Finding the right bipolar disorder treatment path for you can be empowering. This guide can help you simplify the process of finding a therapist. In it, you’ll learn about the therapy types, the advantages of therapy for bipolar disorder treatment, how in-person and online therapy compare, and advice on how to select the best therapist for you.  The types of therapy used for bipolar disorder Often used in conjunction with medication, therapy can play a supporting role in the management of bipolar symptoms by helping individuals explore their experiences, thoughts, feelings, and behaviors under the guidance of a trained professional. Since the disorder affects each person differently, various therapeutic approaches allow for personalized care plans that address specific challenges, triggers, and symptoms. The goal of therapy is not only to manage bipolar symptoms but also to enhance overall quality of life, empower individuals with coping strategies, and support long-term stability. Cognitive behavioral therapy (CBT) CBT is a structured form of talk therapy that has been shown to be effective in helping individuals with bipolar disorder to better manage their symptoms by examining and changing thought patterns, emotions, and behaviors. It typically involves identifying negative thought processes and learning how to replace them with more positive ones. CBT may also involve developing coping strategies and stress management techniques. Free resource: CBT Thought Record Exercise Worksheet Dialectical behavioral therapy (DBT) Often used in conjunction with other therapies, DBT is a more focused offshoot of CBT that concentrates on managing the intense emotions and mood swings associated with bipolar disorder. It achieves this by combining standard cognitive-behavioral techniques with core concepts of distress tolerance, mindfulness, emotional regulation, and interpersonal effectiveness. Learn more: DBT Distress Tolerance Skills for Emotional Crisis Family-focused therapy (FFT) FFT is not just about the individual; it involves the whole family. It educates, supports, and teaches family members effective and constructive ways to interact with the individual with bipolar disorder to create a nurturing and empathetic environment. This type of therapy may also involve addressing family dynamics and communication patterns to improve relationships and promote healing. Interpersonal and social rhythm therapy (IPSRT) IPSRT is an evidence-based approach developed specifically for the treatment of bipolar disorder. Its focus is on balancing social routines and mood symptoms while also developing strategies to improve social skills and stabilize mood. ​​This therapy could be especially helpful for those seeking to consistently maintain daily routines and manage the disruptions in social relationships that can come with bipolar disorder. How therapy can help those with bipolar  Why should you choose therapy? Here's the rundown on some of its benefits: Symptom reduction: Therapies like CBT and DBT are shown to reduce the frequency, duration, and severity of bipolar symptoms. Beyond medication: While medication is a standard treatment for bipolar disorder, therapy offers an additional layer of support. Life skills: Therapy can provide individuals with the tools they need to manage their thoughts, emotions, and relationships, which are especially crucial for those with bipolar disorder. Prevention of relapse: Some types of therapy, like IPSRT, help individuals regulate their social rhythms, which can lead to a more stable life and, in turn, reduce the risk of relapse. Incorporating therapy could enhance your overall treatment plan for bipolar disorder. How therapy complements bipolar meds Medication is a fundamental component of bipolar disorder treatment, vital for stabilizing moods and controlling symptoms. However, medication alone may not address all the complexities of the condition. This is where therapy comes into play, serving as a complementary approach. By participating in therapy, individuals not only work toward managing their symptoms but also develop crucial life skills and coping strategies. These skills help address daily challenges and reduce the impact of stressors that could trigger episodes. Medication brings chemical imbalances under control, laying a foundation for emotional and psychological stability. Meanwhile, therapeutic interventions build on this stability, focusing on the behavioral, cognitive, and emotional aspects of bipolar disorder. This integrated approach can empower you to take control of the entirety of your experience with bipolar disorder, paving the way for a more balanced and fulfilling life. In-person vs. online therapy The traditional in-person therapy model has been a go-to for mental healthcare, but online therapy is quickly becoming very popular. Let’s compare the two. In-person therapy is a traditional approach that allows for improved body language reading and environment control but comes at the cost of being more expensive and less convenient. Online therapy offers accessibility and affordability while still implementing proven therapeutic modalities. Without all the overhead that comes with running an office, online mental health providers like Cerebral can pass along savings to clients. Online therapy can also save you time because there aren’t as many scheduling limitations — plus, there’s no need to commute!  How to find a therapist Selecting a therapist for your bipolar disorder care will take some research. Here are some avenues to explore: Online resources: Services like Psychology Today's directory or Cerebral’s network of online therapists can offer detailed profiles. Get a referral: Your primary care physician or psychiatrist can usually provide a list of recommended therapists. Friends and family: Reach out to friends and family who have positive experiences with therapy, especially if they have the same diagnosis. Check patient organizations: Organizations like the National Alliance on Mental Illness (NAMI) can be excellent resources for finding local support and therapy options. Community centers: Local mental health centers often have a network of resources and professionals. Exploring various options and communicating openly with potential therapists will help you establish a therapeutic relationship that feels like the right match for you. A good fit can make all the difference in your therapy experience and overall treatment success. Things to look for in a therapist Once you have a list of potential therapists, how do you narrow down your options? Look for the following: Affiliations: Is the therapist part of any recognized mental health organizations or networks? Specialties: A therapist with a specific focus on bipolar disorder will likely have more experience treating it. Reviews and ratings: While not definitive, online reviews can provide insights into others’ experiences. Initial consultation: Meeting a therapist for a session can give you a feel for how you might benefit from their approach. When searching for quality care from a credentialed therapist, prioritize experience with bipolar disorder, good communication skills, and a therapeutic practice that resonates with you. What to ask a potential therapist Being prepared with the right questions helps clarify the process. Be sure to ask: Are they accepting new patients?  Do they take your insurance?  Can they coordinate with your doctor or psychiatrist? What’s their background and training in bipolar disorder like? You’ll also want to know what a typical therapy session looks like and how they measure progress toward your goals and motivations for going to therapy. How to know if a therapist is a good fit for you It's important to recognize when you've found a good relationship with a therapist so you can keep building on the work you do together. Signs that you're on the right track include: They’re responsive to your needs. A good therapist will demonstrate having heard and understood you by responding to your concerns and listening to you.  They foster a sense of trust and safety. You’ll need to feel comfortable sharing many things with them, so you should feel that they’ve created a safe, judgment-free environment where you can be open and work through issues and concerns. You see progress. After an appropriate number of sessions, which varies from person to person, you should begin to notice improvement and benefits from your sessions, tailored to your personal timeline and needs. Identifying these positive signs can help you feel assured in your choice of therapist, fostering a rewarding and supportive therapeutic relationship. Why Cerebral might be a good fit for you If you’re looking for convenience, flexibility, and affordability while still getting access to top-rated licensed therapists, Cerebral could be the right choice for you. We’re committed to helping you find the best fit for you. With Cerebral, you’ll have access to a diverse group of mental health care professionals, and we take your preferences into account. Not only can we match you with a therapist who has experience with bipolar disorder, but preferences around an ethnic background, age range, LGBTQIA+ experience, and gender can also be factored in. Plus, you can switch therapists for any reason, at any time. We offer online therapy sessions at times that suit you best — during the day, at night, or over the weekend — allowing you to focus on your mental health without impacting your day-to-day responsibilities. When mood episodes can already cause interruptions in one’s daily life, this flexibility can be an advantage for bipolar individuals. The ability to join sessions from the privacy and comfort of your own home can also be a significant benefit. It’s not uncommon to feel unmotivated during depressive episodes, and the effort, stress, and time it takes to travel to a therapist’s office could be a barrier during those periods. With Cerebral, you can engage in meaningful therapy sessions wherever you are most comfortable. Being in a familiar private space could also help you feel freer to open up and discuss your feelings from the start. Additionally, we have a large network of top-tier licensed prescribers, allowing you to also manage your bipolar medication online from one central place under one affordable subscription with free expedited shipping. Want to give Cerebral a try? Schedule your first session today. Images by freepik and freepik on Freepik.

