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Bipolar Disorder

Bipolar disorders are classified as mood disorders that include characteristics of extreme mood shifts – highs and lows — including depressive symptoms and manic episodes separated by relatively normal periods of mood. At Clarity Clinic, we understand the unique complexities of bipolar disorder, and our dedicated team is here to walk alongside you on your journey toward stability and well-being.
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Overview of Bipolar Disorder

Bipolar Disorder, previously called manic-depressive disorder, is a serious psychiatric condition characterized by intense and unusual mood swings between emotional highs and lows. The highs and lows experienced by individuals with bipolar disorder are significantly more severe than the emotional highs and lows people without the condition go through on a day-to-day basis. Their mood swings also usually bring about extreme changes in energy, activity, sleep, and behavior. These unusually intense periods of emotional volatility are referred to as “mood episodes”, and they last anywhere from seven to fourteen days. Each mood episode represents a marked change in a person’s usual behavior, and they can inhibit people’s ability to lead normal lives. Through prolonged and closely monitored treatment with a professional psychiatrist, those with bipolar disorder can learn to manage their mood swings and lead stable, productive, and successful lives.

Background Information on Bipolar Disorder

According to the Depression and Bipolar Support Alliance, more than five and a half million Americans are affected by bipolar disorder every year. Most individuals that suffer from bipolar disorder develop the condition in their late teens or early twenties, but it can occur at any age. Diagnoses for bipolar disorder are made using the Diagnostic and Statistical Manual of Mental Disorders (DSM), and to be diagnosed, a person’s symptoms must represent a major change from their usual mood or behavior.

The fluctuations between the emotionally “high” episodes (manic or hypomanic mood episodes) and emotionally “low” (depressive mood episodes) make it difficult for individuals with bipolar and their families to recognize their symptoms. They may be able to identify singular symptoms, but they are not always able to recognize the larger underlying issue. Consequently, some people with bipolar disorder will suffer for years before being properly diagnosed and treated.

The longer the condition goes untreated, the more severe the symptoms become. Bipolar symptoms can result in damaged relationships with friends and family, poor work or academic performance, and in some cases even suicide. This fact helps emphasize the importance of treatment and the severity of the condition because it shows that bipolar disorder does not get better on its own. Getting the proper treatment is the only way to ensure that bipolar individuals get their symptoms under control.

The underlying cause of bipolar disorder is unknown, but there are a number of risk factors to be aware of. The most prominent risk factors are genetics, brain structure, and brain functioning. Individuals with a first-degree relative, namely a parent or sibling, with the condition, are more susceptible to developing the condition. In regards to brain structure and functioning, an MRI study found that adults with bipolar disorder have smaller prefrontal cortices with smaller functional capacities than people without the condition.

Mood Episodes & Symptoms of Bipolar Disorder

Mood episodes are the distinct periods in which individuals experience intense emotional states along with unusual sleep habits, activity levels, thoughts, and/or behavior. Each episode denotes a drastic alteration from a person’s typical mood or behavior. During an episode, people will experience symptoms for the majority of the day and bipolar individuals usually experience multiple episodes. The DSM delineated four particular types of mood episodes: manic episodes, hypomanic episodes, depressive episodes, and mixed episodes.

Mania and hypomania are two different types of mood episodes but manifest the same symptoms. Hypomania is simply a mild form of mania. Mania is noticeably more severe, posits more problems in daily activity, and can even induce psychosis. It is important to note that without proper treatment, hypomanic episodes can develop into severe mania or depression. For an individual to experience a manic or hypomanic episode, they must exhibit three or more of the following symptoms:

  • Feeling very “up” or “high” for an extended period
  • Feeling jumpy, wired, or abnormally upbeat
  • Extreme irritability
  • Difficulty concentrating or having racing thoughts
  • Becoming more outgoing and talking faster or more than usual
  • Increasing their amount of activity or thinking they can do a myriad of
    things at once
  • Decreased need for sleep or sleeping less
  • Impulsivity in behavior and decision-making – engaging in excessive risky behaviors deemed pleasurable like shopping sprees or reckless sex

It’s common for bipolar individuals to enjoy the euphoric feelings and increased productivity attributed to manic and hypomanic episodes, but is important to remember that they’re impermanent. Both hypomanic and manic episodes result in an emotional crash that leaves individuals feeling depressed and worn out.

