1. Before Your First Visit: Forms & Records
You’ll complete questionnaires about mood, energy, sleep, and daily functioning. Please bring a list of your medications/supplements, any past evaluations or hospitalizations, and your insurance card.

2. Initial Evaluation: Your Full Story
We’ll talk about your mood history, including both “low” periods (depression) and “high” periods (mania or hypomania), as well as sleep, stress, family history, and how symptoms affect your life. We also check for other conditions (such as anxiety, ADHD, or substance use).

3. Clarifying the Diagnosis
Bipolar disorder can sometimes look like depression, ADHD, or anxiety. We use your history, rating scales, and sometimes input from family or therapists (with your permission) to confirm the diagnosis.

4. Collaborative Treatment Plan (Multimodal)
Your plan may include:

• Medication: mood stabilizers (like lithium, lamotrigine, valproate), atypical antipsychotics, and sometimes antidepressants (carefully monitored). These help prevent extreme mood swings.
  

• Therapy: CBT (cognitive behavioral therapy), DBT (dialectical behavior therapy), interpersonal and social rhythm therapy, or family-focused therapy. Therapy helps with coping, relationships, and managing daily stressors.
  

• Lifestyle strategies: consistent sleep schedule, regular exercise, structured daily routines, limiting alcohol/substances, and avoiding major disruptions in schedule that can trigger mood changes.
  

• Skills & tools: mood tracking apps/journals, stress management, mindfulness, and grounding strategies.
  

• Support systems: family involvement, peer support, or support groups, which can be important in recognizing early warning signs.
  
  

5. If Starting or Adjusting Medication: Safety and Monitoring
We’ll review how medications work, possible side effects, and the need for labs (for medications like lithium or valproate). Finding the right combination can take time, and safety is closely monitored.

6. Short-Term Follow-Ups: Close Monitoring
In the first few weeks and months, visits are more frequent to track mood, sleep, side effects, and overall progress. Adjustments are made based on how you respond.

7. Building Long-Term Stability
Beyond medications, therapy and lifestyle play a big role in preventing relapse. We’ll work on recognizing early warning signs of mania or depression and creating a plan to manage them early.

8. Ongoing Care
Once symptoms are better controlled, visits are usually every 1–3 months. We’ll continue to check mood, sleep, energy, safety, and overall functioning, and adjust the plan as needed.

9. Care Coordination (With Your Permission)
We can coordinate with your therapist, primary care provider, and family (if you’d like) to make sure your care is consistent and supportive.

10. Annual Review & Long-Term Planning
Each year we review your diagnosis, medications, labs (if needed), and life goals. Some people need long-term medication, while others may adjust doses over time. We’ll plan together for both stability and flexibility.

11. If Your Needs Change
Life stress, illness, or sleep disruption can trigger mood swings. If symptoms return or worsen, we’ll adapt, whether that means changing medications, increasing therapy support, or updating your relapse prevention plan.