In our daily lives, feelings of anxiety and fear can surface, intermingling in ways that make them tough to distinguish. However, understanding the distinction between the two helps in managing them effectively, leading to improved emotional resilience. While both are natural and common responses to threats, they’re influenced by different triggers and operate on separate timelines. Confusion between these emotions arises because they share physical symptoms and can affect us simultaneously. In this guide, we’ll dissect the differences between the two. What is anxiety? Anxiety is a natural human response to stress, a feeling of unease or apprehension about what's to come. It’s part of the body’s flight-or-fight mechanism that helps us prepare for an immediate threat by getting us to react to the situation. Anxious feelings become a concern when they occur frequently, leaving a person in a persistent state of anxiety. We all can have feelings of anxiety, but people can also have anxiety disorders. It’s an important distinction to recognize.  Symptoms of anxiety The symptoms of anxiety can vary from person to person, but common physical and emotional indicators include: Rapid heartbeat Sweating or trembling Difficulty concentrating Restlessness or irritability Muscle tension and aches Nausea or stomach upset These physical signs are often accompanied by persistent worry and fear about everyday situations, making it more difficult for a person to function in their daily life.  Types of anxiety disorders Anxiety disorders are classified into specific types, including generalized anxiety disorder (GAD), panic disorder, social anxiety disorder, and phobias. Each type has its own set of symptoms and triggers that can vary from person to person. Explore more: Anxiety Disorders — Here’s What You Should Know What is fear? Fear is also a natural emotion that is triggered by a real and present danger. Functioning as the mind and body's response to an immediate threat, fear motivates us to act in the interest of our survival and safety. It can be triggered by a scary situation, whether it's real or perceived. Symptoms of fear Similar to anxiety, fear also has physical and emotional symptoms that accompany it. These may include: Shaking or trembling Sweating Feeling dizzy or lightheaded Dry mouth or difficulty swallowing Numbness in the body Similar to anxiety, fear is a feeling we all can have, but when the fear becomes irrational, persistent, and significantly distressing, it can evolve into a phobia. Phobias are categorized as a type of anxiety disorder characterized by an intense, excessive, and persistent fear of a specific object, situation, or activity that is often out of proportion to the actual danger presented. Unlike the occasional fear that can be managed or rationalized, phobias can lead individuals to go to great lengths to avoid their source of fear, significantly impacting their daily lives and well-being. The treatment for phobias often includes therapy, particularly cognitive-behavioral therapy, which helps patients gradually build exposure to the feared object or situation in a controlled and safe manner. Understanding ‘fight or flight’ The 'fight or flight' response is the body's reaction to a sudden danger or threat. During this reaction, certain hormones like adrenaline and cortisol are released, and physical changes, such as increased heart rate and blood pressure, occur to prepare a person to either fight the oncoming threat or flee to safety. This response is a survival mechanism that has evolved over time to protect us from danger and harm. The difference between anxiety and fear Fear and anxiety share a common root in the fight-or-flight response, but there are some key differences between the two emotions: Trigger: Fear is triggered by a known or present threat, whereas anxiety can be triggered by both real and imagined future events. Physical symptoms: Both emotions can cause physical symptoms like rapid heartbeat and muscle tension, but anxiety can also lead to digestive issues, sleep problems, and fatigue when experienced long-term. Both emotions involve a range of physical and psychological symptoms that are intended to protect us. However, they can be burdensome if they persist when there is no immediate danger threatening our safety, just as they typically do with anxiety. One major difference between the two is the duration of the feeling. While it can last longer in long-term life-threatening situations, fear is typically short-lived, while anxiety can linger for prolonged periods. Physical symptoms Fear: Immediate and intense; driven by a specific circumstance. Anxiety: Persistent and long-lasting; can be triggered by vague or unknown concerns. Psychological symptoms Fear: Often leads to the need for immediate, direct action. Anxiety: Worry, and a feeling of imminent danger; vague but persistent nature. Being aware of these distinctions will help you manage anxiety or fear effectively, ensuring that responses to both known and unknown threats are appropriate and healthy. Go deeper: Understand how to describe other feelings with our free Emotion Wheel resource. Coping with anxiety and fear Understanding the differences is the first step, but knowing how to cope is where strategies become vital. Here are some of the techniques that can help you manage anxiety as well as fear: Understand your triggers: Identifying what triggers your anxieties or fears is a crucial step in learning how to manage and overcome them. Keep a trigger log, write in a journal, or seek professional help to understand the patterns and root causes. Practice mindfulness: Living in the present moment can be incredibly grounding. Techniques like meditation and controlled breathing exercises can help keep anxiety at bay by focusing on the here and now. Social connection: Opening up to friends and family about your feelings can alleviate the sense of isolation that often accompanies anxiety and fear.  Relaxation techniques: Engage in activities that relax you, such as taking a bath, reading a book, listening to calming music, or trying progressive muscle relaxation. This can help balance your overstimulated system. Exercise: Physical activity is a great way to reduce anxiety and fear. It distracts the mind and releases endorphins that can uplift your mood and energy levels. By addressing anxiety or fear with informed coping strategies, you can work towards reclaiming control and balance in your life. When to seek help Addressing these emotions early on can lead to better outcomes and long-term management, but it’s important to recognize when self-help isn’t enough. If these emotions are interfering with your daily life, it could be a sign to reach out to a mental health professional for further evaluation and help managing anxiety or your fears.  Treatment options for anxiety  Understanding the distinctions between anxiety and fear helps dispel confusion, empowering you with emotional coping strategies and tailored care plans. Several treatment options exist for anxiety disorders, ranging from therapy to medication. Some modalities can also help address phobias or extreme fears. Cognitive behavioral therapy (CBT) CBT is one of the most effective treatments for anxiety disorders. It focuses on changing patterns of thinking or behavior that lead to anxious feelings, helping individuals understand and manage their symptoms better. Dialectical behavior therapy (DBT)  This modality blends cognitive-behavioral techniques with mindfulness practices, focusing on improving emotional regulation by recognizing the triggers that lead to reactive states that can be caused by anxiety disorders. DBT could empower you to interrupt the cycle of anxiety and manage these intense emotional experiences to prevent any escalation of anxiety symptoms. Free resource: How to Soothe Anxiety with DBT Skills Medication In some cases, medication may be prescribed to help manage the symptoms of anxiety disorders. This could include anti-anxiety medication, beta blockers, or selective serotonin reuptake inhibitors (SSRIs) that can help regulate brain chemicals. It’s crucial to discuss the benefits and potential risks with a healthcare provider before pursuing medication. Exposure therapy This form of therapy involves exposing the patient to their fears or anxiety triggers in a controlled environment, helping them become desensitized and learn how to manage their reactions. It is often used to treat specific phobias. Acceptance and commitment therapy (ACT) ACT encourages individuals to accept what is beyond their control while committing to making a conscious behavior change. It's particularly effective for people trying to overcome intense fears and phobias. Remember: Treatment options are not one-size-fits-all, and what works for one person may not work for another. It's essential to work with a mental health professional to find an effective treatment plan for you based on your situation and symptoms and, if applicable, a diagnosis.  How do I know if I have anxiety? If you’re asking yourself the above and wondering if you could possibly have an anxiety disorder, Cerebral is here to help you find answers. In addition to many of our other free therapy and mental health resources, we also offer a free anxiety screener. This tool can help you make an informed decision about whether to seek help from a licensed mental health professional. A self-test can be a useful initial step if you’re looking to get a sense of the level of your anxiety symptoms. You can take a 3-minute self-test to find out where your thinking, behaviors, experiences, and sensations fall on a scale of normal to severe. Images by freepik, freepik, lookstudio, and freepik on Freepik.

