Mental health
Bipolar disorder treatment in Ohio
Outpatient treatment for bipolar I and bipolar II, with medication management by a nurse practitioner and therapy focused on early warning signs, sleep and routine. Acute mania and psychosis need inpatient care, and the assessment says so directly.
- Ambulatory detox
- Not applicable
- Treated at
- Partial hospitalization, Intensive outpatient, Outpatient, Virtual IOP, Alumni program
- Where
- Columbus, Dayton
- Admissions
- (614) 665-8878
Bipolar I and bipolar II
Bipolar disorder runs in episodes at both ends of a mood range. Bipolar I requires at least one manic episode: a week or more of elevated or irritable mood with a clear rise in energy, severe enough to disrupt work and relationships. Bipolar II involves hypomania, the same pattern at lower intensity, along with at least one major depressive episode.
Most people call during a depressive stretch, and hypomania reads as a good few weeks rather than a symptom, which is why bipolar II gets treated as depression for years. The assessment asks about the high periods and about what family members have noticed, since relatives usually see hypomania first. Substance use is common alongside bipolar disorder, and stimulants can produce symptoms that look like mania. Where both are present they are treated in one plan by one team, with ambulatory detox on site first if withdrawal is involved, and that detox covers mild to moderate withdrawal only.
The antidepressant risk
An antidepressant given on its own to someone with bipolar disorder can push mood up into hypomania or mania, or make cycling faster. That is why the assessment spends time on episode history, and why the answer changes which medication is appropriate.
Levels of care
- Partial hospitalization
- 5 days a week, about 6 hours. 4 hours therapy group, 1 hour relapse prevention, 1 hour nurse education, plus 1 to 2 individual sessions. Lunch provided. Nurse practitioner weekly.
- Intensive outpatient
- 3 to 5 days a week, 3 hours of group a day, 9 to 15 hours a week. Nurse practitioner every 2 to 3 weeks.
- Outpatient
- 1 to 2 days a week, 2 hours of group, plus individual sessions.
- Virtual IOP
- fully remote, anywhere in Ohio, with morning, afternoon and evening sessions.
- Alumni
- ongoing counseling, help finding work and twelve step meetings.
Medication management
Leora offers medication management with a licensed psychiatrist, and you meet with a nurse practitioner about your medication. Which medication fits depends on whether your pattern runs more depressive or more manic, what you have taken before, other medical conditions, and the side effects you can live with.
- Lithium; an anticonvulsant mood stabilizer such as valproate or lamotrigine; or a second generation antipsychotic
- Doses adjusted over time rather than settled at the first appointment
- Periodic blood work for some of them, and your prescriber says which apply to you
- An early conversation about stopping, since coming off a mood stabilizer while well is a common route back into an episode
Therapy focus
Cognitive behavioral therapy and dialectical behavior therapy carry the therapy side. The work concentrates on:
- Recognizing your own early warning signs before an episode is fully underway
- Protecting sleep and daily routine, since lost sleep is a reliable trigger
- A written plan for what you and the people around you do then
- Emotion regulation and distress tolerance skills for both poles
- Family sessions and case management, since relatives notice a shift first and episodes leave practical damage
Limits of outpatient care
Leora is outpatient, with no beds, no overnight supervision and no inpatient psychiatric unit. Acute mania, psychosis and active suicidal intent need inpatient care, and the assessment will say so rather than starting a program that cannot monitor you. If you are in immediate danger call 911, and the Suicide and Crisis Lifeline is 988, by call or text.
Common questions
Can Leora treat me if I am in a manic episode right now?
I was diagnosed with depression years ago. Could it be bipolar II?
Will I have to take medication?
What should I bring to the assessment?
Do you treat bipolar disorder if there is no substance use involved?
Where this is offered
Hope inspired
Talk to admissions about the right next step.
Outpatient addiction and mental health treatment in Columbus and Dayton, Ohio, from ambulatory detox to outpatient therapy groups. Walk-ins welcome. Call now, or leave your number and admissions will call you back.
