Bipolar Disorder

Bipolar disorder is a lifelong illness, but you can manage the mood swings and other symptoms it causes by following a personalized treatment plan. Axis Integrated Mental Health has offices in Boulder, Denver, and Westminster, Colorado, where the highly skilled team provides ongoing, holistic treatment for patients with bipolar disorder. Call the Axis Integrated Mental Health office nearest you to schedule a bipolar disorder evaluation or book an in-person or telehealth appointment online today.

What is bipolar disorder?

Bipolar disorder causes intense changes in mood, thinking patterns, energy levels, and behavior. It affects around 5.7 million adults in the United States.

Patients with bipolar disorder experience cyclical mood changes that can last for hours, days, weeks, or months. You may have extreme highs (mania), bouts of hypomania (a less intense mania), extreme lows (depression), and every stage in between.

Bipolar mood swings affect your ability to perform daily functions, affecting sleep quality and quantity, judgment, behavior, and thinking. It’s a lifelong illness, but with the Axis Integrated Mental Health team’s support, you can manage mood swings and other bipolar disorder symptoms successfully.

What effects does bipolar disorder have on behavior?

Manic episodes can cause the following symptoms and behaviors:

• Feeling important or powerful
• Excessive appetite for pleasurable activities like eating, drinking, and sex
• Feeling you can do many activities at once without getting tired
• Racing thoughts
• Distractedness
• Being extra talkative
• Reduced need for sleep
• Being jumpy or wired
• Extreme irritability
• Feeling high, elated, or euphoric

In contrast, during a depressive episode, you’ll likely feel very down, sad, and anxious. You might have difficulty getting to sleep, wake up too early, or sleep too much. Your speech can slow, you might struggle to have conversations, and avoid social contact.

Depression affects concentration and decision-making, and you may feel unable to manage simple tasks. You lose interest in most activities, feel hopeless or worthless, and, in severe cases, think about death or suicide.

Patients with bipolar disorder may not always be manic, hypomanic, or depressive. They can also experience periods of balanced mood (euthymia). It's important to note that many patients are often misdiagnosed with bipolar disorder, and it requires careful evaluation by a mental health specialist, as medication management for this condition differs from traditional depression guidelines.

Does bipolar disorder have different forms?

Bipolar disorder has several forms, including:

Bipolar I disorder

Bipolar I disorder patients have had at least one manic episode with a hypomanic or major depressive episode before or after. Manic episodes last at least seven days and can be so severe that patients require hospitalization. Sometimes, mania triggers psychosis (a break from reality).

Bipolar II disorder

Bipolar II disorder patients experience depression and have had at least one hypomanic episode, but they don’t suffer from severe mania.

Cyclothymic disorder

People with cyclothymia experience frequent hypomania and depression over two years or more.

Is Bipolar Genetic? 

Research shows that bipolar disorder does tend to run in families. Studies estimate that genes account for approximately 60% to 90% of the risk for developing it, making it one of the most heritable mental health conditions. That said, having a relative with bipolar disorder does not guarantee you will develop it, and environmental factors like stress, trauma, or substance use also play significant roles in triggering symptoms. Our blog, “Is Bipolar Disorder Genetic?”, dives deeper into how genetic predisposition interacts with life experiences, offering clarity and guidance for anyone wondering about family risk.

What's the Difference Between Manic Depression and Borderline Personality Disorder?

Bipolar disorder is a mood disorder characterized by distinct episodes of mania or hypomania and depression that typically last for days to weeks. It is fundamentally different from Borderline Personality Disorder (BPD), a personality disorder marked by rapid emotional changes lasting minutes to days, chronic feelings of emptiness, fear of abandonment, and unstable relationships. Bipolar individuals often experience stable functioning between mood episodes, whereas those with BPD face ongoing emotional dysregulation and identity instability. Our blog, “What Is the Difference Between Manic Depression and BPD?”, delves into how these disorders differ in their underlying causes, symptom patterns, and best treatment approaches and clarifies how Axis clinicians ensure accurate diagnoses and tailored care to meet each person’s unique needs.

What treatment helps with bipolar disorder?

Bipolar disorder requires ongoing treatment that typically includes talk therapy and medications like mood stabilizers and antidepressants. Exercise, meditation, yoga, and light therapy can be helpful, and some patients benefit from transcranial magnetic stimulation (TMS) and ketamine therapy. Here's an overview of how we can treat bipolar disorder at Axis Integrated Mental Health.

Medication Approaches for Bipolar Disorder

1. Mood Stabilizers

• Lithium remains the gold standard for managing both mania and depression and reducing suicide risk.

• Other stabilizers like valproate (Depakote), carbamazepine (Tegretol), and lamotrigine (Lamictal) may also be used depending on the type of bipolar symptoms.

2. Antipsychotics

• Atypical (second-generation) antipsychotics such as quetiapine (Seroquel), olanzapine (Zyprexa), lurasidone (Latuda), and aripiprazole (Abilify) can help manage mania and sometimes bipolar depression.

• Often used alone or in combination with mood stabilizers.

3. Antidepressants (with caution)

• Antidepressants may be prescribed short-term, but only alongside a mood stabilizer to avoid triggering mania.

• They are not usually the first-line option for bipolar depression.

4. Combination Therapy

• Many patients need more than one medication (e.g., lithium + an antipsychotic) to stabilize both manic and depressive episodes.

• Treatment is personalized based on response, side effects, and subtype (Bipolar I vs. Bipolar II).

5. Adjunctive Treatments

• Anti-anxiety medications or sleep aids may be used temporarily to manage insomnia, agitation, or acute distress.

Spravato® and Bipolar Disorder

Spravato is FDA-approved for treatment-resistant depression and major depressive disorder with suicidal thoughts, but research suggests it may also benefit people with bipolar depression (the depressive side of bipolar disorder). Because it works on the brain’s glutamate system--not serotonin or dopamine--it can act rapidly, sometimes reducing depressive symptoms within hours to days. Importantly, it’s generally used alongside a mood stabilizer to lower the risk of triggering mania. At Axis, providers carefully screen and monitor bipolar patients before considering Spravato as part of a treatment plan.

TMS and Bipolar Disorder

TMS is a non-invasive treatment that uses magnetic pulses to stimulate parts of the brain linked to mood regulation. While TMS is FDA-approved for major depressive disorder, studies have shown it can also help bipolar depression--improving energy, concentration, and mood without the systemic side effects of medication. TMS is not known to trigger mania, making it a safe option for many patients with bipolar disorder who struggle with depressive episodes.

Tailoring Your Healing Journey

At Axis Integrated Mental Health, medication is never “one-size-fits-all.” Our providers carefully monitor each patient, adjusting medication plans over time, and integrate therapy and advanced treatments (like TMS or Spravato for co-occurring depression) to improve long-term outcomes.

Call Axis Integrated Mental Health at (720) 400-7025 or book an appointment online today for expert bipolar disorder diagnosis and treatment.