What is Bipolar disorder?

Also known as Manic Depressive Disorder, learn the symptoms, misconceptions and different types of this misunderstood diagnosis. 

Bipolar disorder is a serious mental illness that impacts around 5.7 million American adults each year. According to the Depression and Bipolar Support Alliance, bipolar disorder is the sixth leading cause of disability in the world.1

Bipolar disorder often co-occurs with a substance use disorder, which worsens bipolar symptoms and may dramatically increase the risk for suicide. Here, we take a closer look at bipolar disorder, co-occurring disorders and how treatment can help you restore your mental health and reclaim your life.

What Are Signs and Symptoms of Bipolar Disorder?

Bipolar disorder is characterized by alternating episodes of high and low moods. The four types of mood episodes associated with bipolar are mania, hypomania, depression and mixed episodes, which are a combination of symptoms of mania, hypomania, and depression.





Signs and symptoms of a manic episode include:
  • Moments of elation alternating with moments of pessimism
  • Feelings of grandiosity and self-importance
  • Rapid talking
  • Reduced sleep
  • Engaging in high-risk behaviors
  • Impaired judgment
  • Irrational behaviors and thoughts
  • Hallucinations


Hypomania symptoms are similar to those of mania, but they’re far less intense and don’t involve psychosis. During periods of hypomania, you:
  • Feel happier and more energetic than usual
  • May be more irritable than normal
  • Are capable of managing your daily activities
  • Feel able to take on more responsibilities at home, work or school
  • Need fewer hours of sleep
  • Are likely to engage in high-risk behaviors, including substance abuse
  • Feel like your bipolar disorder is under control


Phases of depression that occur with bipolar disorder are characterized by severe lows. Signs and symptoms of a depressive phase include:
  • Feelings of hopelessness and helplessness
  • Feelings of sadness, guilt and self-hatred
  • A loss of interest in activities you used to enjoy
  • Increased sleep
  • Appetite changes
  • Fatigue
  • Thoughts of suicide or death

What are Types of Bipolar Disorder?

The symptoms of bipolar disorder aren’t always cut-and-dry. Five types of bipolar disorder are diagnosed by mental health professionals.

Bipolar I disorder

Bipolar I disorder is the most severe form of bipolar disorder, characterized by at least one manic or mixed episode and one or more episodes of major depression.

Bipolar II disorder

Bipolar II disorder is characterized by a deeper depression than that which occurs with bipolar I. It’s diagnosed after at least one major depressive episode and at least one hypomania episode.

Bipolar Not Otherwise Specified

Bipolar Not Otherwise Specified doesn’t follow a predictable pattern. You may alternate very rapidly between manic and depressive episodes, or you may have repeated episodes of mania or hypomania without any depressive episodes.


Cyclothymia is a less intense form of bipolar involving milder depressive episodes alternating with hypomanic episodes. Diagnosis is made when these alternating episodes last for at least two years.

Bipolar with Rapid Cycling

Bipolar with rapid cycling occurs when you have four or more manic, hypomanic or depressive episodes in a 12-month period. Any of the four types of bipolar disorder can be rapid cycling.

Treating Bipolar Disorder

Bipolar disorder is treatable. The best course of treatment involves both medication and counseling. Medications used to treat bipolar disorder depend on unique symptoms and may include mood stabilizers, antipsychotics, antidepressants, anti-anxiety medications or combination medications that contain both a mood stabilizer and an antidepressant.

Counseling helps individuals with bipolar disorder cope with their symptoms and better understand and manage their bipolar disorder. For example, cognitive behavioral therapy helps you identify and evaluate dysfunctional thought and behavior patterns and recognize the signs that point to an episode shift. Dialectical behavior therapy reduces suicidal ideations and helps regulate emotions, tolerate painful situations, practice mindfulness and maintain boundaries and self-respect.

Bipolar Disorder and Substance Use Disorders

When a mental illness and a substance use disorder are both present, it’s known as a dual diagnosis, or co-occurring disorders. Bipolar disorder commonly co-occurs with addiction. According to the U.S. National Comorbidity Survey, 71 percent of people who have bipolar disorder report a lifetime history of at least one substance use disorder.2

An article in the journal Science & Practice Perspectives stresses that people with bipolar disorder who abuse alcohol have an earlier onset of bipolar symptoms and more frequent hospitalizations. The article explains several reasons why bipolar disorder may commonly occur with an addiction, including:3
  • Self-medication: People with a mental illness are likely to use drugs or alcohol to deal with unpleasant symptoms. While drugs and alcohol may seem to alleviate symptoms initially, they almost always make bipolar symptoms worse.
  • “Kindling” :Repeated disruptions in the brain sensitizes brain cells, and an increase in sensitivity can lead to more frequent alcohol or drug use over a short period of time. It can also lead to worsened symptoms and more frequent cycling of bipolar disorder.
  • Genetics: Both substance use disorders and mental illnesses have genetic risk factors. Additionally, families who have a member with a mental illness are also more likely than those without to also have members who abuse substances, and vice versa.
  • High-risk behaviors: One symptom of mania and hypomania is engaging in high-risk behaviors, which include drug and alcohol abuse.

