Personalized & practical evidence-based medication management options for bipolar disorder
Living with bipolar disorder
Understanding Bipolar Disorder
Bipolar disorder, sometimes referred to as manic-depressive illness, is a complex mental health condition marked by significant shifts in mood, energy, and behavior. These changes can be unpredictable and may affect many aspects of daily life.
Mood episodes typically fall into two categories:
Manic or hypomanic episodes – Involves elevated mood, increased energy, impulsivity, or a sense of invincibility
Depressive episodes – May be characterized by feelings of sadness, fatigue, low motivation, and emotional withdrawal
These shifts can influence how individuals think, make decisions, and interact with others.
During manic phases, some may take risks they wouldn’t normally consider, such as overspending or engaging in impulsive behavior. In depressive phases, everyday tasks may feel overwhelming, and social connection may become more difficult.
Bipolar disorder is more than an emotional rollercoaster, it’s a condition that can shape relationships, routines, and self-perception. Learning about its patterns is an important step toward compassionate support and informed care.
Bipolar Day-to-Day
Living with bipolar disorder often involves navigating unpredictable shifts in mood, energy, and focus. These changes can affect how individuals think, feel, and engage with everyday responsibilities.
A manic episode may bring elevated energy, expansive thinking, and a sense of confidence, but it can also lead to impulsive decisions, disrupted sleep, and racing thoughts that feel difficult to manage.
Depressive episodes, on the other hand, may involve emotional heaviness, fatigue, and low motivation. Even routine tasks—like preparing meals or meeting deadlines can feel overwhelming.
These fluctuations can impact work, school, relationships, and self-care. Concentration may slip, emotions may feel heightened, and routines may become harder to maintain.
With education, support, and thoughtful care, individuals living with bipolar disorder can develop strategies to manage these challenges and work toward greater emotional stability.
The journey may have its ups and downs, but it’s not without hope.
Bipolar Disorder and Relationships
Bipolar disorder can influence how individuals relate to others, sometimes making emotional connection and communication more complex. These challenges stem from the condition itself, not from a lack of care or intention.
Mood shifts, whether elevated energy during manic episodes or emotional withdrawal during depressive ones, can affect trust, routines, and emotional closeness.
Impulsive decisions may lead to financial strain or misunderstandings, while low-energy phases may leave loved ones feeling unsure how to offer support.
Partners may experience confusion or frustration when moods shift unpredictably.
Children might feel unsettled by changes in a parent’s behavior, and extended family members may struggle to understand how best to help.
Still, relationships can grow stronger with education, empathy, and open communication. Sharing information about bipolar disorder and its effects can foster trust and reduce stigma. Setting boundaries and creating routines that support emotional stability can also help maintain connection.
Support goes both ways. Loved ones may benefit from their own resources such as therapy or support groups to process and adapt. With patience and mutual understanding, families and partners can build a rhythm that allows for compassion, resilience, and growth.
Treatment Options
Living with bipolar disorder can present unique challenges, but supportive, evidence-informed care can help individuals work toward greater emotional balance and daily stability.
Treatment
Care plans may include strategies to support mood regulation and reduce emotional intensity. Psychiatric support often plays a key role in managing symptoms, and all care is guided by licensed professionals and tailored to individual needs.
Therapy & Emotional Support
Evidence-based therapies such as Cognitive Behavioral Therapy (CBT), offer practical tools for navigating emotions and thought patterns. Family-focused and rhythm-based approaches may also help strengthen relationships and daily routines.
Lifestyle & Wellness
Consistent sleep, nutrition, and movement routines can support emotional regulation. Mindfulness practices and stress-reduction techniques may help reduce vulnerability to mood shifts.
Community & Professional Guidance
Support groups and trusted providers offer connection, encouragement, and continuity. Psychiatric nurse practitioners and mental health professionals provide thoughtful, individualized care throughout the process.
