Bipolar Disorder Treatment in West Ashley, Charleston
Careful evaluation and long-term medication management for mood episodes, with counseling as part of the plan.
Understanding Bipolar Disorder
Many people first come to a mental health provider during a low stretch, so the lows get attention and the highs do not. The National Institute of Mental Health (NIMH) explains that people with bipolar II disorder may ask for help only with depressive episodes, leaving hypomania unnoticed, and that some people go years without a diagnosis. Getting this right matters, because the care for bipolar disorder is different from the care for depression on its own.
The high periods are called mania, or hypomania when they are milder. During mania, mood may run elevated or irritable. A person may become far more active, get by on very little sleep, think and speak quickly, feel unusually important, chase pleasure to excess and fall behind at work or with friends and family. Hypomania looks similar on a smaller scale. It can pass for a productive week, and relatives or friends may spot the change first.
The low periods can bring sadness, hopelessness or anxiety, lost interest in activities, low energy, poor concentration, changes in sleep, and thoughts of death or suicide. If you or someone you know is having thoughts of suicide, call or text 988 now. If there is immediate danger, call 911 or go to the nearest emergency room now.
In a mixed episode, signs of both poles appear together. NIMH says episodes typically run a week or two or more, with symptoms present for much of each day.
The Main Types
The American Psychiatric Association's DSM-5-TR fact sheet covers bipolar I and bipolar II disorder, and telling them apart shapes the plan. In NIMH's description, bipolar I disorder involves manic episodes lasting 7 days or more, or so severe that a person needs hospital care, usually with depressive episodes as well. Bipolar II disorder involves depressive and hypomanic episodes, and many people with it also carry ongoing low-grade depression. Cyclothymic disorder belongs to the same family of diagnoses, and your clinician can explain it if it applies to you. Four or more mood episodes in one year is known as rapid cycling.
How Common Is Bipolar Disorder?
NIMH estimates that 2.8 percent of U.S. adults had bipolar disorder in the past year and that 4.4 percent will have it at some point in their lives. Past-year rates look similar for men and women. It usually begins in the late teens or early adult years, so an adult who has had years of unexplained mood swings may have a long history worth going over.
How We Evaluate Mood Changes
A diagnosis of bipolar I disorder, bipolar II disorder or cyclothymic disorder is made by a qualified clinician using the DSM-5-TR, the American Psychiatric Association's diagnostic manual. Your first visit looks at your whole life, not only how you feel today. In plain words, NIMH says clinicians look back across your lifetime: the strength of past mood symptoms, the length of each spell, the number of times they came back, and what runs in your family. Your provider may suggest a physical exam or medical tests, because thyroid disease and some drugs can cause mood symptoms or make them worse.
You can help. Written records make patterns easier to spot, which is why NIMH recommends a mood journal or life chart. People close to you may have seen changes you did not, so ask them and share what they say. Also tell us about any stretch when you had far more energy than usual and needed little sleep. We also ask about conditions that often appear with bipolar disorder, such as anxiety disorders, ADHD and eating disorders.
Treatment Options
Bipolar disorder tends to stay even when symptoms quiet down, so NIMH says care usually continues for life, including when you feel well. NIMH also says treatment often helps, even in severe cases, and it can include medication, talk therapy or both.
The 2023 VA/DoD guideline on bipolar disorder treats medicine as the base of care. Medication when indicated, decided jointly with the patient, is used to help prevent mood episodes or make them less severe. Your provider goes over treatment options and side effects with you and adjusts the plan at follow-up visits. Please do not stop a medication on your own, even if you feel well.
Here is a key difference from depression care. NIMH cautions that in bipolar disorder, a plan for depression alone can set off mania or rapid cycling. If you are being treated for depression and have ever had up periods, tell your provider, since that history can change the plan.
Among the talk therapy approaches used alongside medication, NIMH lists cognitive behavioral therapy (CBT), family-focused therapy, and interpersonal and social rhythm therapy. The VA/DoD guideline says adding talk therapy can help when you are not acutely manic. We offer individual counseling only, using CBT, acceptance and commitment therapy (ACT) and trauma-informed care. We do not offer family therapy, so your care can include a referral when another approach makes more sense.
Daily habits support this work. NIMH suggests regular times for eating, sleeping and exercising, and staying away from alcohol and drugs. Winter deserves a plan too, since many people with bipolar disorder find their depression gets worse then.
If You Are in Crisis
Some moments cannot wait for an appointment. If you or someone you know is thinking about suicide or self-harm, call or text 988 right now to reach the 988 Suicide & Crisis Lifeline, which is free and confidential at any hour. If mania or depression has made someone unsafe, or there is any immediate danger, call 911 or go to the nearest emergency room now. Veterans and service members can reach the Veterans Crisis Line by dialing 988 and pressing 1. Hope Behavioral Medicine is not an emergency service.
Getting Care in the Charleston Area
Charleston County has about one mental health provider for every 214 residents, compared with one for every 437 across South Carolina. Our office is on Gardner Road in West Ashley, and we also see adults anywhere in South Carolina by secure video, so you do not have to wait for a local opening or take time off to drive.
We accept Medicare, most major commercial plans, and all South Carolina Medicaid managed care plans except Select Health (First Choice). New patients are often able to be scheduled within a week of requesting an appointment.
Sources
The facts on this page come from: National Institute of Mental Health, Bipolar Disorder (2025); National Institute of Mental Health, Bipolar Disorder (statistics); American Psychiatric Association, DSM-5-TR fact sheet on bipolar I and bipolar II disorders; U.S. Departments of Veterans Affairs and Defense, Clinical Practice Guideline for the Management of Bipolar Disorder (2023); CMS National Provider Identification file, 2024, via County Health Rankings & Roadmaps, 2025.
Common Symptoms
Treatment Options
Frequently Asked Questions
Depression brings periods of low mood. Bipolar disorder includes those lows along with up periods of mania or hypomania. The two can be hard to tell apart, which is why we ask about your whole mood history.
It is possible. Hypomania can go unnoticed, and people with bipolar II disorder may seek help only when they feel low. A qualified clinician can look at whether up periods have been part of your history.
Often, yes. It can feel like extra energy and a productive stretch, with no sense that anything is off, while people close to you see a change. That is why their observations are useful at a visit.
Please talk with your provider first. The condition tends to stay even when you feel well, and your provider can adjust the plan with you.
A mood journal or life chart if you keep one, what people close to you have noticed, any mental health conditions in your family and a list of the medicines you take.
NIMH estimates that 2.8 percent of U.S. adults had bipolar disorder in the past year, and 4.4 percent will have it at some point in their lives.