Bipolar Disorder Treatment in Fort Worth

What is bipolar disorder?

Bipolar disorder is a mental health condition that causes dramatic shifts in your mood, energy level, and ability to think clearly. When you have bipolar disorder, your moods swing from extreme highs (manic episodes) to deep lows (depressive episodes). 

There are several types of bipolar disorders:

Bipolar I disorder

Bipolar I involves full-blown manic symptoms that last at least one week or are severe enough to require hospitalization. Depressive episodes may follow or precede the manic episode. 

Bipolar II disorder

Bipolar II disorder involves a pattern of depressive episodes and hypomanic episodes, which are less severe than manic episodes. 

Cyclothymic disorder

Cyclothymic disorder involves multiple periods of hypomanic and depressive symptoms that last at least two years (or one year in children and teenagers). The symptoms don’t meet the diagnostic criteria for a hypomanic or depressive episode. 

Other types

These include other specified and unspecified disorders that involve symptoms of bipolar disorder but don’t fit into any of the three types described above. 

What are the symptoms of bipolar disorder?

Most people with bipolar disorder experience distinct periods of mania and depression.

Symptoms of a manic or hypomanic episode include:

• Racing thoughts
• Increased energy or activity
• Feeling high or elated
• Feeling jumpy or wired
• Speaking faster than usual
• Decreased need for sleep
• Agitation or irritability
• Exaggerated sense of self-confidence
• Risky behaviors, such as spending lots of money or having reckless sex

Symptoms of a depressive episode include:

• Feeling sad or hopeless
• Decreased energy and activity
• Sleeping too little or too much
• Difficulty enjoying pleasurable things
• Forgetfulness and difficulty concentrating
• Eating too much or too little
• Thoughts of death or suicide

If you have thoughts of suicide or harming yourself, call 911 or go to an emergency room right away.

Why can bipolar depression be so difficult to live with?

Depressive episodes can be debilitating. Low energy, loss of interest, difficulty concentrating and changes in sleep can make work, relationships and everyday responsibilities feel overwhelming. Some people seek help for depression without recognizing earlier periods of unusually high energy, irritability or reduced need for sleep.

An evaluation looks at your mood history over time, rather than depression alone. Understanding that pattern helps guide a treatment plan that addresses depressive symptoms while protecting mood stability.

Read about bipolar disorder being mistaken for depression.

Which medications help stabilize mood?

Medication is a central part of bipolar disorder treatment. Options include lithium, certain antiepileptic medications (also called anticonvulsants) used as mood stabilizers, and certain atypical antipsychotic medications. The choice depends on the type of episode, previous response and individual circumstances. These medicines have different roles: a treatment that helps mania may not be the best choice for bipolar depression or for preventing future episodes.

We review previous medications, side effects and relevant health concerns. Follow-up and any required laboratory monitoring help guide treatment over time.

Can antidepressants worsen bipolar symptoms?

In some people with bipolar disorder, antidepressants can trigger hypomania, mania or more frequent mood episodes, including rapid cycling. The concern is especially important when an antidepressant is used without an appropriate mood-stabilizing treatment.

Antidepressants are not the right choice for every patient. If one is considered, your clinician reviews your bipolar subtype, previous mood switches and current symptoms, and monitors your response. Do not stop or change medication on your own; discuss concerns with your treating clinician.

Could other conditions, substances or medications be affecting my mood?

Bipolar disorder can coexist with anxiety, trauma-related symptoms and substance use disorders. These concerns deserve attention as part of a coordinated treatment plan, rather than treating mood symptoms in isolation.

Alcohol and other substances can mimic or worsen mood episodes and sometimes obscure an underlying bipolar disorder. We review when symptoms began, their relationship to substance use or withdrawal, and whether similar episodes occurred independently. Substance-related symptoms alone do not establish a bipolar diagnosis.

Medical conditions, including thyroid disorders, and some prescribed medicines can also affect mood, energy or sleep. We review your medical history, prescriptions, over-the-counter products and supplements, and coordinate medical evaluation or treatment when appropriate.

Explore outpatient psychiatric and addiction care

What if bipolar depression has not improved with treatment?

Persistent symptoms deserve a careful reassessment of the diagnosis, medication trials, side effects, sleep and other factors that may affect recovery. We discuss additional options in the context of your ongoing bipolar treatment plan.

TMS for bipolar depression

TMS may be considered as an additional treatment for selected patients whose bipolar depressive symptoms have not improved sufficiently with medication. Its use for bipolar depression is off-label; the FDA clearance of BrainsWay Deep TMS for major depressive disorder does not establish clearance for bipolar depression. We discuss the evidence, risks, alternatives and ongoing monitoring for mood changes.

Questions about TMS before an evaluation? You can request a free informational consultation with our practice coordinator to discuss the process and practical questions. A clinician determines whether treatment is appropriate for you.

Learn about Deep TMS treatment in Fort Worth

Learn about off-label TMS

Request a Free TMS Coordinator Consultation

Ketamine when symptoms remain difficult to treat

For carefully selected patients, IV ketamine may be discussed after a specialist review of persistent bipolar depression. This use is off-label. Evidence remains limited, particularly for longer-term treatment, and ketamine is not a routine first-line treatment for bipolar disorder.

Any decision includes a discussion of uncertainty, risks and alternatives, medical screening, supervised treatment, monitoring for mood changes and a follow-up plan alongside ongoing bipolar care.

Learn about IV ketamine treatment

Why are education, therapy and family support essential?

Understanding bipolar disorder is part of treatment. Education helps you recognize early warning signs, understand the role of medication and follow-up, and develop more consistent sleep and daily routines.

Psychotherapy can support coping, relationships and relapse prevention alongside medication. When appropriate, we coordinate with your existing therapist or discuss a referral.

With your permission, a family member or trusted support person can help recognize changes, understand your treatment plan and know when to contact the care team. Support should respect your privacy and preferences.

Related reading: When Sobriety Begins, the Family’s Recovery after Alcohol Addiction May Just Be Starting

Request a bipolar disorder evaluation in Fort Worth

Whether you are seeking an initial evaluation or a fresh look at difficult-to-treat symptoms, we begin by understanding your history, concerns and goals. Contact the Institute for Advanced Psychiatry to discuss scheduling.