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J. Connor Barnhart, MD

Bipolar Disorder Treatment in San Francisco

Also known as: Bipolar Affective Disorder, Manic-Depressive Illness, Manic Depression, Mood Cycling Disorder, Bipolar Spectrum Disorder

4 min readLast updated: 2026-02-20
Reviewed by J. Connor Barnhart, MD

Bipolar disorder is a mental health condition that causes significant shifts in mood, energy, activity levels, and thinking. People with bipolar disorder experience periods of unusually elevated or irritable mood with increased energy (known as manic or hypomanic episodes, "highs"), as well as periods of persistent sadness, social withdrawal, and very low energy (known as depressive episodes, "lows"). These mood episodes can affect sleep, behavior, judgment, and the ability to think clearly, and may interfere with daily activities, relationships, and work responsibilities.

At a Glance

  • An estimated 2.8% of U.S. adults had bipolar disorder in the past year, with approximately 4.4% experiencing it at some point in their lives[1]
  • Approximately 82.9% of people with past-year bipolar disorder experienced serious impairment, the highest rate among mood disorders[1]
  • The average age of onset for bipolar disorder is approximately 25 years, though symptoms can begin in the teens or, less commonly, in childhood[5]
  • An effective treatment plan typically includes a combination of medication and psychotherapy, helping many people manage symptoms and maintain stability[2]
  • Bipolar disorder affects men and women at approximately equal rates[5]

Affected Anatomy

  • Brain neurotransmitter systems (serotonin, dopamine, norepinephrine)
  • Prefrontal cortex
  • Amygdala
  • Hippocampus
  • Hypothalamic-pituitary-adrenal axis
  • Anterior cingulate cortex

What are the symptoms of Bipolar Disorder?

  • Manic episodes are marked by an elevated, expansive, or irritable mood lasting at least seven days that may also be associated with psychosis
  • Hypomanic episodes share some similarities with mania, but are generally less impairing of normal functioning
  • The above states are contrasted by depressive episodes with persistent sadness, hopelessness, or loss of interest in usual activities
  • Decreased need for sleep is common during manic or hypomanic episodes, while sleeping too much is common in bipolar depression
  • Racing thoughts and rapid speech are common during the "highs" of hypomania or mania
  • Increased goal-directed activity or agitation can also characterize hypo/manic states
  • Fatigue, low energy, and difficulty concentrating often occur during depressive episodes
  • Feelings of worthlessness or excessive guilt during depressive episodes
  • Impulsive or risky behavior during manic episodes

When to See a Psychiatrist for Bipolar Disorder

  • Bipolar disorder diagnosis and treatment can be complex and expert care by a psychiatrist is warranted
  • Extreme mood swings between high-energy episodes and major depression
  • Periods of unusually elevated mood, decreased need for sleep, or racing thoughts
  • Impulsive or risky behavior during elevated mood episodes that causes problems
  • Depressive "lows" may alternate with these "highs"
  • Current medication regimen that does not adequately stabilize mood or even seems to make things worse
  • Family history of bipolar disorder combined with mood instability

If any of these apply, consider reaching out to schedule a visit.

What causes Bipolar Disorder?

Causes

  • Genetic predisposition and family history of bipolar or related mood disorders
  • Structural and functional differences in brain regions involved in mood regulation
  • Dysregulation of the brain's circadian rhythm, metabolism, and immune processes
  • Environmental stressors and traumatic life events may trigger episodes in predisposed individuals

Risk Factors

  • First-degree relatives with bipolar disorder or other mood disorders
  • Major life stressors or significant childhood adversity
  • Substance use, particularly stimulants, alcohol, or cannabis
  • Sleep disruption and circadian rhythm disturbances
  • History of other mental health conditions such as depression, anxiety or PTSD

How It's Diagnosed

  • 1Comprehensive psychiatric evaluation including detailed mood history
  • 2Assessment of manic, hypomanic, and depressive episode criteria per DSM-5
  • 3Mood charting and longitudinal symptom tracking
  • 4Standardized screening tools such as the Mood Disorder Questionnaire (MDQ)
  • 5Physical examination and laboratory tests to rule out thyroid dysfunction and other medical causes
  • 6Differentiation from unipolar depression, schizoaffective disorder, and other mood disorders
  • 7Collateral history from family members, therapist, or close contacts when available can be useful in making an accurate diagnosis

How is Bipolar Disorder treated?

