Bipolar Disorder

Bipolar Disorder Treatment in Baltimore

What is Bipolar Disorder?

Bipolar Disorder is a significant mental health condition that adversely impacts millions of individuals around the world. The main component involves shifts in an individual’s emotional state, ranging from an overly elevated mood that can reach intense euphoria to a depressive state. Bipolar Disorder can cause chronic episodes that may last from several days to many weeks. It also affects a person’s regular routine and their relationships with family, friends, work colleagues, and even overall feelings of well-being.


What are the symptoms of Bipolar Disorder?

There is a wide array of symptoms associated with Bipolar Disorder, but these can be generally divided into two primary categories: mania and depression.


Mania symptoms include:


  • Elevated mood or excessive happiness
  • Increased energy and activity levels
  • Impulsiveness and reckless behavior
  • Reduced need for sleep
  • Grandiose thinking
  • Rapid speech and racing thoughts
  • Difficulty concentrating
  • Irritability or aggression


Depression symptoms include:


  • Persistent sadness or hopelessness
  • Loss of interest in activities once enjoyed
  • Changes in appetite and sleep patterns
  • Fatigue and low energy
  • Difficulty concentrating
  • Thoughts of death or suicide


It’s important to note that some people with Bipolar Disorder experience a mixed episode, which is characterized by symptoms of both mania and depression at the same time. An example is an individual who feels revved up but lousy at the same time. A person experiencing this may describe it as feeling agitated. This can be particularly overwhelming and impairing. Anxiety can sometimes be part of a mixed state.


What causes Bipolar Disorder?

The true source of Bipolar Disorder remains a mystery, though mental health experts believe it is triggered by a combination of hereditary traits (genetics), biological processes, and external conditions.


Genetic factors: The presence of Bipolar Disorder in a family unit could indicate that genetics might be involved. Research has proven that children born to parents with the condition are at greater risk for developing it themselves.


Biological factors: Scientific studies have demonstrated that structural and functional differences in the brain, as well as imbalances in neurotransmitters (the chemicals responsible for regulating emotions), can cause a person to develop Bipolar Disorder.


Environmental factors: Intense life circumstances, like trauma, bereavement, or relationship issues, might instigate episodes of depression or mania in people diagnosed with Bipolar Disorder. It has likewise been noted that certain individuals may be tempted to abuse substances and suffer sleeping problems when they’re triggered by these sorts of events.


The cause of Bipolar Disorder in any individual is likely the result of multiple factors, which will vary from one individual to the next. If you believe you may be suffering from Bipolar Disorder, further investigation should be conducted by a qualified professional. Dr. Ranen’s Baltimore practice provides support for adults who are experiencing symptoms of Bipolar Disorder. His extensive individual assessment will help determine a proper diagnosis.


How is Bipolar Disorder diagnosed?

Unraveling the complexities of Bipolar Disorder may require a mental health professional’s ability to distinguish it from other disorders. Bipolar often mimics signs and symptoms of other neurological disorders including depression or anxiety. To arrive at an accurate diagnosis, Dr. Ranen will provide an extensive psychiatric evaluation which will include these steps:


Medical and mental health history: During a mental health assessment, Dr. Neal Ranen will obtain important details about the individual’s symptoms, genetic predisposition to mental illness, and prior treatments.


Lab tests: To determine potential causes of symptoms that are not related to substance abuse, laboratory tests may be conducted.


Psychiatric evaluation: Involves examining one’s symptoms’ frequency and intensity with standard evaluation tools such as the DSM-5. This evaluation is designed to help determine whether an individual meets the criteria for a bipolar diagnosis.


Differential diagnosis: Before arriving at a conclusive diagnosis of Bipolar Disorder, Dr. Ranen will assess other potential sources for the symptoms such as depression, anxiety, Adjustment Disorder (stress-related conditions), or schizophrenia.


Taking the time to properly diagnose a mental health condition is a vital step to ensure that an individual receives the most appropriate and effective treatment plan. Sometimes more than one  session with Dr. Ranen is needed to gather all of the necessary information in making a proper diagnosis.


What are the types of Bipolar Disorder?

There are a variety of subtypes of Bipolar Disorder, each one characterized by distinct mood fluctuation patterns and signs.


