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Home / Conditions / Bipolar disorder treatment in Houston & across Texas
Bipolar disorder treatment in Houston & across Texas
The average person with bipolar disorder spends years being treated for depression first. Getting the diagnosis right changes everything that follows.
Why the diagnosis takes so long
People seek help when they feel bad, not when they feel unusually good. Depressive episodes bring patients to the doctor; hypomanic periods get remembered as “a really productive stretch” or “when I finally had energy”. So the history offered is a depression history, and the treatment that follows is a depression treatment.
That matters because an antidepressant given without a mood stabiliser in bipolar illness can destabilise mood rather than treat it. A patient who has become agitated, sleepless or worse on antidepressants may be giving important diagnostic information.
What to look for in your own history
- Periods of markedly reduced need for sleep — not insomnia, but genuinely not needing sleep and feeling fine.
- Stretches of unusual energy, speed of thought or talkativeness that other people noticed.
- Uncharacteristic spending, risk-taking or impulsive decisions during those periods.
- Depression that started young, recurs, or has never fully responded to standard treatment.
- Agitation, irritability or worsening on antidepressants.
- A family history of bipolar disorder, or of relatives described as “difficult” or “up and down”.
None of these confirms a diagnosis on its own. All of them are worth an evaluation that has time to look at them properly.
How Dr. Torrijos evaluates bipolar disorder
Careful longitudinal history is the whole diagnostic method here — there is no test. The evaluation maps mood over time rather than at a single point: onset, episode pattern, seasonality, response to previous medications, sleep architecture, substance use, and, where you consent, collateral information from someone who knows you well. Family members often remember hypomanic periods that the patient does not.
Medical and substance-related causes of mood elevation are also assessed, including thyroid dysfunction, steroid medication and stimulant use.
Treatment options
Mood stabilisation is the foundation, and several medication classes have good evidence. Antidepressants are used cautiously and generally not alone. Psychotherapy that focuses on routine and sleep regularity has specific evidence in bipolar illness. Consistent sleep and limited alcohol are not lifestyle advice here — they are part of the treatment.
Certain medications require ongoing laboratory monitoring. That monitoring is scheduled and followed, because unmonitored treatment is not safe treatment.
What treatment looks like at Tentie
Frequent follow-up during stabilisation, then longer intervals with reliable monitoring. Bipolar illness is a long-term condition, and the goal is stability over years rather than a fast response over weeks. Recognising early warning signs of an episode is part of the work — the plan includes what to do when you notice sleep starting to slip.
Start with an evaluation
| Patients | Adults 18+ |
| Evaluation | Up to 90 min |
| Fee | [$XXX] |
| Format | In person or video |
| Languages | English, Spanish |
Reviewed by José M. Torrijos, MDBoard-certified adult psychiatrist, licensed in Texas. Last reviewed August 2026.
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Frequently asked
Could I have bipolar disorder and not know?
It is common. Bipolar II in particular is frequently treated as recurrent depression for years, because hypomania rarely feels like a problem at the time. A careful longitudinal history is what surfaces it.
Do I have to take medication for life?
Bipolar disorder is generally a long-term condition and maintenance treatment substantially reduces relapse. Regimens are simplified where possible, and every medication is periodically reassessed for whether it still earns its place.
Will I need blood tests?
Some mood stabilisers require ongoing monitoring of levels, kidney, thyroid or liver function. Where they do, testing is scheduled and reviewed with you.
Can this be managed by telehealth?
Ongoing management works well by video. Some monitoring requires in-person assessment or coordination with your primary care provider, which is arranged as part of the plan.
What if my family disagrees about my history?
Collateral information is genuinely useful and, with your written consent, family perspective can be included. It is one input among several — the diagnosis is made clinically, not by vote.