Recovery from co-occurring disorders isn’t easy, but getting professional help improves your chances of successful long-term recovery from both disorders.

Treating Co-Occurring Disorders

If you have bipolar disorder and a drug or alcohol use disorder, addressing only one condition will not be effective for treating either condition. Co-occurring disorders require integrated treatment that addresses each disorder in the context of the other. Integrated treatment is essential for successful recovery.

A high-quality treatment program will use a variety of research-based therapies to treat both bipolar disorder and addiction at the same time. Each individualized treatment plan is a collaboration among various caregivers, including psychiatrists, therapists, physicians and counselors.

Therapies commonly used in a dual diagnosis treatment program include:


  • Pharmacotherapy, which is the use of medications to treat either the bipolar disorder or the addiction, or both.
  • Traditional “talk” therapies, such as cognitive-behavioral therapy, dialectical behavior therapy and acceptance and commitment therapy. These therapies help people change their thought and behavior patterns and develop essential coping skills.
  • Complementary therapies, such as art therapy, restorative yoga and biosound healing therapy. These therapies help individuals express difficult emotions, develop mindfulness and self-confidence and look at old problems in new ways.
  • Family therapy, which helps to restore function to the household.
  • Psychoeducational classes, which help individuals with co-occurring disorders understand both conditions and develop coping skills for a variety of challenges.
  • As-needed interventions, which may include vocational or educational assistance, help finding safe housing or assistance navigating the legal system.

Therapy helps individuals in dual diagnosis treatment:

  • Better understand bipolar disorder and its symptoms
  • Identify dysfunctional thought and behavior patterns and develop new, healthier ways of thinking and behaving
  • Address underlying issues behind the addiction, which may include chronic stress, family dysfunction or a history of trauma
  • Develop essential skills and strategies for coping with stress, negative emotions, cravings and other addiction relapse triggers
  • Repair damaged relationships
  • Address problems stemming from the bipolar disorder and addiction, including legal issues or problems with finances, relationships or health

A holistic approach to treatment that addresses issues of body, mind and spirit promotes whole-person healing and offers the best outcomes of treatment, according to the Substance Abuse and Mental Health Services Administration.4

Treatment Works

Dual diagnosis treatment works for most people who fully engage with their treatment plan and stay in rehab for an adequate period of time. According to the National Institute on Drug Abuse, treatment lasting less than 90 days is of limited effectiveness.5

During treatment, a combination of medication and therapy helps to reduce symptoms of bipolar disorder. Dual diagnosis treatment will help restore function to all areas of your life and improve your quality of life and sense of well being. Treatment works, and it can work for you, too.


  1. http://www.dbsalliance.org/site/PageServer?pagename=education_statistics_bipolar_disorder
  2. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2847357/
  3. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851027/
  4. http://www.samhsa.gov/recovery
  5. https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-long-does-drug-addiction-treatment

Dr. Venice Sanchez


Clinical Outreach Specialist, Europe Division

Dr. Sanchez works closely with Truvida Recovery patients regarding substance abuse and related mental illnesses and creates a supportive, cooperative and informed therapeutic environment. Her areas of expertise include Substance Dependence, Dual Diagnosis, Depression, Bipolar Disorder, Schizophrenia, Generalized anxiety disorder, Panic Disorder, Bereavement, Acute stress disorder, and more. Ms Sanchez has extensive training with experts in the field of Substance Abuse, and mood and thought disorders underlying the substance use. She received a Bachelor’s degree from University of California, Los Angeles and Medical Degree from Michigan State University College of Human Medicine. She continues training at the UC Irvine Psychiatry Residency Program and has been recognized with the Outstanding Resident of the Year Award.

Jaime Askew


Clinical Director

Ms. Askew is a Licensed Marriage and Family Therapist and Licensed Professional Clinical Counselor who has been working in the field treating substance abuse and mental health issues for over twenty years.  She obtained a Master’s degree in Clinical Psychology, with an emphasis in Marriage, Family, & Child Counseling from Pepperdine University and was among the first to obtain the LPCC license in the state of California.  She has been providing clinical supervision and training to interns, conducting workshops, and is a certified Trauma therapy trainer.  Her areas of expertise include working with legal issues, court ordered treatment, family preservation, trauma therapy, cognitive behavior therapy, family systems, social skills training, play therapy, and career/ vocational counseling.  Her passion is in advocating for at risk populations, holistic healing, and treating the underlying, core issues to help individuals achieve their maximum potential and happiness.  Jaime’s extensive experience and passionate leadership is of extreme importance to the overall TruVida clinical program, and her hands-on guidance of our clinical team insures that each patient is receiving optimal therapeutic treatment and care.