Major depressive episodes (MDE) are the antithesis of manic episodes. During a depressive episode, individuals become much more reserved and tend to isolate themselves. It’s common for depressive symptoms to become severe enough to disrupt their daily lives and make the most routine tasks difficult. When someone is going through an MDE, they will experience five or more of the following nine symptoms for two or more weeks:

  • Prolonged depressed mood – feeling sad or empty for the majority of the
    day
  • Decreased interest or pleasure in almost all activities, even those they
    previously enjoyed
  • Significant weight fluctuations or altered appetite
  • Insomnia or hypersomnia
  • Restlessness or slowed behaviors
  • Fatigue or loss of energy
  • Feeling excessive/inappropriate guilt or worthlessness
  • Inability to think or concentrate

Suicidal Ideation

People with bipolar disorder are more likely to seek out help amidst a depressive episode, which is why bipolar disorder is sometimes misdiagnosed as major depressive disorder. So, it’s extremely important to have your physician conduct a close examination of your previous medical history to prevent this from happening.

A mixed mood episode, or mixed state, is a manifestation of manic and depressive symptoms simultaneously. During a mixed state, individuals are likely to be more irritable than normal, have trouble sleeping, and experience a drastically changed appetite. The National Institute of Mental Health noted that “People in a mixed state may feel very sad and hopeless while at the same time feel extremely energized.” Thus, a mixed-mood episode can be characterized by emotional uncertainty or conflict.

People with particularly severe mood episodes may develop symptoms of psychosis. Psychosis affects a person’s ability to know what’s real and what is not in addition to their thoughts and emotions. The psychotic symptoms an individual exhibits will reflect their particular mood extremity. When a person is experiencing psychotic symptoms during a manic episode, they may believe that they’re rich and famous or have special powers like invincibility. Conversely, psychotic symptoms during a depressive episode include the belief that they’ve committed a crime, the belief that they’ve lost all of their money, or that their life has been ruined in some way or another. As a result, bipolar individuals with psychotic symptoms can be misdiagnosed with schizophrenia.

Types of Bipolar Disorders

There are four primary types of bipolar disorder, and physicians use the DSM to determine the particular form of the disorder an individual has. To be diagnosed, their symptoms must represent a marked change from their usual mood or behavior.

  1. Bipolar I Disorder: Defined by one or more manic or mixed episodes lasting at least seven days, usually accompanied by major depressive episodes.
  2. Bipolar II Disorder: Defined by one or more major depressive episodes accompanied by at least one hypomanic episode. This excludes full-blown manic or mixed episodes.
  3. Bipolar Disorder Not Otherwise Specified (BP-NOS): Diagnosed when symptoms of the illness do not meet the criteria for any of the specific bipolar disorders, but the symptoms are clearly out of the person’s normal range of behavior.
  4. Cyclothymic Disorder: Defined by at least two years of numerous periods of hypomanic symptoms that do not meet the criteria for a manic episode and numerous depressive symptoms that do not meet the criteria for a major depressive episode. This is a mild form of bipolar disorder.

 

There is also a severe form of bipolar disorder called Rapid-Cycling Bipolar Disorder which occurs when a person has four or more episodes of major depression, mania, hypomania, or mixed states over a single year. Rapid cycling can occur at any point within the course of the disorder and will come and go depending on the individual’s treatment. This particular form of bipolar disorder is more common in women and those with bipolar II disorder. It has also been documented that rapid cycling occurs in individuals that experience their first mood episodes in their mid to late teens, which is earlier than most diagnoses.

It is also important that bipolar II disorder is not a milder form of bipolar I disorder. They are completely separate diagnoses. The manic episodes of bipolar I disorder can be more severe, but individuals with bipolar II disorder can be depressed for longer periods and are more susceptible to rapid cycling bipolar disorder.