People managing bipolar disorder may explore different options when seeking to achieve mental balance, including self-medication. With the rise in marijuana being used to treat other conditions, you may be curious and searching for answers about its effects on bipolar disorder. But here's the blunt truth: Research overwhelmingly points to negative outcomes that outweigh any temporary relief its use could potentially provide. Drawing on research, we’ll outline how smoking weed or taking edibles may affect symptoms, impact medication, and lead to other risks. How marijuana affects bipolar symptoms Bipolar disorder is characterized by significant mood swings, including manic highs and depressive lows. Introducing marijuana into this already unpredictable mix can make symptoms and episodes worse. Marijuana makes bipolar symptoms worse People with bipolar disorder may turn to marijuana in an attempt to relieve their symptoms, but it may have the opposite effect. Mania or hypomania During manic phases, dopamine levels are already high, contributing to heightened excitement and impulsivity. When THC (tetrahydrocannabinol) is introduced into your system, it can further increase dopamine levels, potentially intensifying these manic symptoms. This surge can lead to: An escalation in risk-taking behaviors Decreased need for sleep More pronounced mood swings Heightened manic symptoms can disrupt the balance needed to manage bipolar disorder. Depression While it’s often associated with feelings of calm and relaxation, marijuana can also induce feelings of depression in certain individuals. This unexpected outcome is believed to arise from THC's effects on the brain's endocannabinoid system, which is instrumental in regulating emotions and stress. THC's psychoactive properties can further imbalance critical mood-regulating neurotransmitters like serotonin and dopamine. Instead of alleviating the symptoms of bipolar depression, marijuana can intensify feelings of sadness, loneliness, and hopelessness, amplifying existing negative emotional states and thought patterns. Anxiety Marijuana can induce feelings of paranoia and anxiety in some individuals. For those with bipolar disorder, this can be particularly problematic as they often experience anxiety, too. Overall, research suggests that bipolar symptoms will intensify or last longer with marijuana use. One study published in the Journal of Affective Disorders observed that some patients with bipolar disorder reported longer periods of worsened symptoms after marijuana use. Early research also indicates that there’s no advantage in using THC therapeutics for depression or CBD treatments for mania. Why this is important: The unpredictability of marijuana's effects can make mood states more difficult to manage and predict, complicating treatment and recovery efforts. Cognitive effects of marijuana use One of the many concerning effects of marijuana use is its impact on cognitive functions like memory and attention, which can already be affected by bipolar disorder’s symptoms. Use can also influence coordination and reflexes. These cognitive effects can exacerbate the challenges that bipolar disorder’s shifts in thinking and daily functioning present, including: Declined memory: Research indicates that marijuana use, particularly long-term or heavy use, can impair both short- and long-term memory.  Reduced attention and concentration: Marijuana can also affect an individual’s ability to focus, pay attention, and process information efficiently.  The effects of marijuana also extend to psychomotor skills, impairing coordination and slowing reflexes. For someone with bipolar disorder, these effects could make managing medication schedules more difficult, present challenges with school or work tasks, and increase their risk of accidents and injuries. Marijuana interferes with medication Individuals with bipolar disorder often rely on mood stabilizers like lithium or antipsychotics, which are processed by liver enzymes. The active compounds in marijuana, THC and cannabidiol (CBD), can interfere with these enzymes, potentially causing medications to reach dangerously high levels or fluctuate unpredictably in the bloodstream. What this means: Elevated levels of mood stabilizers might lead to toxicity, while insufficient levels may fail to prevent mood swings. Additionally, marijuana use can intensify the sedative effects of bipolar medications, further impairing daily functioning. To help avoid safety issues and unpredictable outcomes, individuals with bipolar disorder should discuss any marijuana use with their healthcare provider. Marijuana use can lead to symptoms of psychosis Some bipolar individuals are already at risk of experiencing psychosis. THC, the active component in marijuana, could trigger psychotic symptoms by interacting with the brain's cannabinoid receptors, affecting mood, perception, and cognition. People with bipolar disorder have brain chemistry and mood regulation mechanisms that are already affected. Introducing THC can disrupt neural pathways further, increasing the risk of experiencing psychotic episodes for some. For those who experience psychosis, symptoms such as hallucinations, delusions, or disorganized thinking could worsen. The association between marijuana use and psychosis is particularly significant for those with a family history of psychotic disorders. Explore more: What You Should Know About Bipolar Psychosis It can increase the frequency of bipolar episodes Marijuana's impact on the brain can destabilize a person's mood, potentially triggering more frequent and intense episodes. THC can disturb the brain's natural mood regulation by affecting neurotransmitters like dopamine and serotonin. This disruption can lead to more frequent and severe mood swings, amplifying the underlying mood instability associated with bipolar disorder. By affecting the brain’s natural mood regulators, marijuana can lead individuals to cycle back and forth between mania and depression, which can make it challenging to manage bipolar disorder. The bottom line: Marijuana's effects can make it more difficult to maintain emotional stability. It may increase the risk of suicide Marijuana use could worsen the condition by increasing suicidal thoughts and behaviors. Bipolar disorder inherently raises the risk of suicide due to its severe mood fluctuations. When marijuana is used, it can intensify depressive symptoms, making the lows feel even more profound and unbearable. Why this is important: Major depressive episodes can be strongly linked to suicidal thoughts and behaviors. Reliance on the substance for relief could also potentially lead to a vicious cycle of dependency and heightened despair and hopelessness, thereby elevating the risk of suicide. Professional guidance is vital for managing the condition safely, and self-medication practices that could lead to more severe outcomes should be avoided. Other effects of marijuana use While marijuana can be regarded for its therapeutic properties, it's important to recognize that regular use has its own set of health risks, too. Specific examples of how marijuana can negatively impact someone's health include: Cardiovascular health: Marijuana use increases heart rate and blood pressure shortly after use, which can be particularly concerning for individuals with pre-existing heart conditions. Over time, this elevated strain on the cardiovascular system could increase the risk of heart-related issues. Respiratory problems: Smoking weed can harm the respiratory system, similar to how smoking cigarettes does. Regular marijuana smokers may experience chronic bronchitis, lung irritation, and an increased risk of respiratory infections. It's critical to consider the added burden of managing a physical health complication on top of a mental health condition. Can marijuana increase the chance of becoming bipolar? While marijuana use has not been definitively linked to causing bipolar disorder, it can potentially act as a trigger for bipolar episodes due to its impact on the developing brain. Studies show that using the drug can increase your chance of developing bipolar disorder as well as producing an earlier onset of the condition.  Research published in JAMA Psychiatry found that marijuana use raises the risk of developing bipolar disorder, and its use also increases the risk of bipolar psychosis even more.  A study in the Journal of Affective Disorders suggested that individuals who use marijuana may experience the onset of bipolar symptoms earlier than those who do not use the drug.  Research in the American Journal of Psychiatry indicates that individuals with certain genetic markers for bipolar disorder are more susceptible to the mood-altering effects of THC, suggesting a genetic basis for the adverse outcomes observed in some cases. Given the potential for the drug to interfere with bipolar disorder management, a careful and individualized approach to treatment and counseling is warranted. For individuals with a genetic predisposition to mental health conditions like bipolar, marijuana use should be approached with extreme caution. How bipolar disorder is treated Treating this disorder requires a multifaceted approach that typically involves a combination of medication, therapy, and lifestyle adjustments.  Medication Bipolar disorder treatment typically includes mood-stabilizing medication tailored to each patient's unique needs to manage the cycles of highs and lows. Lithium and other anticonvulsants are common in stabilizing moods. Antipsychotics may be prescribed for episodes. What works best can differ between people, but a licensed prescriber can help you develop a medication regimen that alleviates your bipolar symptoms.  Therapy In-person or online therapy can help you recognize triggers and develop coping mechanisms without relying on substances like marijuana. It also supports the development of a healthy daily routine, which is crucial for managing the mood swings common in bipolar disorder. Why this is important: Lowering the intensity of mood episodes could help reduce the desire to look to alternatives for symptom relief.  Lifestyle adjustments Equally important are lifestyle adjustments that promote health and balance while managing bipolar symptoms. This can include having a set daily routine, getting regular exercise, eating a balanced diet, and getting enough sleep. Since substance use can be a trigger, avoiding or limiting use may be vital to maintaining your mental and physical well-being. The goal of treatment is to manage symptoms, reduce the frequency and intensity of mood swings, and help you lead a more stable and fulfilling life. Learn more: Treatment Options for Bipolar Disorder The risks outweigh potential benefits Marijuana use complicates an already complex illness and treatment process. It can potentially lead to worse bipolar symptoms, medication issues, and an increased risk of suicide, psychosis, and other health problems. If you haven’t been diagnosed but are wondering about your mental health status, the use of marijuana could potentially act as a catalyst, increasing the chances of the disorder’s onset. People with bipolar are already at a higher risk of developing substance use disorder due to their brain's reward system's altered functioning. Adding marijuana into the mix can further increase the likelihood of developing this disorder. The most important action you can take is to seek professional advice and have an open, honest conversation about the risks of marijuana use. With that knowledge, you can make informed decisions that lead to long-term mental wellness and stability. If you’re managing bipolar disorder and weighing the effects of marijuana use, our care team — including licensed prescribers, online therapists, and care counselors — will work with you to address your mental health needs and substance use concerns. With Cerebral, you can get personalized therapy and work with a licensed professional to manage your medication all from the comfort and privacy of your home. Images by freepik, freepik, and freepik on Freepik. The information in this blog is provided as a general educational resource only, and is not to be used or relied on for any diagnostic or treatment purpose. This information should not be used as a substitute for professional diagnosis and treatment and does not create any patient-physician relationship between you and Cerebral. Please consult your health care provider before making any health care decisions or to get guidance about a specific medical condition.