John Biroc

Consulting Psychologist

Dr. Biroc has a broad base of mental health and addiction recovery training and experience. He has supervised and taught therapists in various methodologies of effectively working with groups and individuals during therapy. He created and set up new group structures and trained staff in understanding the challenges of addiction recovery. He also helped develop curricula in Sociodrama and Psychodrama. Dr. Biroc is devoted to breaking paradigms that prevent progress in the path to lasting recovery. He is a member of the Nat’l Association of Marriage and Family therapists, and has a Ph.D. degree in Psychology, and a M.S. degree in Counseling from USC.

Dr. Nader Siahdohoni

Consulting Psychologist


Dr. Nader is one our esteemed consulting Psychologists who provides our Clients with various breakthrough therapy’s that focus the functional systems including neurons, neurotransmitters, and certain brain waves that enable the way we think, behave, move, feel, and maintain homeostasis. Such therapy’s include NeuroMax neurofeedback, the state of art integrated technology in Neurofeedback, combinations of wireless Electroencephalogram (EEG), real time brain mapping and a unique and exceptional neuropathway therapy called “Visual Concentration Attention Therapy (VCAT)”. Dr Nader graduated from Walden University.

Tiffany Agra


LMFT #103693

Ms. Agra is a Cognitive Behavioral Therapist, who has been working with individuals, couples, families, and groups for the past seven years. Her other therapeutic approaches include Narrative Therapy, Family Systems Theory, Psychodynamic dream interpretation, and Gestalt Psychology. She has also been a Guest Speaker at other organizations. This unique background has made her effective at helping clients overcome the grip of substance addiction. Tiffany obtained two Bachelor’s degrees from the University of California, Davis, and her Master’s degree from the California State University, Long Beach. She has worked for both the county of Orange and Riverside, helping those who struggle with addiction and mental illness. In addition to providing evidenced-based approaches to the clinical program at Truvida Recovery, she brings her compassion as a fellow addict in recovery; living proof that we do get better!

Deborah Wieland


MS, LMFT #96864

Ms. Wieland is an Eclectic EMDR Therapist, using R-TEP and G-TEP, and specializes in several modalities in treating Substance Use issues, Dual Diagnosis, Complex Trauma, and Severe Mental illness. Deborah also provides several types of therapy such as Psychodynamic, Rogerian, CBT, DBT, IFS, PICT, MI, Grief Recovery, Sand Tray, and Attachment Theory to help her patients achieve mental wellness and a sober lifestyle.

She has worked with Psychiatric Hospitals providing crisis interventions and psychotherapy to those struggling with substance abuse issues, mental health issues, and domestic violence. She completed her undergraduate and graduate studies at Vanguard University of Southern California. She has a Bachelor of Arts in Psychology, Summa Cum Laude and a Master of Science in Clinical Psychology. She is currently completing her Doctoral studies in Clinical Psychology at Cal Southern University. Deborah is an active member of EMDRIA, California Association Marriage Family Therapist (CAMFT), American Association of Christian Counselors (AACC), and Psi Chi International Honors Society of Psychology.

Ashley McLaughlin



Ms. McLaughlin is a Licensed Marriage and Family Therapist specializing in EMDR therapy. She brings over ten years of experience working in the field of addiction to the Truvida Team. She obtained a Master’s degree in Clinical Psychology, with an emphasis in Marriage and Family Therapy from Pepperdine University and has two Bachelor’s degrees in Psychology and Economics from University of California, San Diego. Ms. McLaughlin was trained in EMDR in 2013 and since has been helping individuals process through past traumatic experiences that have contributed to current struggles with substance abuse and mental health symptoms. Her extensive experience and passion for this field has helped guide individuals through the process of recovery in order to experience freedom from their past and a hope for their future.

Travis Taylor



Mr. Taylor is a Licensed Marriage and Family Therapist specializing in  Drug Abuse & Addiction,  PTSD, Anxiety, Bipolar Disorder, Borderline Personality, Codependency, Coping Skills, Depression, Dual Diagnosis. Taylor uses an integrative approach geared towards understanding self, specifically what drives one’s thoughts and behaviors. He excels in helping patients identify automatic thoughts that lead to specific feelings and undesired actions. Another useful approach stems from understanding how thoughts and behaviors are fueled by former messages that have been consistently reinforced. Travis has over 6 years of therapeutic practice and obtained a Master’s degree at Vanguard University.