Coexisting Conditions & Complications With Bipolar Disorder

People with bipolar disorder frequently have other mental or behavioral conditions that contribute to their bipolar disorder. Some of the most common cohabitation ailments include:

  • Substance abuse problems
  • Anxiety Disorders
  • ADD/ADHD
  • Eating Disorders

 

Substance abuse problems are the most common cohabitation sickness, and they’re also the biggest complication attributed to bipolar individuals’ stability. Some people attempt to treat their disorder by “drowning their sorrows” in alcohol or recreational drugs. But, this often triggers or prolongs their symptoms and the manic behavioral complications lead them to excessive indulgences. Other common complications with bipolar disorder include but are not limited to:

  • Damaged Relationships
  • Legal or financial problems
  • Poor work or academic performance
  • Suicide or suicide attempts

 

Treating Bipolar Disorder

There is no way to prevent the development of bipolar disorder, but seeking out treatment at the onset of symptoms can prevent conditions from worsening. Proper treatment with a licensed psychiatrist helps all bipolar individuals better manage their mood swings and behavioral symptoms.

Bipolar disorder may be treated with medication, psychotherapy, or a combination of medication and psychotherapy. The most effective forms of treatment typically include a steady, prolonged combination of medication and psychotherapy. Additionally, keeping a log of your daily mood symptoms, treatments, sleep patterns, and life events can help individuals and their physicians track and treat their illnesses most effectively.

Medications Used in Treating Bipolar Disorder

Not everyone responds to medications the same way, and there are different medications used to treat different symptoms of bipolar disorder. Individuals may need to try several different medications before they find a solution that works best for them. The most commonly prescribed medications for treating bipolar disorder are mood stabilizers, atypical antipsychotics, and antidepressants.

Mood Stabilizers: These are typically the first option in treating bipolar disorder. Prescriptions for mood stabilizers typically last for years. Lithium was the first FDA-approved mood stabilizer, and it remains the most popular and effective stabilizer.

Side effects of Mood Stabilizers include:

  • Restlessness
  • Dry Mouth
  • Indigestion
  • Acne
  • Joint or muscle pain
  • Brittle nails or hair
  • Unusual discomfort with cold temperatures

Atypical Antipsychotics: These are typically prescribed along with antidepressants for individuals with bipolar I disorder. These are not as commonly prescribed as mood stabilizers and are only prescribed symptomatically.

Side effects of Atypical Antipsychotics include:

  • Drowsiness
  • Dizziness upon standing
  • Blurred vision
  • Heart palpitations
  • Sun sensitivity
  • Skin rashes
  • Menstrual problems

Antidepressants: These are used to treat all types of bipolar disorder, but are rarely prescribed to exclusively treat the condition. Strictly taking antidepressants increases the likelihood of an individual switching to manic or hypomanic episodes, and/or developing rapid-cycling bipolar disorder. Consequently, antidepressants are usually used in conjunction with mood stabilizers

Side effects of Antidepressants

  • Headache
  • Nausea
  • Agitation
  • Diminished sex drive or difficulty enjoying sex

 

Psychotherapies Used in Treating Bipolar Disorder

Psychotherapy is commonly prescribed along with medication. Therapy is particularly effective because it provides individuals with a condition and their families with support, education, and guidance. There is a myriad of psychotherapy methods used in treating bipolar disorder, but the most popular methods include:

Cognitive Behavioral Therapy (CBT): CBT is an evidence-based form of psychotherapy used to treat numerous behavioral and psychological conditions. CBT helps individuals with bipolar disorder identify and cope with their mood swings. If a person can recognize an impending mood swing, they will be able to effectively address it to mitigate the symptoms.

Interpersonal & Social Rhythm Therapy (IPSRT): IPSRT is empirically validated and designed to help individuals improve their moods by understanding and working with their biological and social rhythms. This helps bipolar people structure daily routines and improve their relationships with others. The structural approach of IPSRT is effective in protecting against manic episodes.

Psychoeducation: The goal of psychoeducation is to provide people with a deeper understanding and coping with mental health conditions. Psychoeducation is typically conducted in a group setting and is helpful for individuals with the condition and their family members.

Family-Focused Therapy: Family-focused therapy is a hybrid of psychoeducation and family therapy. The goal is to enhance family coping strategies, improve communication among family members, improve problem-solving skills, and be able to recognize incoming mood episodes to help their loved ones.

 

Taking the First Step Towards Wellness

If you're ready to take the first step towards wellness, Clarity Clinic is here to support you. Our bipolar disorder treatment offers a comprehensive and personalized approach to help you lead a more fulfilling life. Contact us today to schedule an appointment and embark on a journey toward wellness.