The Differences Between Bipolar Disorder and ADHD Understanding mental health conditions is crucial, especially when disorders can share similar symptoms yet require different approaches for management. Bipolar disorder and ADHD are two conditions that can look like one another. In this explanatory guide, we'll unravel the nuances of these conditions to help you distinguish between them. What is bipolar disorder? Bipolar disorder is a complex mental health condition characterized by extreme shifts in mood, energy levels, thinking, and the ability to function. Previously known as manic depression, bipolar disorder can vary from person to person in its severity and combination of symptoms. These shifts are called mood episodes and are distinctly different from the person's usual state. Types of bipolar disorder Bipolar disorder is divided into several subtypes, with the most common being bipolar I and bipolar II, along with cyclothymia, which is a milder form. Bipolar I disorder involves episodes of severe mania that last at least 1 week, sometimes requiring hospitalization. There may also be depressive episodes, typically lasting 2 weeks or more. Bipolar II disorder is characterized by a pattern of depressive episodes and hypomanic episodes, which are less severe than full-blown mania. Cyclothymia (also known as cyclothymic disorder) features numerous periods of hypomanic symptoms and depressive symptoms that last for at least 2 years, with no more than 2 months of stable moods in between. Bipolar symptoms  When a person is experiencing a manic episode, they may feel euphoric and full of energy. Symptoms of mania include:  Increased energy and activity levels, both physically and mentally Elevated mood or extreme irritability Racing thoughts and talking fast Trouble focusing, easily distracted, and prone to forgetting Little need for sleep Impulsiveness Poor judgment Depressive episodes, on the other hand, can lead to feelings of hopelessness, loss of energy, and thoughts of suicide. Symptoms of depression include:  Persistent feelings of sadness, anxiety, or emptiness A lack of interest in hobbies Fatigue or lack of energy physically and/or mentally Trouble concentrating or remaining motivated Poor memory Difficulty making decisions Changes in appetite Suicidal thoughts or behaviors Bipolar disorder treatment options Treatments for bipolar disorder focus on managing the intensity and duration of mood episodes. This may include a combination of medication and therapy. Mood stabilizers and antipsychotics are common for managing bipolar disorder's mood swings. Therapy, particularly cognitive behavioral therapy (CBT), can help individuals understand and manage their condition's social and psychological aspects. Explore more: Treatment Options for Bipolar Disorder What is ADHD? Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects the ability to pay attention and control impulsive behaviors. It can also cause hyperactivity, which can be challenging to manage. ADHD symptoms The symptoms of ADHD are typically grouped into two categories: inattention and hyperactivity-impulsivity. These symptoms are often present in childhood and can persist into adulthood. Manic symptoms can look like ADHD because they include: High physical and mental energy levels that manifest in ADHD-like restlessness Rapid speech and thought Racing ideas and constant activity Trouble concentrating and/or remembering plans, to-do’s, and commitments  Depressive symptoms can also mimic these symptoms of ADHD: Difficulties with focus and attention due to a depressed mood Lack of energy, leading to reduced activity both physically and mentally Low self-esteem that affects motivation and confidence ADHD treatment options ADHD treatment typically involves a multifaceted approach, including medication, lifestyle modifications, and counseling. When exploring medication options for ADHD, it's essential to engage in a thorough discussion with healthcare providers about the full spectrum of treatment possibilities that might suit your needs. One avenue in managing ADHD symptoms involves non-stimulant medication options. These alternatives work differently from stimulants, focusing on increasing levels of certain neurotransmitters in the brain. Behavior therapy, family therapy, and support groups can benefit someone diagnosed with ADHD and their family members. These therapies can help a person with ADHD implement organizational habits, develop social skills, and manage disruptive behaviors. Key differences between bipolar and ADHD While there are similarities between ADHD and bipolar disorder, there are distinct differences that can help distinguish one from the other, including: Age of onset: ADHD typically presents in childhood, with symptoms appearing before the age of 12. On the other hand, bipolar disorder often develops in late adolescence or early adulthood. Nature of symptoms: The symptoms of bipolar disorder are characterized by distinct cyclical periods of mania and depression that can last for weeks or longer. In contrast, ADHD symptoms tend to be more chronic and less episodic. However, they may fluctuate in intensity. Triggers: Environmental triggers are more commonly linked to mood episodes in bipolar disorder, whereas external situations don’t impact symptoms of ADHD. Diagnosing ADHD vs. bipolar disorder Proper diagnosis of either disorder helps select a course of action for managing symptoms. However, due to the complexity of symptoms and their potential overlap, making an ADHD or bipolar diagnosis can be challenging. It often involves: A comprehensive assessment of symptoms and family history The ruling out of other conditions that could be causing similar symptoms Psychological and cognitive testing to evaluate cognitive and behavioral patterns Can you have ADHD and bipolar disorder? Yes, ADHD and bipolar disorder can occur together, particularly in adults. This presents a unique diagnostic and treatment challenge, as both conditions may need to be addressed simultaneously. Management strategies include: Careful consideration of medication to avoid making symptoms worse Education and regular monitoring to manage symptoms  A collaborative approach between the patient and any medical and/or mental health professionals involved Seeking treatment for bipolar and/or ADHD If you suspect you have either or both conditions, seeking professional help is important, as early diagnosis and intervention can significantly improve outcomes. With Cerebral’s online therapy and medication management services, you can get personalized treatment from the comfort of your home. Our highly-rated mental health professionals will help you understand your condition, implement coping strategies, develop a treatment plan, and provide the support you deserve through all the phases of treatment. Images via DC Studio and pressfoto on Freepik. The information in this blog is provided as a general educational resource only, and is not to be used or relied on for any diagnostic or treatment purpose. This information should not be used as a substitute for professional diagnosis and treatment and does not create any patient-physician relationship between you and Cerebral. Please consult your health care provider before making any health care decisions or to get guidance about a specific medical condition.

Bipolar Psychosis: What You Should Know Navigating bipolar disorder can involve more than just managing depressive and manic episodes; it also might include the potential challenge of psychosis. This helpful guide explains how to recognize bipolar psychosis, outlines common questions, highlights risk factors that may lead to psychosis, and provides some examples of the types of support commonly offered to those who have been diagnosed with psychosis. What is bipolar psychosis? Bipolar disorder affects roughly 3 out of every 100 U.S. adults, with psychosis being an occurrence that can arise during a mood episode for some individuals. Psychosis, more formally known as psychotic symptoms or psychotic experiences, refers to times when a person perceives or interprets things differently from those around them — essentially, a loss of contact with or change in beliefs about reality. It’s a feature that can manifest in both the manic and depressive phases of bipolar disorder.  What happens during a psychotic episode? Understanding what happens during a psychotic episode is pivotal to recognizing and managing it effectively. The experience can be disruptive, confusing, distressing, or even frightening. Here is a breakdown of key occurrences: Early warning signs that an episode is approaching can include heightened sensitivity, difficulty concentrating, withdrawal, and changes in sleep and eating patterns. Hallucinations are sensations that seem real to the person experiencing them despite lacking any actual external source. Examples include hearing voices, seeing things, or feeling sensations that aren't there. Delusions can occur when someone is experiencing a psychotic episode. These irrational and unfounded yet strong beliefs can range from feelings of persecution to grandiose ideas about one’s abilities and significance. Paranoia during psychosis can lead to an intensified distrust of others and feelings of threat that aren't based in reality. This can cause severe anxiety and alter a person's usual behavior. A cognitive fog that causes confusion and changes in thinking can happen during psychotic states. Typical thought processes can be disrupted, sometimes making it challenging for the individual to look after themself or make decisions. Jumbled thoughts and fragmented speech can occur. Irrational thought patterns may also be experienced. A lack of awareness of the change in one’s behavior and perceptions can lead to poor judgment, impulsivity, and risky behavior. Other common symptoms may include a lack of motivation, declining personal hygiene, and social withdrawal. Safety should be a primary concern during a psychotic episode. The altered perception of reality can lead to increased risk including dangerous behaviors, self-harm, or harm to others. In such instances, immediate professional intervention is necessary. Call 911 if you’re having a mental health emergency. Text HOME to 741-741 if you're emotionally distressed and need immediate support. Call 988 for the National Suicide Prevention Hotline. Types of bipolar psychosis There are two primary types of psychosis. These classifications help licensed prescribers and therapists tailor treatment approaches to the symptoms of bipolar psychosis.  Mood-Congruent Psychosis This type of psychosis involves behaviors or thoughts that are consistent with depressive or manic mood states. For instance, during a depressive episode, someone may believe they committed an unforgivable sin. Mood-Incongruent Psychosis On the other hand, mood-incongruent psychosis involves beliefs or experiences that don’t line up with the presented mood state. During depression, for example, someone may feel that they have supernatural abilities. Commonly asked questions about psychosis What’s the difference between psychosis and schizophrenia? While both bipolar disorder and schizophrenia can involve psychosis, the experiences are different. Bipolar psychosis tends to be shorter and often related to severe mood symptoms. Schizophrenic psychosis is typically longer-lasting, with more severe disorganization in thoughts and behaviors, and often occurs outside of mood episodes. How long does psychosis last? The length of a psychotic episode can vary in those with bipolar disorder. Psychosis can last for as little as a day or several weeks. Understanding the typical length of an episode can help individuals prepare for the recovery period and take steps to prevent or lessen the impact of future episodes. How is bipolar psychosis diagnosed? Diagnosing bipolar psychosis requires a thorough evaluation by a mental health professional. This assessment involves discussing symptoms, reviewing medical history, and, at times, conducting physical exams and lab tests to rule out underlying medical conditions that could be causing symptoms. The causes of psychosis Understanding the triggers of a psychotic episode is crucial for management and prevention. What triggers bipolar psychosis? These are some of the common causes: A lack of sleep can be a serious trigger for a bipolar episode, including psychosis.  