Depression & Bipolar Disorders

Our approach starts with distinguishing between unipolar depression and bipolar spectrum disorders—critical because treatment paths diverge significantly. A manic or hypomanic episode changes diagnostic classification and often alters medication selection dramatically. We review your full symptom timeline, family history, and any prior treatment responses to avoid misdiagnosis, which is common when depressive episodes dominate clinical presentation.

Medical conditions like thyroid dysfunction, neurological disorders, or vitamin deficiencies can mimic or worsen mood symptoms. We order or review relevant lab work and physical exam findings to rule these out. For instance, some medical conditions such as thyroid dysfunction may present with mood and energy symptoms that resemble depression but require fundamentally different management. This step ensures we treat the root cause, not just the symptom cluster.

When medication is indicated, we prioritize stability over speed—avoiding trial-and-error approaches. For depression, we consider antidepressants only after assessing bipolar risk; for bipolar disorder, mood stabilizers or atypical antipsychotics form first-line treatment. We monitor for side effects and efficacy over weeks, adjusting slowly to preserve adherence and minimize destabilization. Your input on lived experience guides each decision.