Bipolar Disorder Providers

Elizabeth
Elizabeth Black, LCPC
Director of Clinical Therapy- Lakeview
Jessica
Jessica Selk, LPC
Therapy
Eldina
Eldina Okic, LCPC
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Rebecca
Rebecca Helm, LSW
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Peri
Peri Drury, Clinical Intern
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Ryan
Ryan Atkins, PA
Psychiatry
Kaitlyn
Kaitlyn Ehler, LSW
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Cesar
Cesar Feijoo, PA-C
PA-C
Hannah
Hannah Wychocki, PA-C
PA-C
Maisha
Maisha Lowery, LCPC
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Hope
Hope Hirsch, LPC
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Nathaniel
Nathaniel Epstein, MA
Therapist
Gabriella
Gabriella Lerner, PA-C
PA-C
Cyrus
Cyrus Ma, PA-C
PA-C
Maggie
Maggie Semprevivo, LSW
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Kamille
Kamille Haywood, LSW
Therapy
Michelle
Michelle Augoustatos, LCSW
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Zachary
Zachary Delgado, LSW
Therapy
Nicholas
Nicholas Zaris, MA
Therapy
Jordyn
Jordyn Pope, MA
Therapist
Laurel
Laurel Meiborg, LSW
Therapy
Haley
Haley Tarling, MA
Therapist
Debby
Debby Fox, MA
Therapist
Raul
Raul Andrade, MA
Therapist
Sarah
Sarah Tarabey, LCPC
Therapist
Kumail
Kumail Hussain, MD
Young Adult and Child/Adolescent Psychiatrist
Kyla
Kyla Goggin, LCSW
Therapist
Michele
Michele Sitorus, PsyD
Licensed Clinical Psychologist
Jaimee
Jaimee Jaucian, LCPC, BC-DMT
Therapy
Yenisis
Yenisis De Los Santos, LSW
Therapy
Sloan
Sloan Kodroff, LCPC
Therapist, Clinical Supervisor
Rahael
Rahael Mathew, LCPC
Therapist
Megan
Megan Becker, PA-C
PA-C
Emma
Emma Arsic, PA-C
PA-C
Paul
Paul Bamberger, PA-C
PA-C
Tonie
Tonie White, LCSW
Therapy
Jason
Jason Brescia, LPC
Therapy
Sankrant
Sankrant Reddy, MD
Psychiatrist
Virginia
Virginia Harren, LCPC
Clinical Supervisor
Stephanie
Stephanie Osborne, PA-C
Psychiatry
Ashley
Ashley Seredynski, PA-C
PA-C
Christine
Christine Lantin, PA-C
PA-C
Brittney
Brittney Segoviano, LCPC
Therapist
Callie
Callie Perlman, LPC, NCC
Therapist
Jessica
Jessica Funk, PsyD
Therapy
Maria
Maria Vasilopoulos, LPC, NCC
Therapy
Chad
Chad Gaynier, LCPC
Therapist
Bianca
Bianca Miller, LCPC
Therapist
Sean
Sean Saltzberg, LCSW
Therapist, Clinical Supervisor
Victoria
Victoria Nieman, LCPC
Therapist
Timothy
Timothy Kaatman, MD
Psychiatry
Sudhakar
Sudhakar Shenoy, MD
Adult and Child/Adolescent Psychiatrist
Sharon
Sharon Koys, PA-C
PA-C
Sara
Sara Fakhri, MA
Therapy
Veronika
Veronika Schroeder, Clinical Intern
Therapy Clinical Intern
Sarah
Sarah Smith, MA
Therapy Clinical Intern
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Sean Saltzberg, LCSW
Therapist, Clinical Supervisor
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Shanta Gomez, MS
Therapy
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Reggie Pacheco, PsyD
Licensed Clinical Psychologist
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Sarah Beerman, LCSW, CADC
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Renie Stoller-Zak, LCPC
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Sahar Eftekhar, DO
General & Addiction Psychiatrist
Rebecca
Rebecca Gilfillan, MD
Psychiatrist
Rebecca
Rebecca Mueller, PA-C
PA-C
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Rachael Pettinicchi, MA
Therapy Clinical Intern
Shelby
Shelby Gordon, LCSW
Therapy
