Bipolar disorder can make life feel unpredictable. Periods of high energy, racing thoughts, and little sleep can give way to depression so heavy it is hard to get through the day. Many people spend years searching for stability, cycling through medications, or being treated for depression alone before getting the right diagnosis.
At Psychiatric Pathways in Bloomington, Brenna Christie, FNP-C, PMHNP-BC, provides careful, compassionate bipolar disorder treatment for adults across the Twin Cities. Our clinic focuses on accurate diagnosis and psychiatric medication management to build lasting stability, with advanced options such as ketamine therapy for bipolar depression that has not responded to standard treatment.
If you are having thoughts of suicide or feel unsafe, call or text 988 (the Suicide & Crisis Lifeline) or go to the nearest emergency department. If there is immediate danger, call 911.
Understanding Bipolar Disorder
Bipolar disorder is a long-term brain-based condition that causes significant shifts in mood, energy, sleep, and focus. According to the National Institute of Mental Health, about 2.8% of U.S. adults had bipolar disorder in the past year, and most of those cases involved serious impairment.
It is more than ordinary mood swings. Bipolar disorder involves distinct episodes that can last days, weeks, or longer, and it is linked to differences in brain signaling and the body’s internal clock. With the right treatment, most people can achieve long periods of stability.
Types of Bipolar Disorder
- Bipolar I disorder: At least one manic episode lasting seven days or more, or severe enough to need hospital care, usually with depressive episodes as well.
- Bipolar II disorder: Depressive episodes alternating with hypomania, a milder form of mania, without full manic episodes.
- Cyclothymic disorder: Ongoing shifts between milder hypomanic and depressive symptoms lasting two years or more.
Signs and Symptoms
- Mania or hypomania: Unusually high energy or elevated mood, less need for sleep, racing thoughts, rapid speech, irritability, impulsive or risky decisions, and inflated confidence.
- Depression: Persistent sadness, hopelessness, fatigue, loss of interest, trouble concentrating, changes in sleep and appetite, and sometimes thoughts of suicide.
- Mixed features: Symptoms of mania and depression at the same time, such as agitation and restlessness combined with hopelessness.
Bipolar disorder affects more than mood. It can strain relationships, work, finances, and family life, and loved ones often feel unsure how to help. Treatment supports the whole picture, not just symptoms.
Why an Accurate Diagnosis Matters
Because people usually seek help during depression, bipolar disorder is often first diagnosed as unipolar depression. That matters, because antidepressants taken without a mood stabilizer can trigger mania or rapid cycling in some people with bipolar disorder. ADHD, trauma, anxiety, and thyroid problems can also overlap with or mimic bipolar symptoms. A careful evaluation is the foundation of safe, effective care.
Bipolar Disorder Treatment in Minnesota Led by Brenna Christie
Brenna Christie is dual board certified as both a Family Nurse Practitioner and a Psychiatric-Mental Health Nurse Practitioner, with 13 years in practice. She trained at the University of Colorado and the Rocky Mountain University of Health Professions and is a member of the American Society of Ketamine Physicians, Psychotherapists and Practitioners (ASKP3). Mood disorders are her primary specialty, and bipolar disorder is among her areas of expertise.
At Psychiatric Pathways, bipolar care is built on:
- Whole-person care: Her background in family medicine means lab work, sleep, thyroid and metabolic health, and medication side effects are all part of the plan.
- Shared decisions: Every medication change is made with you, so you stay in control of your care.
- Coordinated care: We work alongside your therapist and primary care provider so your plan stays aligned.
- Consistent follow-up: Bipolar disorder is long-term, and so is our commitment to monitoring and adjusting your plan as life changes.
