Understanding Bipolar Disorder
Bipolar disorder is a complex mood disorder characterized by alternating periods of elevated mood (mania or hypomania) and depression. Bipolar I involves full manic episodes that may require hospitalization; Bipolar II involves hypomanic episodes and major depressive episodes. Cyclothymia involves milder mood cycling. All subtypes require expert diagnosis and long-term medication management.
Signs & Symptoms
- Manic/hypomanic: elevated or irritable mood, decreased sleep need, grandiosity, racing thoughts, impulsive behavior
- Depressive: persistent low mood, loss of interest, fatigue, concentration difficulties
- Rapid cycling: 4+ mood episodes per year
- Mixed features: simultaneous depressive and manic symptoms
How Dr. Agresti Treats This Condition
Bipolar disorder requires expert long-term medication management. The cornerstone of treatment is mood stabilization — typically with lithium, valproate, or atypical antipsychotics — to prevent both manic and depressive episodes. Dr. Agresti has extensive experience with the complex pharmacology of bipolar disorder, including managing medication combinations and monitoring for long-term side effects.
Medication Options
- Mood stabilizers: Lithium, Depakote (valproate), Lamictal (lamotrigine)
- Atypical antipsychotics: Seroquel (quetiapine), Abilify (aripiprazole), Latuda (lurasidone)
- Note: Antidepressants used cautiously (risk of triggering mania)
- Regular monitoring: blood levels, kidney and thyroid function (lithium)
The Concierge Advantage
With Dr. Agresti's concierge model, medication adjustments happen quickly when you need them — not at your next appointment weeks away. Text him directly if symptoms worsen. Get same-day refills. Reach him directly when you're having a difficult day. This level of access makes a meaningful difference in psychiatric treatment outcomes.
Frequently Asked Questions
Yes. With appropriate mood stabilization, most patients with bipolar disorder can achieve significant stability. Regular medication management, monitoring, and lifestyle factors (sleep regularity, stress reduction) are key to long-term management.
Antidepressants can trigger manic episodes in bipolar disorder and should be used cautiously, typically only with a mood stabilizer. This is a critical reason why it is important to disclose all mood history to your psychiatrist — antidepressants prescribed for unrecognized bipolar depression can worsen the overall course of illness.
Lithium has a narrow therapeutic window and requires regular blood level monitoring. During dose adjustment: every 1–2 weeks. When stable: every 3–6 months. Kidney function and thyroid tests every 6–12 months. Dr. Agresti coordinates this monitoring as part of ongoing care.
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