Hormonal changes can impact mood stability and be linked to the onset of psychosis. High levels of stress or traumatic events could cause the onset of psychosis. Drug or alcohol use could have an effect, and substance abuse can be a strong trigger for psychosis. Genetics can also be a factor, as family history can play a role in bipolar disorder and psychosis. Treatment for psychosis Managing bipolar disorder’s psychotic episodes typically involves a combination of medication, therapy, support, and self-care. During a psychotic episode, medications may need to be adjusted or added, and one may need to check in with or see their prescriber often. Antipsychotic medications are often used to manage the symptoms of psychosis. Like all medications, these have risks and benefits, and it's important that you consider those with a healthcare provider. Cognitive behavioral therapy (CBT) can also be effective in helping individuals manage and prevent psychotic symptoms by providing tools to challenge and reframe irrational beliefs. Having a strong support group is really important for people who experience psychosis — those trusted individuals can help distinguish reality from imagined perceptions. Support and education programs for loved ones can also be a valuable resource to help them become more informed and prepared to provide help through the recovery process. Maintaining a balanced lifestyle that includes regular exercise, a healthy diet, and adequate sleep can help stabilize mood and reduce the risk of psychotic episodes. Additionally, identifying and avoiding personal triggers such as stressful situations or substance use is crucial. Be prepared: Fill out this free mental health emergency plan so you have a roadmap for action if your symptoms escalate.  What to do after a psychotic episode After experiencing bipolar psychosis, it’s crucial to regroup and reestablish a sense of stability. Many of the same interventions that are recommended during an episode apply in the recovery process, which may also involve adjusting treatment, seeking support, and focusing on self-care. It’s also essential to have open and honest communication with a trusted mental health professional. Following a psychotic episode, it may be beneficial to: Schedule a check-in with a licensed prescriber. Medications may need adjustments to ensure their effectiveness and minimize side effects.  See your therapist. Continued therapy can provide a safe space to explore feelings, address challenges, and develop strategies for managing symptoms and preventing relapse. Prioritize self-care. Engage in physical activity, maintain a nutritious diet, and do what you can to get adequate sleep. Connect with your support system. Leaning on the support of friends, family, or support groups can offer comfort and understanding, reducing feelings of isolation. ​​Psychotic symptoms, though common in bipolar disorder, vary in how they impact the condition's progression and outcomes. With support and management strategies that work for you, you can regain balance and continue to lead a fulfilling life.  Helping someone experiencing psychosis Supporting someone in the midst of psychosis requires sensitivity and patience. You’ll want to: Maintain a calm and non-confrontational stance. Offer reassurance and support. Acknowledge their feelings, even if you don’t share their perceptions. You could risk making things worse if you try to convince them that their beliefs are false, dismiss or belittle their experiences, argue with them, or encourage dangerous or impulsive behaviors, potentially leading to increased distress, isolation, or even harm to themself or others. People experiencing a psychotic episode have a higher risk of suicide. If someone demonstrates severe symptoms — such as expressing suicidal thoughts, showing intense paranoia or agitation, or acting abusively or violently — contact local emergency services immediately. Stability through support The complexities of bipolar disorder and psychosis may present challenges, but you don’t have to face them alone. With the right knowledge, support, and strategies in place, you can find stabilization and greater control over your life.  Support groups, education, and therapy are just as essential for those who care for individuals with bipolar psychosis as they are for the affected person themself. From online therapy to medication management, Cerebral can deliver a tailored approach to address these mental health needs. Discover how we’re different from other online mental health providers. Images by vecstock and tirachardzon Freepik. The information in this blog is provided as a general educational resource only, and is not to be used or relied on for any diagnostic or treatment purpose. This information should not be used as a substitute for professional diagnosis and treatment and does not create any patient-physician relationship between you and Cerebral. Please consult your health care provider before making any health care decisions or to get guidance about a specific medical condition.

Living with bipolar disorder — with its intense highs and profound lows — can make life feel unpredictable. It’s completely normal to wonder how you can achieve more balance and stability. This guide is designed to equip you with actionable strategies to manage symptoms. We'll explore the nature of bipolar disorder, its signs, available treatments, and daily self-care routines that can enhance your well-being. Educate yourself on bipolar disorder If it’s a new diagnosis, the first step toward achieving stability and empowerment is knowledge. By familiarizing yourself with the condition, you can begin to make sense of your experiences and take proactive measures toward your mental well-being. What is bipolar disorder? Bipolar disorder is a mental health condition characterized by extreme shifts in mood, thinking, energy levels, and activity. It can manifest in several types, with the most common being bipolar I and bipolar II. Bipolar I disorder: Defined by manic episodes that last at least 7 days. For many, treating mood shifts can occur in a mental health professional’s office or during online sessions. However, in some instances, severe mood episodes require hospital care. Bipolar II disorder: One or more depressive episodes with at least one hypomanic episode, which is less severe than a full-blown manic episode. Cyclothymic disorder (Cyclothymia): Characterized by periods of hypomanic symptoms as well as periods of depressive symptoms lasting for at least 2 years (1 year in children and adolescents). These symptoms are less severe than those of full manic or depressive episodes. What are bipolar disorder’s symptoms? Recognizing the symptoms is critical to seeking appropriate help. Common bipolar symptoms include: Manic or hypomanic episodes, which are signified by a period of increased energy, activity, and euphoria. Depressive episodes, which are marked by sad or empty moods, sleep disturbances, changes in appetite, irritability, and more. Rapid cycling, which is characterized by at least four episodes of major depression, mania, hypomania, or mixed states within a year. Changing thoughts, which could include thinking too fast or too slow, trouble with concentration and memory, or making decisions without considering consequences or harms. Symptoms of mania and depression can occur simultaneously, and there can be seasonal patterns to episodes. Stay proactive When living with bipolar disorder, it’s important to pay attention to your mental state. Here are ways to actively support yourself: Understand your triggers. Those with bipolar disorder can have unique triggers that lead to mood episodes. It could be stress, changes in sleep patterns, or even certain foods. By identifying your triggers, you can anticipate and possibly prevent mood swings. Track your moods. A mood tracker can help you see patterns over time, allowing you to anticipate mood shifts better. Stay on your medications. Adhering to your medication regimen is crucial for maintaining stability. Always take your medications as discussed with your prescriber, and communicate any concerns or side effects with your healthcare provider. Have a crisis plan. A well-thought-out crisis plan can be a lifeline during particularly difficult times. This plan could include the contact information of your support network, your mental health team, and steps you can take to ensure your safety. These steps collectively form a vital strategy for navigating life with resilience and self-compassion Grow your support network Managing bipolar disorder is not something you have to do alone. Building a strong support network can help you through tough times and add a helpful layer to your wellness strategy. Cultivating a robust support system entails several key strategies: Keep friends and loved ones informed. Open communication about your bipolar disorder can foster understanding and empathy among those closest to you. When your support system is aware of your condition, they can offer compassion and support during mood fluctuations. Consider therapy. Therapy, particularly cognitive behavioral therapy (CBT), has been shown to be effective in helping individuals manage bipolar symptoms. An in-person or online therapist can work with you to develop coping strategies and address negative or distorted thought patterns that can make mood episodes worse. Try a support group. Joining a support group for individuals with bipolar disorder provides an opportunity to share experiences, learn from others, and feel less alone. You're setting up a foundation for stability by surrounding yourself with understanding and compassion. Stick to a healthy routine Maintaining a consistent and healthy lifestyle can help reduce the frequency and intensity of bipolar episodes. Do: Eat healthy, stay active, and get good sleep A balanced diet of fruits, vegetables, and lean proteins can support mood stability. Conversely, high-sugar foods and unhealthy fats can trigger mood swings and should be consumed in moderation. Explore more: Eating for Mental Health It’s well-documented that regular exercise benefits mental health. It can help you manage stress, improve sleep, and even out mood swings. The U.S. Department of Health and Human Services recommends 30 minutes of moderate-intensity physical activity five days a week. Disruptions in sleep patterns can be a trigger for bipolar episodes. Practicing good sleep hygiene, such as avoiding screens before bed and establishing a regular sleep schedule, can be helpful in managing bipolar disorder. Avoid: Alcohol, drugs, and isolation Substance use can worsen symptoms and interfere with the effectiveness of medications. Until you’ve had open conversations with your healthcare provider, it's best to steer clear of alcohol and drugs when you have bipolar disorder. Learn more: Can I Drink Alcohol With Bipolar Disorder? Isolation can also make depression worse. Making an effort to stay connected with others, even when you don’t feel like it, is essential for your mental well-being. Remember: Every step toward regularly making healthy choices is a stride toward a more balanced and fulfilling life. Manage stress Stress is an unavoidable part of life, but for those with bipolar disorder, it can be especially problematic. Learning to manage stress can be the key to staying on a more even keel. Consider using these strategies: Practice meditation. Studies have shown that mindfulness meditation reduces stress and improves emotional resilience. You can incorporate this practice into your daily routine to help keep stress levels in check. Try breathing exercises. Focusing on your breathing can calm your nervous system and alleviate anxiety. Avoid overstimulation. It can trigger episodes in some individuals, so pay attention to how your body and mind react to certain stimuli. Then, make adjustments as necessary to avoid becoming overstimulated. Managing stress isn't about eliminating it but learning how to deal with it in a healthy manner. Explore more: How to Meditate: A Guide for Beginners These practices contribute to emotional balance and empower you to face life's challenges with a sense of calm and preparedness.  Getting the support you deserve While these strategies play a crucial role in self-care and supporting your mental health, other treatments may be needed to lead a more stable and fulfilling life with bipolar disorder. Medication helps keep your mood steady, and therapy can help you handle emotional ups and downs. Remember: Everyone's different, so it's all about finding what works best for you with the help of healthcare professionals. Designed to provide accessible and personalized care, Cerebral offers convenient and affordable mental health services. You can connect with our mental health professionals for medication management and online therapy options. With a commitment to self-awareness, diligent management of symptoms, a strong support system, and access to professional help, a balanced life with bipolar disorder is within reach.  Images via lookstudio and freepik on Freepik. The information in this blog is provided as a general educational resource only, and is not to be used or relied on for any diagnostic or treatment purpose. This information should not be used as a substitute for professional diagnosis and treatment and does not create any patient-physician relationship between you and Cerebral. Please consult your health care provider before making any health care decisions or to get guidance about a specific medical condition.

