For when the highs and lows have started running your life.
Board-certified medication management for adults navigating bipolar disorder, mood instability, and the difficult work of finding steady ground. Online visits across Ohio. Care that takes the long view, not just the moment.
It often takes years to recognize the pattern.
Bipolar and related mood conditions are some of the most misunderstood — in popular culture and sometimes in healthcare too. Many people live with them for years before getting accurate care. Here’s what the lived experience often actually looks like.
The high that felt productive
Weeks where sleep felt optional, ideas came faster than you could write them down, and you got more done than usual — followed by a crash you couldn’t explain.
The depression that felt different
You’ve been treated for depression before, and antidepressants didn’t help — or made things worse. The picture didn’t quite fit.
The decisions you can’t recognize
Choices — spending, relationships, leaving jobs — that made sense at the time and don’t now. A pattern you’ve started to see.
The irritability that surprises people
A short fuse that doesn’t match who you usually are. Family or partners noticing it before you do.
The mood that shifts within a day
Fine in the morning, undone by afternoon, somewhere else entirely by night. Less “moody” than uncontrolled.
The quiet wish for steadiness
Not the highs, not the lows. The version of you that gets to feel like a person, day after day. That’s a reasonable thing to want.
The forms mood conditions can take.
Bipolar disorder isn’t one condition — it’s a category that includes several distinct patterns. Getting the right diagnosis matters because the treatment is different from depression alone, and using the wrong tools (like antidepressants without mood stabilizers) can actually make things worse. At Open Chair, the conditions most commonly treated through medication management include:
Bipolar I — characterized by manic episodes (often severe, sometimes requiring hospitalization), usually with depressive episodes too. The form most people picture when they hear “bipolar.”
Bipolar II — characterized by hypomanic episodes (less severe than full mania) and major depressive episodes. Often missed because the “up” periods feel functional rather than out of control.
Cyclothymia — persistent mood instability that doesn’t reach the threshold for full bipolar I or II. Real, treatable, often underdiagnosed.
Mixed-feature presentations — episodes that combine elements of mania and depression at the same time. Particularly disorienting to live with and important to identify.
Mood instability alongside other conditions — ADHD, trauma, and certain medical conditions can produce mood patterns that look bipolar but require different treatment approaches. The evaluation sorts which.
Psychotic-spectrum conditions in maintenance — schizophrenia, schizoaffective disorder, and related psychotic conditions when symptoms are stable or already well-managed on medication. Open Chair welcomes patients seeking to continue established medication management or who are receiving care during stable maintenance phases. New diagnoses involving active psychosis, paranoia, or acute symptoms require a higher level of care than telehealth can safely provide.
Medication management, thoughtfully done.
Mood disorder treatment is long-game work. The right combination of medications can bring real stability, but finding it takes patience — and a relationship with a provider who knows your specific patterns. That relationship is the foundation.
Listen first
Your first visit is a 60-minute psychiatric evaluation. We talk through your full mood history — the highs as well as the lows, what’s been tried, what’s helped, what hasn’t. Accurate diagnosis takes a careful conversation.
Build a plan together
If medication is appropriate, we discuss the realistic options — mood stabilizers, the role of antidepressants when paired with mood stabilizers, and what to expect over the first few months. You decide alongside me, not for me.
Adjust as we go
Mood treatment is iterative. We track patterns over months, not just weeks, and refine the plan as we learn what your specific biology responds to. You’re not stuck with the first version.
Before you book, the things people usually want to know.
- I’ve been diagnosed before, but I’m not sure it’s right.
- You’re not alone. Bipolar is one of the most commonly misdiagnosed conditions — sometimes labeled when it isn’t, sometimes missed for years when it is. We can revisit the picture together. A second careful look isn’t a waste; it’s often the start of better care.
- Will I have to take medication forever?
- For most forms of bipolar disorder, ongoing medication is the standard of care because it prevents future episodes — and each episode can make the next one more likely. That said, the specifics depend on your situation. We’ll talk through the realistic time horizon honestly, and any change to your plan is a conversation, not a directive.
- Will medication make me lose the “up” times?
- This is a fair concern, and worth being honest about. Mood stabilizers work by reducing the extremes — both directions. For some people, that feels like loss; for most, the trade-off is worth it because the lows lift, the consequences shrink, and life becomes more navigable. Stable is different from flat.
- What about side effects?
- Mood stabilizers vary considerably in their side effect profiles, and finding one that works for your body is part of the work. We discuss what to watch for at the start, monitor with bloodwork when relevant, and adjust the plan if something isn’t working for your life.
- Do I need to also be in therapy?
- Therapy isn’t required, but for most people with bipolar conditions it’s genuinely useful — specifically therapy that includes mood tracking, early-warning recognition, and relapse prevention. We can talk about whether therapy might be a useful addition and offer recommendations.
- What if I’m in the middle of an episode right now?
- If you’re experiencing severe symptoms, having thoughts of harming yourself or others, or losing touch with reality, please go to your nearest emergency room or call 988. Open Chair Psychiatry treats bipolar conditions in their outpatient forms; active crises require a higher level of care than telehealth can safely provide.
Ready when you are.
Booking takes about two minutes. No referral needed. Most major Ohio insurance accepted.
Book Appointment →Educational only. The information on this page describes general approaches to mood and bipolar treatment and is not medical advice. Treatment recommendations are individualized and made during a clinical evaluation. If you are in crisis or thinking about harming yourself, please call or text 988 or go to your nearest emergency room.