Sonnie
Sonnie Cousins, MA
Therapy
Nicole
Nicole Ortiz, PhD
Licensed Clinical Psychologist
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Elana Horowitz, PA-C
PA-C
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Pavan Prasad, MD
Psychiatrist
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Mary Leighton, LPC
Therapy
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Raymond Myles, PsyD
Licensed Clinical Psychologist
Michael
Michael Colombatto, PsyD
Licensed Clinical Psychologist
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Marlena Gebhard, LCSW
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Michela Stevenson, MA
Therapy
Lovea
Lovea Smith, LCPC
Director of Therapy– Loop
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Mariyah Hussain, MD
Adult and Child/Adolescent Psychiatrist
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Leslie Wolf, LCPC
Therapist
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Marc Sandrolini, MD
Psychiatry
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Maddie Barnes, LCSW, PMH-C
Therapist, Clinical Supervisor
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Lindsey Ashamalla, PsyD (PD)
Therapist
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Khrystyna Helner, LPC, MBA
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Laura Schroeder, LCPC
Therapist
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Katerina Fager, LCPC
Clinical Specialist
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Kelli Lo, LSW
Therapy
Kiran Binal
Kiran Binal Maharaja, MD
Psychiatrist
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Karen Richardson, LCSW, ICDVP
Therapy
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Keri Perillo, LCPC, CADC
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Lizzie Ausland, LCPC, CADC
Therapist
Kimberlie
Kimberlie Kuehne, LCPC
Therapy
Katherine
Katherine Evans, LCPC
Therapist
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Kalyan Rao, MD
Psychiatrist
Jonathan
Jonathan Kolakowski, MD
Psychiatrist
Karla
Karla Avila-Polanco, Clinical Intern
Therapy Clinical Intern
Judy
Judy Bitzer, LCPC
Therapist
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Kaitlyn Delaney, MA, ATR-P
Therapy
James
James Histed, Clinical Intern
Therapy Clinical Intern
Julia
Julia Ray, Clinical Intern
Therapy
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Kayleen Bare, LPC, MA
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Jessica Masbaum, LCSW
Therapist, Clinical Supervisor
Janel
Janel Wenger, AMFT
Therapist
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Ivy Poma, PA-C
PA-C
Jeanette
Jeanette Marinier, PA-C
PA-C
Jamie
Jamie Schubert, PA-C
PA-C
Sherita
Sherita Hernton, PA-C
PA-C
Julie
Julie Daley, MSW
Therapy Clinical Intern
Jodi
Jodi Randle, LCPC, CADC
Therapist, Clinical Supervisor
Emily
Emily Schaffer, PA-C
PA-C
Emily
Emily Maurer, LCPC
Therapist
Frank
Frank Sassetti, PsyD
Licensed Clinical Psychologist
Emily
Emily Street, PA-C
PA-C
Emily
Emily Shelton, LCPC, LMHC, CADC, CAGCS, CRSS
Therapy
Eric
Eric Buchkoe, PsyD (PD)
Therapy
Tyler
Tyler Basham, Intern
Therapy Clinical Intern
Elizabeth
Elizabeth Russell, Clinical Intern
Therapy Clinical Intern
Thomas
Thomas Thurlow, NP
Psychiatry
Dawn
Dawn Leatherman-Kulis, LCPC
Therapy
Savannah
Savannah Sullivan, PA-C
PA-C
Kathryn
Kathryn Ross, PA-C
Psychiatry
Summer
Summer Slininger, PA-C