Treatment for Bipolar Disorder: Our Approach
Effective treatment for bipolar disorder starts with medication that stabilizes mood and prevents future episodes. Therapy, sleep routines, and lifestyle support build on that foundation. For bipolar depression that does not respond to standard treatment, advanced options may help.
| Treatment | How It Helps | Often Used When |
| Psychiatric medication management | Mood stabilizers and other medications to prevent mania and ease bipolar depression | The foundation of care for everyone with bipolar disorder |
| Ketamine therapy | Works on glutamate pathways; may ease bipolar depression within hours or days | Bipolar depression has not responded to standard medications, with mood stabilizers in place |
| Spravato | FDA-approved esketamine for treatment-resistant depression (not approved for bipolar disorder) | Rarely; only after careful review, if at all |
Psychiatric Treatment for Bipolar Disorder
Psychiatric treatment for bipolar disorder focuses on an accurate diagnosis, the right combination of medications, and ongoing monitoring to keep mood steady over time.
What to Expect During Your Evaluation
- Mood and energy history: We map your past episodes, energy peaks, sleep patterns, and how you have responded to previous medications, including any that seemed to make things worse.
- Medical screening: We review lab work and physical health, including thyroid and metabolic factors that can affect mood and some medications.
- Personalized stabilization plan: We build a plan that pairs medication management with sleep and routine support and coordination with therapy.
Medication Management for Bipolar Disorder
- Mood stabilizers: Lithium, divalproex, and lamotrigine help prevent mood episodes. Lithium also has strong evidence for reducing suicide risk.
- Atypical antipsychotics: Several are FDA-approved to treat mania, bipolar depression, or both, and some are used for long-term prevention.
- Careful use of antidepressants: When used at all in bipolar disorder, antidepressants are generally combined with a mood stabilizer and monitored closely.
Finding the right plan often takes several weeks to a few months, and some medications require periodic lab checks. We schedule regular follow-ups to adjust doses, monitor side effects, and keep your plan working. If depression remains a major part of your experience, our psychiatry for depression services can add support.
When Bipolar Depression Does Not Improve
For many people, mood stabilizers keep mania under control, but depressive episodes remain the hardest part of the illness and can be slow to respond. When bipolar depression persists despite well-managed medication, advanced treatment may help.
Ketamine Treatment for Bipolar Disorder
Ketamine has been used safely in medical settings for decades as an anesthetic. At much lower doses, it has shown promise for treatment-resistant depression, including bipolar depression. Unlike traditional antidepressants, which mainly target serotonin, ketamine acts on the brain’s glutamate system, which is thought to help the brain form new connections that chronic stress and depression have weakened.
Ketamine treatment for bipolar disorder is used to treat bipolar depression, not mania. It is not FDA-approved for bipolar disorder, so its use is considered off-label, and research in bipolar depression is more limited than in unipolar depression. Ketamine is generally given while you continue your mood stabilizing medication, and it is not appropriate during an active manic episode or psychosis. Because any treatment for depression carries some risk of triggering mania in bipolar disorder, we monitor your mood closely before, during, and after treatment.
How Ketamine May Help
Some patients with bipolar depression describe feeling lighter, more motivated, and more hopeful after treatment, sometimes within hours or days rather than the weeks standard medications can take. Results vary, and ketamine is not a cure, but for the right patient it can be a helpful part of a broader, stabilizing plan.
What to Expect During Treatment
Treatment begins with a complimentary consultation, which typically takes about an hour, to review your mood history and confirm whether ketamine is appropriate. IV ketamine infusions are given slowly over about 40 to 60 minutes in a calm, monitored setting, and each visit takes about two hours in total. You stay awake and may feel deep relaxation, a floating sensation, or mild dissociation. These effects are temporary and closely supervised. Most patients begin with a series of treatments over several weeks.
Ketamine infusions are $395 per session and are self-pay. We accept HSA and FSA, and we can provide a superbill that may allow partial reimbursement depending on your plan.
Is Ketamine Safe for People With Bipolar Disorder?
