Online bipolar disorder treatment
in California.
Bipolar disorder is one of the most commonly misdiagnosed psychiatric conditions. Years of depression treatment that doesn't fully work is often the first sign. A thorough evaluation screens specifically for the lifetime mood history that distinguishes bipolar from unipolar depression — because the treatment approach is fundamentally different.
Request an AppointmentTypes of bipolar disorder
Bipolar disorder is not a single condition. Understanding the type matters because it affects both medication selection and long-term management.
Bipolar I is defined by at least one manic episode — a distinct period of elevated or irritable mood, decreased need for sleep, grandiosity, racing thoughts, and increased goal-directed activity that causes significant impairment. Depressive episodes are common but not required for the diagnosis.
Bipolar II involves recurrent depressive episodes and at least one hypomanic episode. Hypomania is a less severe form of mania that doesn't cause full impairment and doesn't include psychotic features. Many people with bipolar II are only diagnosed after years of depression treatment that didn't fully work.
Cyclothymia is a chronic pattern of hypomanic and depressive symptoms that don't meet full criteria for either bipolar I or II. It's often misidentified as mood instability or personality-based reactivity.
Why bipolar disorder is often missed
Most people with bipolar disorder present first with depression. They seek help when they feel low — not when they feel elevated. Hypomania in particular is often experienced as productive, energetic, and positive — it doesn't feel like a symptom until it tips into dysphoria or impulsive decisions with consequences.
Bipolar is frequently misdiagnosed as unipolar depression, ADHD, anxiety, or borderline personality disorder. The key is a thorough history that specifically asks about lifetime elevated mood periods — not just the current depressive episode.
Antidepressants alone in bipolar disorder can trigger cycling, mixed states, or frank mania. This is why the evaluation screens carefully for bipolar features before any antidepressant is prescribed.
Medication options for bipolar disorder
Mood stabilizers
Lithium remains a cornerstone treatment for bipolar I and has the most evidence for preventing both manic and depressive recurrence. It requires periodic serum level monitoring, along with renal and thyroid function checks — these can be done at a local lab. Valproate (Depakote) is used for mania and mixed states, particularly when lithium is not tolerated. Lamotrigine (Lamictal) is particularly effective for the depressive phase of bipolar II and has a favorable side effect profile, though titration must be done slowly to reduce the risk of a rare but serious rash.
Atypical antipsychotics
Several atypical antipsychotics have FDA approval for bipolar disorder. Quetiapine (Seroquel) is approved for both mania and bipolar depression and is widely used. Lurasidone (Latuda) is approved specifically for bipolar depression. Olanzapine (Zyprexa) and aripiprazole are used for manic episodes. Each has a different metabolic side effect profile that factors into selection.
Antidepressants
Antidepressants are not first-line in bipolar disorder and are generally used only when mood stabilizers or atypical antipsychotics haven't adequately addressed the depressive phase. When used, they are typically combined with a mood stabilizing agent and monitored closely for switching or cycling.
Medication decisions are individualized and depend on diagnosis, medical history, current medications, safety considerations, and clinical appropriateness. This page is educational and does not replace individualized medical advice. If you are in crisis, call 988 or go to the nearest emergency room.
Lab monitoring and telehealth
Some bipolar medications require regular lab monitoring. Lithium requires serum levels, renal function (BMP), and thyroid function (TSH) — typically every 6–12 months once stable. Valproate requires liver function tests and drug levels. Atypical antipsychotics require metabolic panels (glucose, lipids) at baseline and periodically. Lab orders are provided, and you can complete them at any local lab or through your PCP.
Insurance and cost
Accepted plans: Aetna, Cigna, Quest Behavioral Health, Carelon Behavioral Health, Anthem Blue Cross California. See insurance details or call (323) 970-2625.
If depression treatment hasn't fully worked, a bipolar evaluation may be worth having.
Request an AppointmentBipolar disorder questions,
answered plainly.
Yes, for stable or moderately symptomatic outpatient bipolar disorder. Telehealth is appropriate for evaluations, medication management, and ongoing care. It is not appropriate for acute mania with severe impairment or psychiatric emergencies.
Mood stabilizers (lithium, valproate, lamotrigine) and atypical antipsychotics (quetiapine, lurasidone, aripiprazole) are primary options. The choice depends on the bipolar subtype, the current phase, and individual tolerability and lab requirements.
Bipolar disorder involves episodes of elevated or expansive mood (mania or hypomania) alongside depressive episodes. Many people present with depression only at first. The distinction matters because antidepressants alone can worsen bipolar disorder.
Some do. Lithium requires serum levels and renal and thyroid function tests. Valproate requires liver function and drug levels. Lab orders are provided and can be completed at any local lab.
Ready to get started?
Request an evaluation and your appointment will be confirmed within one business day.