PA-C
Irena
Irena Markova, PMHNP
Psychiatry
Ravali
Ravali Poreddy, MD
Psychiatrist
Ariella
Ariella Panos, PA-C
PA-C
James
James Ham, PA-C
Psychiatry
Rayna
Rayna Gorstein, PA-C
PA-C
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Daniel Shuter, LSW
Therapist
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Victoria Akhteebo, LPC
Therapy
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Sierra Purcell, PA-C
PA-C
Darian
Darian Carter, LPC
Therapy
Emily
Emily Hoag, MD
Psychiatrist
Ali
Ali Sheikha, PA-C
PA-C
Grace
Grace Starrs, PA-C
Psychiatry
Cassie
Cassie Donahue, PA-C
Psychiatry
Gayathri
Gayathri Ganesh, PA-C
PA-C
Stella
Stella Tantillo, LSW
Therapy
Samuel
Samuel Budyszewick, LCSW
Director of Therapy- Evanston
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Sydney Means, LCSW
Therapist, Clinical Supervisor
Sara
Sara Pickens, LSW
Therapy
Ryan
Ryan Watters, LSW, CADC
Therapy
Samuel
Samuel Eckert, PA-C
PA-C
Cindy
Cindy Meraz, LPC
Therapy
Chloe
Chloe Wesley, Clinical Intern
Therapy
Nayeli
Nayeli Cruz-Castillo, LCPC
Therapy
Rafael
Rafael Lopez, MD
Psychiatrist
Nicholas
Nicholas Little, PA-C
PA-C
Samantha
Samantha Espinosa, MA
Therapy
Randi
Randi Schulman, LCSW
Therapist, Clinical Supervisor
Savanna
Savanna Murphy, LSW
Therapy
Kaitlin
Kaitlin Digrispino, LPC
Therapy
Madison
Madison Gunter,
Therapy Clinical Intern
Scott
Scott Shadrick, PA-C
PA-C
Khadija
Khadija Manzoor, LPC, CRC
Therapy
Mira
Mira Ebalo, PA-C
PA-C
Lauren
Lauren Stanley, LCSW
Therapy
Meredith
Meredith Henry, LSW
Therapy
Mark
Mark Bey, LPC
Therapy
Samantha
Samantha Adjekum, LCPC
Therapy
Miriam
Miriam Mixon, LCSW
Therapist, Clinical Supervisor
Joel
Joel Muller, Ph.D.
Director of Clinical Therapy- River North
Mary
Mary Ivory, LCPC
Therapy
Cynthia
Cynthia Sodini, LCSW
Therapy
Jessica
Jessica Baran, LCPC
Therapy
Justin
Justin Lee, PA-C
PA-C
Jacqueline
Jacqueline Campagna, MA, EdS
Therapy
Jordan
Jordan Valentic-Holden, MA
Therapy
Jerri
Jerri Ganz, LCSW
Therapy
Katherine
Katherine Cunningham, LPC, CADC
Therapy
Lauren
Lauren Lustfeldt, LCPC, CADC
Therapy
Elia
Elia Narvaez-Mushtaq, LPC
Therapy
Heather
Heather Holmes, PA-C
PA-C
Sam
Sam Donham, LCPC
Therapy
Carol
Carol Briggs, LPC, NCC
Therapy
Emily
Emily Filip, PA-C
PA-C
Gloria
Gloria Aguilar, LPC
Therapy
Cristina
Cristina From, LPC, MS
Therapy
Emily
Emily Mathews, MA, ATR-P
Therapy
Autumn
Autumn Holtschlag, ALMFT, LPC
Therapy
Liz
Liz Hand, LCSW
Therapist, Clinical Supervisor
Jenna
Jenna Jacobson, PA-C
PA-C
Dane
Dane Davlantis, LCPC
Therapist, Clinical Supervisor
Carolyn
Carolyn Tatar, AMFT
Therapist
Caitlin
Caitlin Daughtry, PA-C
PA-C
Camryn
Camryn Schmidt, PA-C
PA-C
Dillon
Dillon Pfau, LSW
Therapy
Bridget
Bridget Brodlo, MA
Therapy
Courtney
Courtney Daly, LPC, CADC
Therapy
Candace
Candace Clark, LCSW
Therapy
Christopher
Christopher Edwards, LCSW
Therapist
Carolyn
Carolyn Klinkert, LCPC
Therapist, Clinical Supervisor
Angelina
Angelina Wheeler, LCPC
Therapist, Clinical Supervisor
Abbey
Abbey DeBaene, LCSW, CADC
Therapy
Brittany
Brittany Wilson, LPC
Therapy
Brent
Brent Hope, LCSW
Therapy
Carleigh
Carleigh Joseph, Clinical Intern
Therapy Clinical Intern
Corrin
Corrin Bogan, Intern
Therapy Clinical Intern
Alexandra
Alexandra Gregor, PA-C
PA-C
Allegria
Allegria Knouse, PA-C
PA-C
Bakhtawar
Bakhtawar Usman, PA-C
Psychiatry
Antonina
Antonina Lunetta, LCPC
Therapist, Clinical Supervisor
Alyssa
Alyssa Bobak, PA-C
PA-C