In-person in Houston, online across Texas • In-network with Aetna, BCBS, Cigna, UHC/Optum, Tricare, Curative, Oscar • Therapy in English, Spanish, Portuguese, Farsi
Bipolar
Bipolar Therapy in Houston
Bipolar disorder is usually treated as a medication problem, and medication genuinely is central to it. But a diagnosis isn't only about chemical balance; it is something a person has to live with, think about, and build a life around. Bipolar therapy concerns what the episodes have cost, what the person has come to fear in themselves, and what happens in the long stretches between crises, which is where most of a life is lived. It also coordinates care with psychiatrists so medication fits into a larger structure.
Real Talk provides psychotherapy for adults with bipolar I and bipolar II disorder, in person in Houston and, when appropriate, online across Texas, in coordination with the patient's doctors, and in network with major insurance plans.
We do not prescribe, and we do not treat therapy as a substitute for medication where it is indicated.
How We Work With Bipolar Disorder
We seek to address losses that accumulate around episodes: jobs, relationships, money, trust, and the grief of actions taken during crises. We also attend to the fear of recurrence, which can organize life around avoidance, and to what belongs to the illness and what belongs to the person. The diagnosis itself is a theme, as it arrives late for many people. Finally, there is room for the ordinary difficulties (relational, occupational, historical) that a diagnosis does not exempt anyone from and that too often get absorbed into it.
Over time, the illness stops being the only lens through which the person's life is read; early signs get noticed and spoken about before they become episodes; medication appointments and therapy sessions stop being parallel tracks and become one treatment. And the question shifts from when the next episode will come to what the person is building between them.
Presentations We See
Bipolar I, with the full manic episodes that usually forced the diagnosis and often the hospitalizations that preceded treatment. Bipolar II, in which the depressions dominate and the hypomanias were missed for years, remembered as good periods rather than recognized as episodes. Recent diagnosis, and the disorientation of receiving one after decades of being treated for depression alone. Long-standing diagnosis in a stable stretch, when medication is working and the person finally has room to ask what the illness has done to their life and what in their life was never the illness. Bipolar disorder alongside anxiety, trauma, or substance use. Patients returning from hospitalization or an intensive program. And family members seeking their own treatment for what living alongside the illness has asked of them.
After Hospitalization or an Intensive Program: Many people arrive here after a hospitalization, a partial hospitalization program, or an intensive outpatient program. With your authorization, we contact the program you are leaving so they know you arrived, we introduce ourselves to your psychiatrist, and we stay in contact with both. Every patient with bipolar illness at Real Talk has a prescriber of record and continuous attention to risk. We are not a crisis service, and if you need a higher level of care again, we will say so and help you get there rather than hold a treatment that has outgrown this setting. Our therapy after hospitalization page describes this in more detail.
What We Pay Attention To
We pay attention to the person's relation to the diagnosis, which is as consequential as the diagnosis itself. We attend to early signs of shifting states as they appear in sessions, in speech, sleep, spending, and pace, and we say what we see. And we listen for what remains constant across states, because a treatment that only tracks mood loses the person it is treating.
Why Doctoral Training Matters for Bipolar Disorder: Doctoral training matters most when the diagnosis is uncertain or arrived recently, when bipolar symptoms are entangled with trauma, anxiety, or personality difficulty and the strands must be distinguished, when psychotherapy and medication must function as one treatment, and when a patient is returning from hospitalization and needs a clinician prepared to hold the case rather than monitor it (our therapy after hospitalization page describes that transition).
Bipolar Therapy in Houston: Our Clinicians
Our clinical director reads every inquiry and recommends a clinician within minutes on weekdays, hours on weekends.
Questions About Therapy for Bipolar Disorder
Do you prescribe medication?
No. Medication for bipolar disorder is managed by a psychiatrist, and we work in coordination with yours. If you do not have one, we can help you find one.
I was just diagnosed. Is therapy necessary if the medication is working?
Medication does not address what the years before the diagnosis cost, what the diagnosis means to you, or the patterns in your life that no prescription reaches. For many people, the period after diagnosis, precisely when things are calmer, is when the real work becomes possible.
Do you see patients after psychiatric hospitalization?
Yes. Post-hospitalization care is part of our practice, described on our therapy after hospitalization page. The weeks after discharge are exactly when sustained treatment matters most.
Reading For Deeper Thinking
Kay Redfield Jamison. An Unquiet Mind.
Book. Vintage, 1995.
Terri Cheney. Take Me as I Am, Whoever I Am.
The New York Times, 2008. Read here.