Bipolar 1 Disorder: This type is characterized by recurrent episodes of elevated moods and extreme energy levels (full manic episodes) as well as depressive episodes. It is one of the most common types of Bipolar Disorder, and it affects around 1-2% of the population worldwide.


Bipolar 2 Disorder: This type is characterized by depressive episodes alternating with hypomanic episodes instead of full manic episodes. Unlike mania in Bipolar 1, hypomania in Bipolar 2 does not cause significant impairment in day-to-day functioning and relationships, and is shorter in duration. In this way, Bipolar 2 is considered to be less severe than Type 1. Bipolar  2 is often mistaken for non-Bipolar depression because the “up” phases themselves are not a problem, and can be experienced by the person as their best and most productive self. Although the highs in Type I can be obvious, Type II can be particularly overlooked because the patient never seeks care when they are in the “up” phase (you never hear, “Doctor, this is the best I’ve ever felt, please do something about it!”) — they understandably come for treatment when they’re depressed, just like patients with non-Bipolar Depression.


Cyclothymic Disorder (Cyclothymia): This type is characterized as a milder form of Bipolar Disorder. The disorder is characterized by recurrent episodes of hypomanic and depressive symptoms that last for two or more years. The episodes are less severe than in Bipolar I Disorder but still cause significant distress or impairment in day-to-day life.


Rapid-Cycling Bipolar Disorder: This type is characterized by a rapid onset of episodes of mania, hypomania, depression, and mixed states that occur four or more times in a 12-month period. This form of the disorder is often seen as more severe than other types of Bipolar Disorder and can lead to significant emotional distress.


Other Specified and Unspecified Bipolar and Related Disorders: This category is a broad category that encompasses a variety of mental health conditions that have similar symptoms to Bipolar Disorder, but lack the specific criteria for diagnosis of the condition.


It’s important to emphasize that the different subtypes of Bipolar Disorder often overlap. A proper diagnosis is essential for guaranteeing that an optimal treatment plan can be established.



How do you treat Bipolar Disorder?

Bipolar Disorder is a manageable condition with a proper treatment plan. Treatment plans can include a variety of techniques including:


Medication: To manage bipolar symptoms, it is common to be prescribed mood stabilizers such as lithium, valproic acid (Depakote), lamotrigine (Lamictal), or a group of medications called the “atypicals”. The “atypicals” are actually very commonly prescribed medications but received that name because they were different from the medications at the time (now almost 3 decades ago!). Although several of the mood stabilizers are also approved for the depressed phase of Bipolar, antidepressants may be recommended to alleviate certain manifestations of the condition, but need to be prescribed judiciously because they can result in manic, mixed or rapid cycling states.


Psychotherapy: Numerous studies demonstrate that cognitive behavioral therapy (CBT), interpersonal and social rhythm therapy (IPSRT), and family-focused therapy are highly beneficial in treating Bipolar Disorder.



Lifestyle changes: Taking care of oneself is an important tool for managing Bipolar Disorder symptoms. Through regular physical activity, a nutritious diet, and ample rest, individuals can see improvements in their symptoms. Abstaining from drugs and alcohol is also very helpful while learning how to manage stress and one’s symptoms.


Supplements and other add-on treatments: Although not a substitute for medication in Bipolar, supplements can be a helpful adjunct. Dr. Ranen can discuss this with you in further detail. Bright light therapy can help Bipolar Depression, but unlike with non-Bipolar depression it should be done mid-day instead of in the morning.


Each person’s course of treatment should be tailored by the intensity and occurrence of symptoms as well as their specific wants and needs. Dr. Neal Ranen can assist in creating the individualized plan that works best for you.


Why choose Dr. Neal Ranen?

Dr. Neal Ranen offers Bipolar Disorder treatment in Baltimore, Maryland. His personalized mental health services provide patients with individualized therapy. His therapeutic process for treating Bipolar Disorder typically includes medication management to stabilize mood swings, as well as providing additional support such as cognitive-behavioral therapy (CBT) or interpersonal and social rhythm therapy (IPSRT). Dr. Ranen’s treatment goal is to help you manage your symptoms and improve your overall quality of life.