Kat Johnson

AOD Counselor, Group Facilitator

With almost 10 years experience working at treatment centers, Kat Johnson shares her wisdom and passion for balanced living, creative writing, and meditation and how each plays a role in early recovery and beyond. Certified as a CADC II, and supported by a bachelors in psychology, Kat’s infectious energy brings her groups to life. She is grateful for every opportunity to spread health and wellness.

Paige A. Chastain

AOD Counselor, Case Manager

Ms. Chastain has dedicated her life to helping the suffering addict/alcoholic, bringing personal experience to both individual substance abuse and group counseling settings. She has worked in the field of addiction for several years, currently working as an addiction counselor and case manager.  Paige too, is a collaborative member of the multi-disciplinary team providing excellence in addiction services, working with clients from detox to intensive outpatient levels of care. She holds a strong skill-set in Psychoeducation, Motivational Interviewing and Dialectical Behavior Therapy.  She also has extensive experience with 12-step recovery programs. Paige is passionate about treating the client with empathy, compassion and respect throughout the client’s journey.  Paige holds an AA from Saddleback College, a BA from the University of California of Irvine and is a certified CADC-I holding memberships with CCAPP and NAADAC.

Lesley Richards

AOD Counselor, Interventionist

Ms. Richards began in this field of healthcare as a volunteer for substance abuse treatment centers and worked her way up from there. Lesley has dedicated her life to helping the suffering addict. it is here strong belief that everyone deserves to have the opportunity to have a safe and sober life.  She is very compassionate about her work as an addiction counselor, and has a strong commitment in helping patients struggling with addiction in developing healthy coping mechanisms, and developing new positive behavioral habits.  Her Group counseling sessions are highly sought after within the TruVida program.  Lesley is a Certified Alcohol and Drug Counselor (CADC), National Certified Intervention Professional (NCIP), Nationally Certified Recovery Coach (NCRC), and is a member of the California Consortium of Addiction programs (CCAP), as well as the International Association of Addiction Professionals.

Christine Green

Treatment Facilitator

Christine Green is a certified personal trainer, and yoga instructor. Ms. Green is dedicated to helping patients struggling with substance abuse transform their lives through a consciousness-based approach to body-in-motion fitness.

Christine passionately shares her 18 years experience with our clients by sharing her specialized Yoga & Energy Healing Program, which she has developed over the past 8 years of working directly with addicts and alcoholics. Her Yoga program facilitates integration of all the layers of life – environmental, physical, emotional, psychological, and spiritual with the primary initial goal of overcoming withdrawal symptoms and cravings from drug and alcohol dependency. TruVida is fortunate to have her as part of the team.

Allison Goode

Art in Recovery Counselor

Allison Goode is a lifelong resident of Laguna Beach and professional artist for over 15 years, and has developed a very successful and trans-formative Art in Recovery program in treatment facilities through out California. Her passion for the fine arts and helping others recover from substance abuse addiction is contagious. Allison has a unique ability to connect with clients through the creative process helping clients set positive goals for their recovery. Ms. Goode has studied Fine Art and Graphic Design at Laguna College of Art and Design, is a certified RADT1 technician, and is currently completing her CCAPP certification program.

Thomas Mladinich

Admissions Manager

Mr. Mladinich hard work ethic and dedication make him a key part of the TruVida team. Tom’s ability to connect and relate with others have allowed him to excel as admissions manager. His personal experience has allowed him to proudly serve those in need of recovery from addiction. Tom is eager to work with our clients and provide the experience, strength and hope that they need to find success in recovery.

Willie Sanchez

Operations Manager

Mr. Sanchez is a self-motivated professional with a positive attitude. He is actively involved in a 12 step fellowship. He effectively contributes to each Patient with their struggles with addiction. Willie is RADT1 certified counselor and has been educated at Long Beach City College.

Jose Flores

Program Manager

Mr. Flores is a highly motivated and hardworking team member with TruVida. He has several years of experience working in treatment helping individuals get back on track, achieving a lot of great results. He brings problem solving skills and experience to use everyday, and is proud and passionate about his profession as a RADT-I program manager.

Dr. Andrew Morrow

MD, Psychiatrist


Dr Morrow is a member of the American Board of Psychiatry and Neurology Psychiatry, who specializes in the treatment of depression, anxiety, bipolar disorder, thought disorders, other mental health issues, and substance abuse addictions. Having undergone extensive training in medical school, psychiatric residency and over 15 years of psychiatric practice, he is well trained in both psychotherapy and medication management of mental problems. Dr Morrow integrates psychological, and social characteristics with biological therapy to treat the whole person; mind, body, and soul, and it is with great humility that he pursues the goal of freedom from substance abuse addictions.

Dr DeSanto conducted his undergraduate education at St. Louis University with a B.S. in Chemistry graduating summa cum laude. He then attended medical school at St. Louis University School of Medicine, and completed his residency training and served as chief resident at University of California, Irvine Medical Center.