatrist for Bipolar Disorder? I Can Help

If you’ve been searching for a bipolar psychiatrist near me but have yet to find someone who is a good match for you, feel free to contact our office at any time. While I work as a psychiatrist in Thousand Oaks and serve the greater Los Angeles area, I also offer telepsychiatry and this can be a good option to consider if you can’t find a good fit in your immediate area.
 
I have extensive experience working with patients with bipolar disorder as well as co-occurring disorders. I can create a diagnosis and treatment plan that addresses all of the issues you face and help lead you on a journey to a brighter, happier future. If you need a bipolar disorder psychiatrist, please don’t wait another day to seek treatment. Help is available, and bipolar disorder can be managed successfully and long-term.
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    Author

    Dr Jesalva is a psychiatrist.  He is in private practice in Thousand Oaks, CA since 1989.  He successfully treats very challenging patients with varying co-occurring disorders with medications.
    ​

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  • Home
  • Services
    • Psychiatric Consultation
    • Telepsychiatry
    • Depression
    • Anxiety
    • Bipolar Disorder
    • ADD/ADHD
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    • Drug Abuse
  • About
    • Bio
    • Message from the Dr
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  • FAQ's
    • Questions about Dr Jesalva
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    • Questions about the office
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    • Telemedicine
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    • 2024 Fee Schedule
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