Steady, long-term medication management for bipolar disorder by video — with the lab monitoring, sleep focus and regular follow-up that mood stabilizers require.
Tyler Patten, APRN, PMHNP-BC — board-certified psychiatric nurse practitioner
Book Now →Most people with bipolar disorder spend far more time depressed than manic or hypomanic. They usually first seek help during a low, get diagnosed with depression, and start an antidepressant. Without anyone asking about past periods of unusually high energy, little need for sleep or racing ideas, the real diagnosis can take years — and antidepressants on their own can make things worse.
Good bipolar care is ongoing: the right mood stabilizer, regular follow-up, routine lab monitoring, and a plan for early warning signs. That is exactly the kind of care that is hardest to keep up when the nearest psychiatric prescriber is a long drive away. Utah, Idaho and Nevada all have too few psychiatric providers, and rural areas have the fewest.
Telehealth makes consistent follow-up realistic. Visits are by secure video, labs can be drawn near you, and prescriptions go to your local pharmacy.
Recurrent depression with periods of hypomania that are easy to overlook.
Ongoing maintenance after a manic episode, including medication monitoring and relapse prevention.
Long-running ups and downs that don’t meet full criteria for mania or major depression.
Antidepressants that caused agitation or sleeplessness, or a strong family history of bipolar disorder.
A careful review when you’re not sure the label fits.
Weight gain, sedation or other side effects worth revisiting, or a regimen that has grown complicated.
Mood stabilizers do the heavy lifting in bipolar disorder, and I use them thoughtfully: lithium, lamotrigine and certain atypical antipsychotics are the core options, chosen around your history, your goals and side effects you can live with. Several of these require baseline and ongoing labs — kidney and thyroid function for lithium, for example — and I order and track those as part of your care.
Medication is the foundation, but it isn’t the whole plan. Sleep is the most powerful lever in bipolar disorder, so protecting a regular sleep schedule comes first. I also look at stress, nutrition and gut health, alcohol and other substances, and the early signs that tend to come before an episode for you specifically.
I don’t prescribe controlled substances, including benzodiazepines and stimulants. Telehealth outpatient care is a good fit when you’re stable or mildly symptomatic. Active mania, psychosis or thoughts of suicide need in-person or emergency care first — and I’ll tell you honestly if that’s the right next step.
You need to be physically located in one of these states during each video visit.
Lithium and other mood stabilizers need regular follow-up and labs. For Utahns outside the Wasatch Front, video visits and nearby lab draws make that monitoring realistic.
In a state with the fewest psychiatrists per person, steady bipolar follow-up can be the hardest care to find. We see adults anywhere in Idaho by video.
Irregular sleep from shift work can destabilize mood in bipolar disorder. For Nevada patients, sleep scheduling is built into the plan from the first visit.
Further reading:
Book a 60-minute evaluation with Tyler Patten, PMHNP-BC. Most new patients are seen within two weeks.
Book Now →Questions first? Call or text (435) 625-3098 or email office@affordablepsych.org.