When administered in a professional medical setting with careful patient selection, ketamine has a well-established safety profile. Some patients experience temporary nausea, dizziness, elevated blood pressure, or dissociation during treatment. For people with bipolar disorder, we also watch for any signs of elevated mood. A thorough evaluation, a stable mood stabilizer regimen, and close follow-up are part of every ketamine plan.
Spravato Treatment for Bipolar Disorder: What to Know
Many people ask about Spravato (esketamine) for bipolar disorder. Spravato is an FDA-approved nasal spray for treatment-resistant depression, but it is approved for major depressive disorder, not bipolar disorder, and people with bipolar disorder were generally not included in the studies that led to its approval.
Because of that, Spravato is not a standard treatment for bipolar disorder. If you have bipolar disorder and are interested in Spravato, we will review your history carefully and discuss whether it, IV ketamine, or another approach is the safest fit. For patients with major depression rather than bipolar disorder, learn more about our Spravato treatment center.
Living Well With Bipolar Disorder
Medication is the foundation, but day-to-day habits also help protect stability:
- Regular sleep: Consistent sleep and wake times are one of the most powerful ways to prevent mood episodes.
- Tracking mood: Noticing early warning signs, such as sleeping less or feeling unusually driven, helps you and your provider act early.
- Therapy: Approaches such as CBT and family-focused therapy can build coping skills and strengthen relationships.
- Limiting alcohol and substances: These can trigger episodes and interfere with medication.
Conditions That Often Occur Alongside Bipolar Disorder
Bipolar disorder often occurs with other conditions, including anxiety, PTSD, OCD, ADHD, and substance use. Some, like anxiety and ADHD, can also mimic parts of bipolar disorder. If you are unsure whether your symptoms are bipolar disorder or depression, a careful evaluation can help clarify.
Bipolar Disorder Care Across the Twin Cities
Our clinic is located at 3601 Minnesota Dr #510 in Bloomington, serving adults throughout the Twin Cities, including Minneapolis, Edina, Richfield, Eden Prairie, and surrounding communities. Many follow-up visits for medication management can also be held via telehealth. We are in-network with several major insurance plans and accept HSA and FSA payments.
Frequently Asked Questions About Bipolar Disorder Treatment
When should I see a psychiatric provider for bipolar disorder?
Consider an evaluation if you notice distinct periods of unusually high energy and little sleep followed by low periods, if antidepressants have made you feel agitated or “wired,” or if mood shifts are disrupting work or relationships.
What is the difference between bipolar disorder and depression?
Both involve depressive episodes, but bipolar disorder also includes episodes of mania or hypomania. The difference matters because treatment is different, and antidepressants alone can worsen bipolar disorder.
Can bipolar disorder be treated without medication?
Clinical guidelines place mood stabilizing medication at the center of bipolar treatment, because it helps prevent future episodes. Therapy, sleep routines, and lifestyle changes are important additions, but they generally work best alongside medication.
How long does it take to find the right medication?
Often several weeks to a few months. Doses are adjusted carefully to reach good mood control with the fewest side effects.
Can ketamine help bipolar disorder?
Ketamine may help bipolar depression that has not responded to standard treatment. It is used off-label, typically alongside a mood stabilizer, and with close monitoring for any signs of mania. It is not used to treat mania.
Can Spravato be used for bipolar disorder?
Spravato is FDA-approved for treatment-resistant major depression, not bipolar disorder. It is not a standard bipolar treatment, but we are happy to discuss your options during a consultation.
Can I keep seeing my current therapist?
Yes. We encourage it, and we are happy to coordinate so your care stays aligned.
What should I do if I think I am becoming manic?
Contact your provider right away if you notice early signs such as sleeping much less, racing thoughts, or unusual impulsive behavior. If you feel unsafe or out of control, call 911 or go to the nearest emergency department.
Take the First Step Toward Stability
Living with bipolar disorder can feel exhausting, but steady, lasting stability is possible with the right care. At Psychiatric Pathways, Brenna Christie and our team are here to help you build it.
Call (952) 592-5421 or schedule your complimentary consultation today.