I offer several approaches for bipolar disorder:

Psychodynamic Therapy

Psychodynamic therapy is an evidence-supported form of talk therapy rooted in longstanding psychoanalytic theory about how unconscious thoughts, past ...

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Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a structured, evidence-based form of psychotherapy that focuses on identifying and modifying unhelpful patterns ...

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Psychotherapy

Psychotherapy, also called talk therapy, refers to a variety of treatment approaches that aim to help a person identify and change troubling emotions,...

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Medication Management

Medication management refers to the ongoing, physician-supervised process of prescribing, monitoring, and adjusting psychiatric medications to treat m...

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Lifestyle Optimization

Lifestyle optimization is an evidence-based approach to mental health that uses individually tailored behavioral interventions – including sleep hygie...

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Prognosis and Recovery

  • Bipolar disorder is typically a lifelong condition that can be effectively managed with ongoing treatment
  • Research suggests that a combination of medication and psychotherapy is often most effective
  • Many individuals achieve sustained periods of mood stability with consistent treatment adherence
  • Early identification and intervention are associated with improved long-term outcomes
  • Recurrence of mood episodes is common, making long-term management and monitoring important

Frequently Asked Questions

Bipolar disorder is a mental health condition that causes significant shifts in mood, energy, and activity levels. People with bipolar disorder experience manic or hypomanic episodes (periods of unusually elevated mood and energy) as well as depressive episodes (periods of persistent sadness and low energy). These mood changes can affect sleep, concentration, behavior, and daily functioning.
Symptoms vary by episode type. Manic episodes may involve elevated or irritable mood, decreased need for sleep, racing thoughts, rapid speech, and impulsive behavior. Depressive episodes may include persistent sadness, loss of interest in activities, fatigue, difficulty concentrating, and changes in sleep or appetite. Some individuals may also experience psychotic symptoms or suicidal thoughts during severe episodes.
The exact cause is not fully understood, but research suggests a combination of genetic, neurobiological, and environmental factors. Having a first-degree relative with bipolar disorder increases risk. Brain structure and "wiring" may also play a role, while exposure to major life stressors or trauma can trigger episodes in predisposed individuals.
See a psychiatrist if you experience extreme mood swings, prolonged depressive episodes alternating with elevated moods, or if current treatment is not providing adequate stability. Early evaluation and treatment by a physician can improve long-term outcomes.
Treatment typically involves a combination of mood-stabilizing medications and psychotherapy. Lifestyle modifications including regular sleep schedules, stress management, and mood monitoring are also important. Treatment is generally long-term and may be adjusted over time based on individual response.
Many people diagnosed with bipolar disorder are able to achieve sustained periods of mood stability with consistent treatment. A combination of medication and psychotherapy is often most effective. Ongoing monitoring, early identification of warning signs, and strong support systems can help reduce the frequency and severity of mood episodes over time. People living with bipolar disorder that is appropriately diagnosed and managed lead full lives.
The main types include Bipolar I disorder (characterized by at least one full manic episode lasting at least seven days or requiring hospitalization), Bipolar II disorder (characterized by hypomanic and depressive episodes without full manic episodes), and Cyclothymic disorder (involving chronic fluctuating mood with highs and lows that do not meet full criteria for a major depressive or hypomanic episode).
Yes. Dr. Barnhart trained in the UCSF Bipolar specialty clinic during residency and has focused expertise in mood stabilization using up-to-date psychiatric medication management, along with a holistic approach.

Your Practitioner

J. Connor Barnhart

J. Connor Barnhart, MD

Dr. J. Connor Barnhart is a board-certified psychiatrist and psychotherapist practicing in San Francisco. He completed his psychiatry residency at UCSF, where he trained in the Bipolar, LGBT, and Women's Mental Health specialty clinics and developed focused expertise in integrative psychiatry through a year-long rotation at the UCSF Osher Center. He attended medical school at the University of Pennsylvania's Perelman School of Medicine and graduated from Brown University with honors in Human Biology. His practice combines insight-oriented therapy, medication management, supplements, and lifestyle optimization to holistically address the root causes of mental health challenges including depression, anxiety, and difficulties with focus.

Sources & References

This article draws from 5 sources, including NIH, leading medical institutions.

Government & Research

Medical Institutions

Educational & General

Medically reviewed by J. Connor Barnhart, MD · Last reviewed: 2026-06-03