Bipolar Spectrum Disorders
Bipolar I, Bipolar II, and cyclothymia — specialist psychological therapy in collaboration with psychiatry.
Important: For bipolar spectrum disorders, I only work with clients who are under the active care of a psychiatrist
and taking prescribed medication. With your written consent, I collaborate with your psychiatrist to support safe, stabilising work.
Understanding the bipolar spectrum
Bipolar spectrum conditions involve shifts in mood, energy, sleep, thinking, and the sense of self over time. These changes can be dramatic or subtle, episodic or chronic, and are often misunderstood — sometimes for years.
I offer careful, structured psychological therapy for adults living with Bipolar I, Bipolar II, or cyclothymia,
with a strong emphasis on stability, pacing, and containment.
Bipolar I, Bipolar II, and cyclothymia
Bipolar I disorder
Bipolar I involves episodes of mania, which may include elevated or irritable mood, reduced need for sleep, racing thoughts,
impulsive decision-making, and sometimes psychotic features. Depressive episodes are common but not required for diagnosis.
Bipolar II disorder
Bipolar II is characterised by hypomanic episodes alongside often significant depressive episodes. Hypomania can feel productive or energising, which can make it harder to recognise as part of the pattern.
Cyclothymia
Cyclothymia involves chronic fluctuations between low mood and hypomanic symptoms that may not meet full criteria for major depression or mania, yet can be deeply disruptive over time.
What these shifts can affect
Mood and emotional intensity, energy and sleep, thought speed and clarity, judgement and impulsivity, relationships, creativity, work, and self-trust.
A collaborative, medically integrated approach
Psychological therapy for bipolar spectrum conditions is most effective when it sits alongside psychiatric treatment.
Medication is often central to mood stability; therapy then becomes a place to build insight, continuity, and steadier ways of living with intensity.
- Psychiatric care and prescribed medication are required to work with me in this area.
- With your written consent, I can liaise with your psychiatrist (and GP where appropriate).
- Therapy is offered as an adjunct to medical care — never as a replacement.
How therapy can help
When the right structures are in place, therapy can help you to:
The aim is not to flatten emotion or suppress vitality, but to support continuity, choice, and psychological safety.
When depression is too severe: timing and suitability
At times, depression can become so severe that it significantly impairs concentration, initiative, memory, and the ability to sustain relational contact. In these states, people may genuinely want therapy yet be unable to attend consistently or use sessions in a way that helps.
Therapy depends on rhythm — regular attendance, continuity, and the capacity to reflect and integrate. When depression is acute, the most ethical step is usually stabilisation first (often via psychiatric treatment and medication adjustment). Once mood begins to stabilise, therapy becomes far more effective for making sense of the episode, reducing relapse risk, and rebuilding steadier internal rhythms.
EMDR and trauma-focused work
Many people with bipolar spectrum disorders also have histories of trauma, neglect, or significant loss. I offer EMDR selectively and cautiously, only when mood stability is well established, medication is settled and monitored, and there is agreement (with consent) with the treating psychiatrist.
- Mood stability is established
- Medication is settled and monitored
- Clear agreement with the treating psychiatrist (with your written consent)
- Appropriate preparation, stabilisation, and containment are in place
EMDR is never rushed in bipolar presentations. The priority is always containment, pacing, and nervous-system regulation.
Referrals and next steps
I accept referrals from psychiatrists, GPs, and other clinicians, as well as self-referrals where psychiatric care is already in place.
Before beginning therapy, we will consider current stability, psychiatric involvement, and whether this approach is clinically appropriate and safe.
Enquiry
If you are unsure whether therapy is the right step at this point, you are welcome to get in touch. With your written consent, I can liaise directly with your psychiatrist to clarify suitability.