Treatment Outcomes
Living with bipolar disorder may involve recognizing it as a long-term condition, but it doesn’t define a person. It’s one part of a broader story, not the whole narrative.
Modern treatment approaches aim to support emotional stability and improve daily functioning. Many care plans focus on reducing the intensity of mood swings and helping individuals build routines that promote balance. Medication, when used, is often most effective as part of a comprehensive care strategy.
Therapy plays a vital role
Cognitive Behavioral Therapy (CBT), for example, offers practical tools for navigating emotions and identifying thought patterns. Psychotherapy provides space to process experiences, rebuild confidence, and set meaningful goals. Some therapeutic approaches also focus on strengthening relationships and improving communication within families.
Consistency matters
Regular sleep, balanced nutrition, and physical activity can support emotional regulation. Stress management techniques—such as mindfulness or breathing exercises may help reduce vulnerability to mood shifts.
Treatment is not always easy, but it can be transformative. Many individuals find that as they build coping strategies and receive support, they’re able to reconnect with passions, pursue personal goals, and deepen relationships.
Stability can open the door to feeling more grounded and resilient. Support from trusted providers, family, and community adds strength to the journey.
With thoughtful care, individuals living with bipolar disorder can focus on growth, connection, and a life filled with meaning.
Bipolar Treatment at Birch Grove Mental Health
Personalized, evidence-based medication strategies
Let’s Get Started
Taking control of your bipolar disorder means finding stability for yourself and those in your life
Birch Grove Mental Health
Other conditions we diagnose and treat
Anxiety – Persistent, overwhelming worry
- Excessive worry or fear
- Restlessness or feeling on edge, difficulty relaxing
- Fatigue or feeling easily tired despite adequate sleep
- Difficulty concentrating or remaining focused
ADHD – Inattention, hyperactivity, impulsivity
- Difficulty staying focused or on-tasks
- Hyperactivity includes constant movement, fidgeting
- Impulsively or hastily acting without thinking
- Difficulty with detail resulting in careless mistakes
Blog post…
Recognizing Adult ADHD
more…
ADHD Testing & Treatment
Depression - Sad, fatigued, unmotivated
- Persistently low or depressed mood
- Loss of interest or pleasure in activities once enjoyed
- Significant changes in appetite or weight
- Sleep disturbances such as too much or too little sleep
Trauma – Nightmares, hypervigilance, flashbacks
- Intrusive, distressing flashbacks of the traumatic event
- Avoid people & situations that remind you of the trauma
- Persistent negative emotions, feeling detached from others
- Easily startled, feeling on edge, or difficulty sleeping
Thought Disorders – Disorganized, paranoid, delusional
- Disorganized thinking, incoherent speech.
- Loose associations by jumping between unrelated topics.
- Tangentiality through inclusion of irrelevant information.
- Incoherence (word salad), illogical word combinations
Obsessive Compulsive Disorder (OCD) – Checking, counting, germaphobic
- Compulsive repetitive behaviors or rituals
- Repeatedly intrusive disturbing or unwanted thoughts
- Obsessive, recurrent urges or anxiety causing mental images
- Avoid situations that trigger obsessions or compulsions
Panic Disorder – Intense, sudden fear
- Panic attacks episodes of intense fear & discomfort
- Symptoms include palpitations, sweating, trembling
- Fear of future attacks creates worry of more attacks
- Avoids places where previous attacks occurred
The stuff of life
- Stress Management
- Life Transitions
- Relationship issues
What patients say about us…
My teen son has started seeing Sunami for several months. It’s been great to see and hear his trust in her grow. We are building a toolset that my son can practice and use. It takes a village; happy and relieved to have found Sunami for my son’s mental health journey.
I’ve had nothing but positive experiences with my provider at Birch Grove. Sessions start on time. They get back to me promptly if I ever need anything. They had emergency coverage the one time I was struggling and my provider was on vacation. Highly recommend.
This practice has been so helpful for my whole family. They have been so flexible with appointments and are always responsive. Our NP is very knowledgable and caring. Highly recommend!
Meet The Team
We are a team of psychiatric nurse practitioners united by a shared passion for making a difference in the lives of those facing mental health challenges.