Every day, we find ourselves facing choices that, on the surface, seem inconsequential. Yet, for individuals with bipolar disorder, the choice to drink can have real impacts and implications. The relationship between alcohol and bipolar disorder is complex and can tip the scales of mood, medication effects, and overall mental wellness. This detailed guide explores how alcohol can affect those with bipolar disorder and the risks of use. Effects of alcohol on bipolar disorders Grasping the nuances of the types of bipolar disorder — and how alcohol can distinctly impact each — is crucial in making informed decisions. Bipolar disorder, formerly known as manic depression, is a mental health condition characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). These episodes can significantly impact a person's ability to function, think, and relate, leading to other serious health concerns. Bipolar I disorder Individuals with bipolar I disorder experience severe mania that may involve breaks from reality (psychosis). If you have bipolar I, drinking alcohol can make the challenges of the condition worse by: Interfering with your medication, making it less effective or even harmful.  Making depressive episodes worse and harder to manage because it’s a depressant.  Possibly causing you to act even more impulsively or take more risks when you're feeling manic.  It's really important to understand these risks when you’re considering drinking. Bipolar II disorder Bipolar II disorder is characterized by at least one episode of major depression and at least one hypomanic episode. People with this type of disorder don’t experience a progression of symptoms to mania. If you have bipolar II disorder, drinking alcohol can complicate things in several ways:  Alcohol might hide or confuse the signs of hypomania, making it harder to manage. Since hypomania can still greatly affect decisions and life, not catching it early can be problematic.  Alcohol can make depressive episodes last longer, happen more often, and be more intense. This is especially risky for those with bipolar II, as they typically face more depression. Alcohol can mess with bipolar medication, either weakening its effects or causing negative reactions.  If you have bipolar II, it's essential to make careful decisions about drinking and to keep an open dialogue about use with a healthcare provider. Cyclothymic disorder Cyclothymic Disorder involves milder, yet chronic, fluctuations between hypomanic and depressive symptoms. Even though mood swings aren't as extreme as the other bipolar disorders, they’re still impactful and drinking alcohol can complicate things. If you have cyclothymic disorder, alcohol can worsen depression and make hypomanic episodes riskier by increasing impulsive behaviors. It can also interfere with treatment by obscuring symptoms and reducing the effectiveness of medications. Therefore, individuals with cyclothymic disorder or any bipolar disorder are advised to use alcohol with caution or not at all. Consult with healthcare providers about the safest course. Does drinking alcohol make bipolar worse? It can make symptoms worse. And no matter what type of bipolar disorder you’ve been diagnosed with, the effects of drinking on symptoms are two-fold: Because it's a depressant, drinking alcohol can make feelings of sadness or depression much worse.  The temporary euphoric feelings alcohol can give might feel similar to the highs of mania, causing mood swings to become even more unpredictable and challenging to manage. The severity of symptoms could differ, as each individual may react differently and a variety of factors could affect alcohol’s impact. Drinking alcohol with bipolar disorder Many with the disorder can still drink alcohol; however, practicing moderation is recommended if you and your healthcare provider determine that drinking is okay for you. That still allows you to enjoy social gatherings and celebratory events, but making informed choices around drinking is key. Here are several best practices: Medical consultation: Before considering alcohol, engage in a candid discussion with your healthcare provider. They can offer personalized advice based on your current medication, condition stability, and overall health. Limit intake: If your healthcare provider agrees that occasional drinking is safe, work with them to define limits to avoid overconsumption.  Be in a safe place and take precautions: Understand how mixing alcohol with medications affects you and plan ahead accordingly. Stay safe by having a driver lined up so you won’t drink and drive, and arrange for child- or eldercare when planning to drink. Plan ahead: Before attending social events where alcohol will be present, devise a plan. This could include setting a drink limit, ensuring you've eaten, or bringing a non-drinking friend along for support. Avoid drinking during mood episodes: Refrain from alcohol if you are experiencing bipolar symptoms, as it can exacerbate mood swings and interfere with your medication's effectiveness. Monitoring how alcohol affects your mood and symptoms will also help guide your choices, as you’ll start to recognize patterns that may signal problematic interactions between alcohol consumption and bipolar episodes. There are cases where sobriety is going to be the safest course of action, and there are treatment options to help. That’s why having an open dialogue with your healthcare provider is so important. And, if you find yourself drinking more than you intended or can’t stop drinking, seek professional help. Drinking alcohol on bipolar medication If you’re taking medication for bipolar disorder, mixing what you’ve been prescribed with alcohol can have serious risks. The combination of sedatives and alcohol may cause extreme drowsiness, slow down breathing, and, in some cases, result in overdose. Combining alcohol with mood stabilizers, often used to treat bipolar disorder, can undermine or cancel out their effectiveness. Alcohol can change how these medications are processed in the body, potentially diminishing or undoing their positive effects or increasing adverse side effects. Additionally, alcohol is known to lower inhibitions and impair judgment, which may make you less careful about taking your medicine. It could lead to missed doses or discontinuing medication without talking to a medical professional first. Chronic alcohol use can also affect liver function, and the liver is crucial for breaking down many bipolar medications. If your liver isn't working properly, medication levels in the blood could become dangerously high or drop too quickly, making your medication less effective.  Bipolar and alcohol use disorder Alcohol use disorder (AUD) is when drinking causes distress or harm. Those with bipolar disorder are at a heightened risk for this disease, with approximately 56% of individuals with bipolar I or II disorder having a history of AUD. This highlights the need to watch for issues with substances. If issues do arise, treatment plans that address both bipolar condition and AUD may be recommended. Treatment options for alcohol use disorder One condition can make the other worse, and vice versa, so the ideal approach to treating individuals with bipolar disorder and alcohol use disorder is through integrated treatment. This involves a combination of medication-assisted treatment, therapy, and support groups. It could also include a detox and/or rehab program when needed. Medication for alcohol use disorder (MAUD): This includes pharmaceutical therapies like naltrexone, disulfiram, acamprosate, topiramate, and gabapentin that help reduce alcohol cravings and prevent relapse. Mood stabilizers are also often used and recommended to manage bipolar symptoms. Cognitive behavioral therapy (CBT) and motivational enhancement therapy (MET): These approaches can help identify motivations, address maladaptive behaviors, and support long-term recovery. They also foster resilience, empowering you to identify, confront, and rectify thought patterns, which will also help in managing bipolar disorder.  Therapy: Seeing a mental health professional regularly can also help you practice effective coping strategies, allowing you to develop healthier ways to handle stress and control your reactions to emotional triggers in alternative ways. Support groups: Participation in groups such as Alcoholics Anonymous (AA), Dual Diagnosis Anonymous (DDA), LifeRing Secular Recovery, or other peer support networks can help you by providing accountability partners, coping strategies from people who have experienced the same challenges, and a safe place to speak about issues that arise. Detox: Inpatient or outpatient medically supervised detox programs allow someone to withdraw from alcohol, either within a highly structured environment with around-the-clock supervision or from home with regular check-ins that aim to promote safety during the detox process.  Rehabilitation: Residential or outpatient treatment programs help address the roots of alcohol misuse. Rehab offers a comprehensive approach to recovery, tackling not only the physical aspects of alcohol misuse but also the psychological factors that can contribute to it. If you’re affected by both bipolar disorder and alcohol use disorder, there are many pathways to recovery. It may not always be the easiest road, but there are people who are ready to help you navigate it. Cerebral will be with you for every step  If you’re managing bipolar disorder and considering the role alcohol may play in your life, our care team — including licensed prescribers, online therapists, and care counselors — collaborates to create tailored treatment plans that address your mental health needs and substance use concerns. All from the comfort of your home, you can access integrated mental health treatments, seek personalized therapy, and work with a professional to manage your medication. We’re partners in this. We recognize your role as a key player in managing your mental health. That’s why we’ve specifically designed our program to be centered around you and your goals. We help you track your progress and understand what to expect as you continue to improve and grow. If substance use is intertwined with your bipolar experiences, our care team will approach treatment holistically, helping you receive the support necessary to focus on your well-being. Under one affordable monthly subscription, you’d have access to integrated treatment with Cerebral. Why this matters: Opting for such dedicated, customized, and convenient support can make a difference on the path to living a more stable, fulfilling life. If you’re ready to explore getting help, we commend you — it’s a brave step. You can learn about what we offer and make the decision that’s right for you. Or, if you’d like to dig a little deeper into how we’re different, you can learn more about Cerebral Way and how Cerebral compares to other online therapy and medication management options. Images by wirestock, Freepik, and master1305 on Freepik. The information in this blog is provided as a general educational resource only, and is not to be used or relied on for any diagnostic or treatment purpose. This information should not be used as a substitute for professional diagnosis and treatment and does not create any patient-physician relationship between you and Cerebral. Please consult your health care provider before making any health care decisions or to get guidance about a specific medical condition.

