An Individualized Approach to Bipolar Disorder

Jennifer Seay
Mar 19
2 min read

By Jennifer Seay, PMHNP-BC

Bipolar disorder is often misunderstood as simply “mood swings,” but in reality, it presents in very different ways depending on the individual.

In my clinical experience, I commonly see three general patterns.

Some patients experience deep, overwhelming depression—feeling hopeless and unable to see a way forward. Others live in a more constant state of irritability and agitation, where even small stressors feel intense and difficult to manage. And for some, symptoms can escalate into anger, aggression, or even violent outbursts.

Across all three, there is often a shared pattern: the ability to shift quickly from feeling stable—or even optimistic—to the opposite extreme, sometimes triggered by stress, and sometimes by internal thought patterns alone.

Treating the Pattern, Not Just the Diagnosis

Because bipolar disorder presents differently in each person, I don’t believe in a one-size-fits-all treatment approach.

For patients in a deeply depressed state, I may use low-dose lithium augmentation to help stabilize mood and support brain receptor activity. This can help lift patients out of that low state while maintaining balance.

For those struggling more with irritability, agitation, and mood instability, Depakote (valproate) can be very effective in calming fluctuations and creating a more even emotional baseline.

In cases where anger, impulsivity, or aggressive outbursts are more prominent, Tegretol (carbamazepine) can help patients regain control over those intense responses and reduce the frequency and severity of episodes.

No Two Patients Are the Same

Many patients don’t fit neatly into one category. Some experience a combination of these patterns, and their treatment needs to reflect that.

My role is to carefully evaluate symptoms, identify patterns, and build a plan that supports stability without overmedicating or overlooking key aspects of the condition.