Sunami Gurung
MA, NH, RI, VT
Psychiatric Nurse Practitioner

Natasa Ristivojevic
MA, NH
Psychiatric Nurse Practitioner

James Quackenbush
MA, NH
Psychiatric Nurse Practitioner

Juliana S Pires
MA, NH, RI, VT
Psychiatric Nurse Practitioner

Erin Savage
MA, NH
Psychiatric Nurse Practitioner
Sunami Gurung
Psychiatric Nurse Practitioner
Approach
- Person-centered approach
- Tailored treatment plans
- Evidence-based medication management & psychotherapy
Clinical interests
- Depression & Anxiety
- Bipolar disorder
- OCD
- Trauma & PTSD
- ADHD
Languages
- English
- Nepali
- Hindi
Locations
- MA, NH, RI, VT
Salma Trainor
Psychiatric Nurse Practitioner
Approach
- Passion for supporting others
- Empathic relations is foundational
- Collaborative and inclusive
Clinical interests
- OCD
- Depression
- Anxiety
- Bipolar disorder
Languages
- English
Locations
- MA & NH
Natasa Ristivojevic
Psychiatric Nurse Practitioner
Approach
- Wholistic approach prioritizing human connection
- Evidence-based interventions
- Judicious medication management
Clinical interests
- Psychotic disorders
- Mood disorders
- Substance use
Languages
- English
- Serbian
Locations
- MA & NH
James Quackenbush
Psychiatric Nurse Practitioner
Approach
- Collaborative focus on goals and you
- Evidence-based planning
- Empowering you toward well-being
Clinical interests
- Depression & Anxiety
- PTSD
- Borderline
- Personality disorder
- Bipolar disorder
- Schizophrenia
Languages
- English
- French
Locations
- MA, NH
Juliana S Pires
Psychiatric Nurse Practitioner
Approach
- Medication management
- Coping skills development
- Empathic listener, genuine, honest
Clinical interests
- Depression & Anxiety
- Bipolar disorder
- Schizophrenia
- Trauma & PTSD
- ADHD
Languages
- English
- Portuguese
Locations
- MA, NH, RI, VT
Erin Savage
Psychiatric Nurse Practitioner
Approach
- Compassionate & empathic listening
- Tailored treatment to goals
- Utilize cognitive behavioral therapy & coping skills development
Clinical interests
- Depression & Anxiety
- Bipolar disorder
- schizophrenia
- Trauma
Languages
- English
Locations
- MA, NH
Insurance, Costs, Payments
Massachusetts
Aetna
Blue Cross Blue Shield
Cigna
Harvard Pilgrim
Mass General Brigham Health
Tricare
Tufts
UHC – Optum
New Hampshire
Blue Cross Blue Shield
Carelon Behavioral Health
Cigna
Harvard Pilgrim
Tricare
Tufts
UHC – optum
Rhode Island
Aetna
Blue Cross Blue Shield
Cigna
UHC – Optum
Vermont
Blue Cross Blue Shield
Cigna
UHC – Optum
Costs
15 min Consultation – Free
Evaluation $300
Follow-up $180
Payment Options
Zelle / Venmo
Major Credit Cards
Your dedication to managing your bipolar disorder inspires and strengthens the connections around you
Why Birch Grove Mental Health?
Our team of Psychiatric Nurse Practitioners are passionate about supporting individuals affected by mental illness
Through effective and practical treatments, we see victories every day
In Person Sessions
MA & NH
You-Centered
Prioritizing your Care, Progress, and Wellbeing
Your Goals
Personalized Treatment Plans
Telehealth
Flex to your schedule and life
Your Voice Matters
Collaborative Decision Making
You Have a Life
Flexible hours and ways to connect
FAQs
Benefits of Online Psychiatric Treatment?
- Easy scheduling: Book appointments at your convenience without the need to commute.
- Support when you need it: Access professional care from the comfort of your home.
- Privacy & flexibility: Maintain confidentiality while receiving care tailored to your schedule.
How long does the appointment last?
- Initial appointments are typically 60 minutes
- Subsequent appointments are 30 minutes or more – durations vary based on need
How will I know where to start my online session?
Once we confirm your appointment date & time, the link to your session room will be forwarded via email.
What types of therapy do you offer?
We provide individual therapy for children, teens, adults, and older adults. Our approaches include Cognitive Behavioral Therapy (CBT), Motivational Interviewing, and Solution-Focused Brief Therapy (SFBT).
Where do you offer services?
We provide services in:
In-person & telehealth
- Massachusetts
- New Hampshire
Telehealth only
- Rhode Island
- Utah
- Maine
- Ohio
- Vermont
- New York
- Colorado
- Connecticut
services are provided by licensed professionals
We provide care for a wide range of mental health concerns, including:
- AnxietyDepression
- Bipolar Disorder
- ADHD (Attention Deficit Hyperactivity Disorder)
- Stress management
- Behavior Issues
- Mood Disorders
- Medication Management
- Thinking Disorders
- Weight Loss
What are your hours of operation?
Telehealth and in-person appointments hours are
Mon-Fri, 6:30am – 6:30pm
What is the cancellation policy?
You can reschedule or cancel your appointment with at least 24 hours’ notice to avoid cancellation fees.
What should I expect from the scheduling process?
Our scheduling process involves a few simple steps:
- Contact us via the Get Started button
- Complete intake forms via our secure patient portal.
- Add payment information: To confirm your appointment, you will need to add your payment information to the portal. This information is securely stored and only accessible to you via your personal login and password.
- Submit insurance information: If applicable, we will need to verify your insurance information to ensure that we can process your payment and accept your coverage.
- Choose your provider and appointment time: Once your forms and payment are completed, you can select your preferred provider, date, and time for the appointment.
- Appointment confirmation: After all forms are filled out and payment is processed, we will confirm your appointment.
Are your providers licensed to prescribe medications?
Yes, all of our providers are fully licensed and able to prescribe both controlled and non-controlled medications as part of a comprehensive treatment plan.
How can a parent or guardian schedule an appointment for a minor?
Parents or guardians can schedule appointments for their children by contacting us through the Get Started link at the top of the page. Parental consent will be required before the first session.
Personalized Bipolar Disorder Treatment