Bipolar disorder takes an average of eight years to be diagnosed correctly, usually because the depressions got treated while the highs went unmentioned. Alice Tran, PMHNP-BC provides careful diagnosis and steady long-term bipolar care, in Fairfax and by telehealth across Virginia.
Book an Appointment →Most people with bipolar disorder seek help during depression, and the hypomanic stretches of bipolar II rarely feel like a complaint: days of extraordinary energy, little need for sleep, fast ideas, confident decisions. So depression gets diagnosed alone, an antidepressant gets prescribed alone, and for some patients that ignites agitation, rapid cycling, or a full high. If antidepressants have repeatedly failed you or made you feel strange and revved, that history is a diagnostic clue, not a dead end.
Every depression evaluated in this practice is screened for bipolarity as a matter of routine: episode patterns, sleep changes, family history, and exactly how past medications behaved. Distinguishing bipolar I, bipolar II, and cyclothymia from recurrent depression, ADHD, and personality patterns is careful work, and it is the work that determines whether the next five years are stable or chaotic.
Treatment centers on mood stabilizers such as lamotrigine and lithium and selected atypical antipsychotics, chosen for your episode pattern and monitored properly, with lab work ordered to a location near you anywhere in Virginia. Genetic testing is available when relevant, including HLA-B*1502 screening before certain medications for patients of Asian ancestry. The real medicine in bipolar care is follow-up: catching a mood shift two weeks early routinely prevents a two-month episode.
The subtle highs no one reports. If "treatment-resistant depression" has been your label for years, this evaluation is worth having.
Lamotrigine, lithium, and modern alternatives with actual lab monitoring and plain-language reasoning at every step.
A first manic episode is frightening for everyone involved. Steady outpatient follow-up afterward is what protects the years ahead.
College in Charlottesville, first job in Richmond, family in Fairfax: telehealth keeps the same clinician through every move within Virginia.
Related: Bipolar disorder overview · Signs of hypomania adults miss · Bipolar II vs. BPD · Medication management in Virginia
That pattern is one of the classic flags for missed bipolar II, and it deserves a structured evaluation rather than a fifth antidepressant. Bring your full medication history; how each drug behaved is diagnostic gold.
The goal is the opposite. Patients stabilized well typically say they finally feel like themselves without the wreckage. If a medication flattens you, that is a dosing conversation, and follow-ups exist exactly for it.
Yes, for evaluation, medication management, and monitoring, with labs done locally. Acute mania or a safety crisis needs emergency in-person care, and that boundary is discussed openly from the first visit.
Every two to four weeks during changes, stretching to every one to three months once stable. Consistency, not intensity, is what keeps bipolar disorder quiet.
Bipolar evaluation and long-term care, in Fairfax & statewide by telehealth.
Book Now →Or call/text: (703) 791-9099
Reviews help other patients find the care they need. If you have had a positive experience, we would be grateful if you took a moment to share it.
We read every review and appreciate every kind word.