Navigating pregnancy is an exciting yet challenging time for a parent-to-be, filled with joy, anticipation, and meticulous planning for a new stage in life. However, the experience can be complex for individuals living with bipolar disorder. Managing this mental health condition alongside the physical and emotional demands of pregnancy and newfound parenthood requires careful consideration and planning. From the safety of pregnancy to postpartum considerations, this detailed guide can help you or a pregnant individual in managing bipolar disorder through pregnancy and beyond. Understanding bipolar pregnancy risks  Understanding the implications your condition might have on your pregnancy and child is essential. The good news is that with informed decision-making, frequent monitoring, and an integrated healthcare approach, it’s possible to have a safe pregnancy with bipolar disorder. However, there are important risk factors to consider that go beyond the conventional scope of prenatal health, including: Mood stability can be affected by fluctuating hormone levels during pregnancy. Medication may need to be adjusted as you work with a healthcare provider to weigh the benefits of mood stabilization against possible risks to the baby.  The hereditary risk may cause concerns for those with bipolar disorder. Research has shown genetic predisposition for bipolar can be a factor, but it's not the sole contributor.  During pregnancy, a primary goal is the safety and well-being of both the individual and the baby. How bipolar disorder can impact pregnancy During pregnancy, hormonal and physiological changes can significantly impact mood and mental health, especially for individuals with bipolar disorder. These mood symptoms can also occur after childbirth. Here are four aspects of pregnancy and how they intersect with the mental health condition: Hormone fluctuations: Pregnancy induces major hormonal shifts. These changes can affect mood regulation, which may lead to heightened or increased bipolar symptoms. Work closely with healthcare providers to monitor these changes and adjust treatment plans as needed. Sleep patterns. Sleep disturbances are common in pregnancy due to physical discomfort and hormonal changes. However, getting good sleep is an essential component of bipolar disorder management. A lack of sleep can trigger both depressive and manic episodes. Implementing a sleep routine and discussing sleep-promoting options with a healthcare professional can help maintain stability. Medications. Many individuals take medication for bipolar disorder to manage symptoms. However, medications may pose risks to the baby during pregnancy. You may want to see a perinatal specialist, or you may be referred to one if the risks require that expertise.  Breastfeeding. Decisions about nursing should factor in your mental health needs and your baby’s safety. Certain medications can be passed through breast milk, so these decisions should be made in consultation with a healthcare provider. Having a clear understanding of the potential impacts allows you to prepare for changes in support and management Bipolar disorder and postpartum The postpartum period is a critical time for individuals with bipolar disorder. The abrupt hormonal changes following childbirth can trigger mood episodes. Educating yourself about the signs of postpartum mood disorders and how they may intersect with bipolar disorder symptoms can be crucial for early intervention and support.  Postpartum depression Postpartum depression is a common concern for all new parents but can present unique challenges for those with bipolar disorder. In addition to after childbirth, depression can also occur during pregnancy. Distinguishing between postpartum depression and a bipolar depressive episode is critical for determining the appropriate treatment plan. Postpartum psychosis Postpartum psychosis is a rare but severe condition that can occur in a small percentage of individuals with bipolar disorder following childbirth. It’s characterized by symptoms like hallucinations, delusions, and severe mood swings. Immediate medical attention is crucial for safety. Baby pinks A less common but equally important concern is "baby pinks," a less severe and more sustained form of postpartum mania. It can lead to impulsivity and risky behaviors. In this situation, monitoring and support are needed to keep both the parent and child safe. Tips for a healthy pregnancy with bipolar Preparing for pregnancy is a significant step, especially when managing a mental health condition like bipolar disorder.  Adjust bipolar treatment during pregnancy If medication is part of your treatment plan, switching to an alternative option may be discussed. Always consult a mental health professional experienced in perinatal care to make these adjustments. Cognitive behavioral therapy (CBT) and interpersonal therapy can be beneficial in managing bipolar disorder symptoms during and after pregnancy. Discuss the frequency and type of therapy that would be most effective for your well-being with a therapist and your pregnancy care team. Build out your support system A strong support network is invaluable in managing bipolar disorder. Surround yourself with people who understand your condition and can offer support before, during, and after pregnancy. This community can provide emotional reassurance and practical assistance, helping you feel less isolated in your experiences. Engaging with support groups, either in-person or online, can also offer a sense of belonging and provide helpful insights from others who share similar experiences. An in-person or online therapist could also be a valuable addition to your support system. Remember: It's okay to ask for help when you need it, and it's vital to also surround yourself with people who can allow you to take time to rest and care for yourself. Make your overall well-being a priority Managing bipolar disorder while pregnant can be complex, but taking care of your mind and body makes it easier. These tips apply at all times, but following them is especially critical during this important part of your life: Make healthy food choices. Maintaining a balanced diet can support both mental and physical well-being during pregnancy. Consult with a nutritionist if you need assistance in developing a diet plan that works for you and your baby. Stay active. Regular, moderate exercise has been shown to improve mood in individuals with bipolar disorder. Talk with your healthcare provider and adapt your exercise routine to your changing body's needs during pregnancy. Practice mindfulness. When dealing with a complex condition like bipolar disorder, mindfulness can be a powerful tool. Incorporate practices like meditation and breathing exercises into your daily routine to help manage stress and mood. Try to get enough sleep. For a new parent, this is obviously easier said than done, but it’s especially important for someone with bipolar disorder to get adequate rest. As much as you can, prioritize healthy sleep habits to reduce the likelihood of mood disturbances. Managing bipolar disorder during pregnancy requires education, planning, and a proactive approach to mental health treatment. Whether you are preparing for pregnancy, currently pregnant, or navigating the postpartum period, working with a specialized care team can play a key role in taking the steps toward a healthy pregnancy and a more balanced life as a new parent. Because each individual's experience with bipolar disorder is unique, tailored support that focuses on both the parent and child is essential during critical times like pregnancy and the postpartum period. At Cerebral, we offer personalized online therapy and medication management. Our highly regarded care team will develop a program with your mental health goals and milestones at the center so you can track your progress and know what to expect along the way. If bipolar disorder and pregnancy are on your mind, reaching out to one of Cerebral’s mental health specialists could be your first step toward more clarity and understanding. Images by freepik and freepic.diller on Freepik. The information in this blog is provided as a general educational resource only, and is not to be used or relied on for any diagnostic or treatment purpose. This information should not be used as a substitute for professional diagnosis and treatment and does not create any patient-physician relationship between you and Cerebral. Please consult your health care provider before making any health care decisions or to get guidance about a specific medical condition.

