Bipolar I, Bipolar II, cyclothymia, mood instability. Specialty mood-stabilizer management plus pharmacogenomic-guided treatment selection.
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Bipolar disorder is a mood disorder marked by periods of mania (or hypomania) alternating with periods of depression. It's distinct from "mood swings" — manic and depressive episodes last days to weeks, not hours, and they meaningfully affect functioning.
Bipolar I involves full manic episodes (decreased need for sleep, racing thoughts, impulsive behavior, grandiosity, sometimes psychosis). Bipolar II involves hypomanic episodes (less severe than mania) plus depression — and is often misdiagnosed as recurrent depression because patients seek help during depressive phases.
Bipolar disorder is highly treatable, but treatment selection matters more than for almost any other psychiatric condition. The wrong medication (or the wrong dose) can destabilize symptoms; the right combination is often life-changing.
If symptoms are interfering with daily life — or if you've felt this way for more than two weeks — it's worth a conversation with a psychiatrist.
Effective treatment usually combines medication, therapy, and lifestyle factors. We work with you to find the right combination.
Gold standard for bipolar I. Reduces both manic and depressive episodes; reduces suicide risk. Requires periodic blood monitoring.
Lamotrigine (especially for bipolar depression), valproate, carbamazepine. Each has different strengths and side effects.
Quetiapine, lurasidone, olanzapine, aripiprazole. Several are FDA-approved for bipolar depression and/or maintenance.
Standard antidepressants can trigger mania in some bipolar patients. We use them carefully, with mood-stabilizer coverage.
Especially valuable in bipolar — genetic testing can help avoid trial-and-error and pick mood stabilizers most likely to work for you.
Sleep disruption is both a trigger and a warning sign of episodes. Protecting sleep is core to bipolar treatment.
Many patients arrive having been treated as "depression" for years before a hypomanic episode reveals bipolar II. Re-evaluation matters: the right diagnosis changes everything about treatment.
Dr. Punia is a Fellow of the American Society of Clinical Psychopharmacology (FASCP) — meaning specialty expertise in complex medication management. For bipolar disorder specifically, this matters: lithium dosing, lamotrigine titration, navigating drug-drug interactions, and managing pregnancy considerations all benefit from specialist depth.
We coordinate with therapists experienced in bipolar disorder (CBT, family-focused therapy, social rhythm therapy). We also help patients build relapse-prevention plans — early-warning signs to watch for and what to do if they appear.
Four California clinics for in-person care, plus TelePsychiatry for patients anywhere in the state.
Yes — diagnosis is based on lifetime history, not the current episode. If you've had a clear manic or hypomanic episode at any point, even years ago, you have bipolar disorder.
No. Lithium is one excellent option but not the only one. Many patients do well on lamotrigine, atypical antipsychotics, or combinations. We pick based on your specific pattern.
That's an important diagnostic clue. We taper the antidepressant carefully and start a mood stabilizer. Many patients with this history are ultimately diagnosed with bipolar II.
Yes — with planning. Some bipolar medications are safer in pregnancy than others. We work with your OB to plan transitions before conception when possible.
Yes. We accept Medi-Cal, Medicare, and most major commercial insurance for ongoing bipolar care.
