At Steadfast Psychiatry, Daniel Georges, MSN, PMHNP-BC, provides individualized psychiatric evaluations and medication management for eligible adults located in New York. The assessment and treatment plan are built around your symptoms, clinical history, goals, and preferences.
Understanding bipolar mood episodes
Bipolar disorders involve episodes of depression and periods of mania or hypomania, which are distinct from ordinary day-to-day mood fluctuations. Mania may involve markedly increased energy, decreased need for sleep, unusually elevated or irritable mood, rapid speech, impulsive behavior, or impaired judgment. Hypomania may be less severe, while depressive episodes can cause substantial loss of energy, motivation, and functioning.
Getting the diagnosis right
A comprehensive evaluation examines the timing and duration of episodes, sleep patterns, changes in energy and behavior, effects on functioning, family history, prior medication responses, and possible medical or substance-related contributors. Attention is also given to conditions that can overlap with bipolar symptoms. An accurate history is especially important because treatment approaches for bipolar depression and unipolar depression may differ.
Individualized medication planning
Depending on the type of bipolar disorder, episode history, and current presentation, treatments may include mood stabilizers or certain second-generation antipsychotic medications. Medication selection considers evidence for the specific phase of illness, medical history, pregnancy considerations when relevant, potential metabolic or other adverse effects, laboratory monitoring, and individual preferences. Antidepressant use warrants special care because it may not be appropriate as monotherapy in bipolar I disorder.
Long-term stability and coordinated care
Follow-up focuses on sleep, emerging mood changes, adherence, tolerability, psychosocial stressors, and functioning. Regular sleep-wake routines, psychotherapy, support systems, and plans for recognizing early warning signs can complement medication management. Some severe manic or depressive episodes, psychosis, or acute safety concerns require in-person or higher-level care rather than routine telehealth follow-up.
Why episode history matters
Bipolar I disorder includes at least one manic episode; bipolar II disorder involves hypomania and major depressive episodes without a history of full mania. These episodes are defined by sustained changes in mood and energy with associated symptoms—not minute-to-minute mood shifts alone. A longitudinal history, sleep patterns, family history, substance use, and responses to antidepressants help clarify diagnosis. Depression, anxiety, ADHD symptoms, and other concerns can coexist and require careful differentiation.
Treatment matched to the phase of illness
Medication choices for acute mania, bipolar depression, and maintenance are not interchangeable. Depending on the presentation, options may involve mood stabilizers or selected second-generation antipsychotics, with individualized discussion of laboratory tests, metabolic effects, other adverse effects, and safety considerations. Sleep regularity, early warning sign recognition, psychotherapy, and follow-up also support stability. Severe mania, psychosis, or immediate safety concerns require urgent in-person assessment rather than standard telehealth follow-up.
Frequently asked questions
How is bipolar disorder different from everyday mood swings?
Diagnosis relies on patterns of distinct mood episodes, symptom clusters, duration, and functional effects—not simply frequent changes in emotion.
Will every person with bipolar disorder take the same medication?
No. Options vary by diagnosis, current episode, previous response, health history, monitoring needs, and preferences.
Can bipolar disorder be treated through telehealth?
Some patients can receive outpatient follow-up by telehealth. Appropriateness depends on current symptoms, stability, safety, and clinical needs.
Next steps
A consultation can help determine whether this treatment approach is appropriate for your concerns. Recommendations depend on an individualized evaluation; an appointment does not guarantee a particular diagnosis or prescription.
View appointment availabilityEducational content only; not individualized diagnosis or treatment. Review periodically for clinical accuracy.
Clinical reference materials
These resources inform general evidence-based care; treatment recommendations are individualized.
Editorial content updated October 21, 2026. Formal clinician review is pending; this information does not replace individual assessment.