Free consult
A 15-minute phone call to decide whether psychiatric medication management fits what is happening. No card required.
§ 01 Bipolar psychiatry
Stability is not the same as being flat.
Private psychiatric telehealth for Washington adults navigating bipolar disorder, mood cycling, depression with activation history, irritability, sleep-driven shifts, and medication stabilization.
No card required for the consultation request. We use the call to decide whether medication management is the right next step.
At a glance
Bipolar psychiatry here means careful telehealth evaluation and medication management for Washington adults with mood cycling, depression with activation history, irritability, sleep-driven shifts, or uncertainty about bipolar-spectrum patterns. Care emphasizes stability, sleep protection, risk reduction, and collaborative follow-up.
The practice’s public clinical focus is depression and anxiety, trauma and PTSD, veterans, and adjustment after service, illness, or loss. This page stays available for depth and existing links; the home page reflects current priorities.
§ 02 What this care is
Medication management for mood stability.
We look at the longitudinal pattern: depression, activation, sleep changes, irritability, impulsivity, family history, antidepressant response, prior hospitalizations, and the medications that have helped or caused problems.
The goal is not to remove personality, ambition, or range. The goal is to reduce destabilizing swings, protect sleep, and make mood more predictable and livable.
This is a private cash-pay practice for adults physically located in Washington State. I do not accept or bill insurance. Superbills are available for possible out-of-network reimbursement when applicable.
$250 intake
A 60-minute psychiatric evaluation with history, medication review, mood-pattern assessment, and an initial plan.
$150 follow-up
Thirty-minute follow-ups to track sleep, cycling, mood, side effects, labs when needed, and medication response.
§ 03 Common presentations
The pattern matters more than a single day.
Bipolar disorder often becomes clearer when we look across time: sleep, energy, depression, activation, irritability, and medication response.
01
Depressive episodes with low energy, hopelessness, sleep changes, or shutdown.
02
Periods of increased energy, reduced sleep, racing thoughts, or impulsivity.
03
Irritability, agitation, anger spikes, or feeling internally sped up.
04
Antidepressants that helped briefly, did nothing, or made things feel activated.
05
Mood changes tightly linked to disrupted sleep or circadian rhythm.
06
Medication side effects, weight concerns, sedation, or emotional flattening.
07
Uncertainty about bipolar II, cyclothymia, mixed features, or recurrent depression.
08
The need for a careful plan instead of another rushed medication change.
§ 04 Medication can help with
Protecting the baseline before chasing symptoms.
Good bipolar care is precise, longitudinal, and careful about what each medication is supposed to protect.
Mood cycling
Reducing destabilizing highs, lows, mixed states, irritability, and the crash that can follow activation.
Sleep protection
Tracking and protecting sleep because sleep disruption can be an early warning sign, not a side detail.
Medication tolerability
Balancing stabilization with side effects, labs when needed, weight concerns, sedation, and emotional range.
§ 05 What this is not
Clear boundaries reduce risk.
Not crisis care
If you are in acute danger, manic crisis, or thinking of harming yourself or someone else, call 988, 911, or go to the nearest emergency department.
Not antidepressant-only thinking
Depression in bipolar disorder requires careful review of activation risk, sleep, history, and mood stabilization.
Not therapy replacement
Medication management can coordinate with therapy and lifestyle supports, but it does not replace them.
Not controlled substances
I do not prescribe stimulants, benzodiazepines, or controlled sleep medications. Controlled-substance prescribing is not part of this practice.
§ 06 Related paths
Depression care
For persistent low mood, low motivation, cognitive slowing, and medication-history questions.
Explore depression careAnxiety and sleep
Sleep disruption and anxiety can destabilize mood and complicate bipolar symptoms.
Explore anxiety and sleep careQuestions before you start?
If you are unsure whether medication management is appropriate, that is exactly what the free consultation is for.
Free 15-min consult§ 07 Questions
What if I am not sure whether I have bipolar disorder?
You do not need to arrive certain. The evaluation looks across time: depression, activation, sleep, family history, antidepressant response, substance effects, medical factors, and prior medication trials.
Why does sleep matter so much?
Sleep disruption can be both a trigger and an early warning sign. Protecting sleep is often central to preventing mood escalation or destabilization.
Can you coordinate with my therapist or primary care clinician?
Yes, with your permission. Bipolar care often benefits from coordination, especially when medication management is one part of a broader support plan.
What is the first step?
Request a free 15-minute consultation. No card is required for that call, and we use it to decide whether a full psychiatric evaluation makes sense.
Stability can be precise, not flattening.
A short consultation is enough to decide whether this kind of psychiatric care fits what is happening.
Book a free 15-minute consultation