In many romantic partnerships, mutual appreciation and acknowledgment form the bedrock of love and trust. But, if you’re feeling underappreciated, it can lead to real emotional distress. Why this matters: If left unaddressed, this ongoing relationship conflict can even erode the foundation of the partnership. This  guide covers what it means to feel underappreciated, the impacts on you and your relationship, and actionable strategies people may use to address and overcome this common issue for couples. What does it mean to feel underappreciated? Feeling underappreciated refers to a sense of not being valued or acknowledged for one’s contributions, gestures, or presence. In a partnership, these feelings can emerge when acts of love or support go unnoticed or unreciprocated, leading to a void of positive reinforcement and a decline in relationship satisfaction. Unappreciated partners often feel a disconnect between their efforts and the feedback they receive. This emotional dissonance can result in a range of negative emotions, including: A lack of motivation to invest in the relationship Resentment Loneliness Withdrawal If you’re feeling this sense of neglect, it may cause you to become distant and disengaged, potentially seeking solace in work, hobbies, or friendships outside of your partnership. You may also find yourself starting and engaging in more arguments with your partner. In extreme cases, the feeling of being undervalued may drive a person towards infidelity as they search for validation, appreciation, and emotional connection elsewhere. It's worth noting: These reactions, while potentially damaging to the relationship, signify a deeper underlying issue that needs to be addressed through open communication, therapy, or couples counseling. Early recognition of those warning signs allows you to address issues before they escalate into more severe relationship problems or cause even more personal emotional distress.  Impact on your personal mental health Feeling unappreciated by your partner can have a considerable impact on your mental health, including: Increased stress Anxiety Reduced self-esteem  A negative self-image Depression When seeking to resolve these feelings, it’s vital to also cultivate a robust sense of self-worth that isn’t dependent on external validation. Why this matters: This can lessen the negative impact of external circumstances and instill a stronger sense of emotional resilience. Effects on your relationship The impact of one partner feeling underappreciated can ripple throughout the relationship. It can lead to: A breakdown in communication A lack of intimacy A reduction in the willingness to compromise  Over time, unresolved feelings of underappreciation can contribute to an emotional disconnection that may be difficult to repair. This is why early recognition and intervention are critical to maintaining a healthy and fulfilling partnership. Don’t ignore your feelings Acknowledging that you feel underappreciated is the first step toward resolution. Ignoring or downplaying your emotions can result in them manifesting in harmful ways, such as passive-aggressiveness or emotional withdrawal. Holding back your feelings to avoid confrontation is not a long-term strategy for a healthy relationship. Instead, it’s important to find constructive ways to express your emotions and collaboratively work with your partner toward a solution. How to resolve the problem of feeling undervalued Talk with your partner Just like with addressing any relationship conflict, resolving feelings of underappreciation often begins with an open and honest dialogue. Here’s how to do just that:  Take some time to reflect on your feelings and identify specific instances where you felt undervalued before you talk so you can express your feelings clearly and specifically. Choose a time when you both are calm and focused, and find a quiet, private place where you won’t be interrupted. This setting helps create a safe space for vulnerability and openness. Start the conversation by sharing specific instances that made you feel unappreciated and how that made you feel. Use ‘I’ statements to convey ownership of your feelings without assigning blame, and avoid using generalizations that can lead to defensiveness. Encourage your partner to express their view on the matter as well. Sometimes, your partner is unaware of the impact their actions — or lack thereof — have on you.  Listen actively to your partner's response by showing empathy, avoiding interruptions, and trying to understand their perspective, even if it differs from yours. Clearly articulate the actions or changes that would help you feel more valued. Be realistic and considerate in your requests, and ensure that they don’t come across as demands (e.g., “You need to do X.”). Approach the situation as a team, discussing the ways you can both contribute to making each other feel valued and appreciated. Agree to revisit the conversation to see how the changes are going. Acknowledge progress and address any ongoing relationship issues during these discussions. By discussing the issue constructively, you can lay the groundwork for mutual understanding and positive change. In general, you can take this same approach to many other relationship conflicts. Go deeper: Here's How Couples Therapy Builds Communication Skills Set boundaries Boundaries in a relationship are not just about physical space but also about respect for each other’s emotional needs. If certain behaviors consistently make you feel underappreciated, it’s important to set clear boundaries about what is and isn’t acceptable. For example: You can establish that you won’t tolerate dismissive language when you express your feelings. You can enforce that limit by tabling the conversation if that occurs. By setting boundaries in a relationship, you not only protect your emotional well-being but also provide the structure within which a healthier relationship can thrive. Divide responsibilities with your partner A common source of feeling unappreciated is an imbalance in the distribution of responsibilities. Whether it’s household chores, financial management, or nurturing mutual friendships, an equitable division of labor can help ensure that both partners feel their contributions are valued. What to do: Sit down with your partner and discuss how to divide tasks based on availability, skill, and preference. This simple act can reduce the likelihood of one partner feeling overburdened and unacknowledged. Show your partner appreciation Especially after you’ve addressed your feelings, it’s important to model the behavior you wish to receive. Even before having that open, honest conversation, expressing your gratitude is a powerful way to start breaking the cycle of underappreciation. What to do: Find opportunities to genuinely express gratitude for your partner’s contributions each day, no matter how small. Practice self-care Self-care is crucial when navigating the emotional complexity of feeling underappreciated. Engage in activities that bring you joy and fulfillment, whether it’s solo exercise, creative hobbies, or spending quality time with friends. Why this matters: You’ll affirm your own value and regain self-esteem, allowing you to recognize your worthiness in receiving the love and attention you deserve. Couples therapy can help with additional support Sometimes, resolving feelings of underappreciation may require more than personal or interpersonal efforts. Professional help, such as couples therapy, can provide the tools and guidance necessary to work through unresolved issues and emerge with a stronger, more connected partnership. What is couples therapy? Couples therapy is a form of counseling designed to help partners improve their relationship. An in-person or online therapist will work with a couple to identify underlying relationship issues, improve communication, and develop strategies for conflict resolution and mutual support. Benefits of couples counseling Whether it’s in-person or online, couples therapy offers a structured environment where both partners can explore their feelings and experiences. The therapy process can uncover unspoken grievances, provide a neutral space to discuss sensitive topics, and empower partners with the skills to enhance their relationship. The benefits of couples therapy extend beyond the resolution of specific issues like underappreciation. Couples often report increased intimacy, better communication, and a deeper understanding of one another following therapy. How to talk to your partner about couples therapy You may feel like initiating a conversation about couples therapy with your partner could be unwarranted. It’s important to recognize that it’s not exactly the same as marriage counseling, which typically addresses specific, immediate conflicts within a marriage. Couples therapy can be a beneficial step for all kinds of couples who want to resolve difficult partnership dynamics by diving deeper into the root causes of relationship issues. Go deeper: Couples Therapy vs Marriage Counseling: What's the Difference? You also may wonder about your partner’s reaction or willingness to consider couples counseling. Frame the discussion as an opportunity for growth and an investment in your future together. Remember: Seeking therapy is not a sign of failure but a proactive step to ensure that both partners are fulfilled and appreciated within the relationship. Cerebral’s approach to couples therapy Cerebral’s approach to couples therapy is rooted in evidence-based practices and tailored to the unique needs and goals of each couple. Knowing that it can be tricky to coordinate two people’s schedules, we offer convenient, online therapy sessions conducted by licensed mental health professionals. You can look for Cerebral's highly-rated couples therapists who offer appointments in the morning, afternoon, evening, or even on the weekend. Consider this: The cost of online couples counseling can also be more affordable. In the United States, in-person couples therapy sessions can range from $100 to $300 per hour. However, online sessions, which studies show are just as effective as in-person meetings, can cost as little as $65 a session.  Feeling underappreciated can be a painful and isolating experience. Through honest communication, boundary setting, appreciative gestures, and, if necessary, professional help, you can move past this hurdle and create a more connected and fulfilling partnership. Whether you’re just starting as a couple or navigating decades of partnership, discover all the ways couples therapy benefits every stage of your relationship. Images by Drazen Zigic and Freepik on Freepik.