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ΡΩΤΗΣΤΕ τους Εμπειρογνώμονες

  • 1. Can you treat bipolar disorder?
    Yes, of course. We have been treating successfully most types of bipolar disorder for almost two decades now. Many claim that bipolar disorder cannot be treated, Nevertheless, the majority of our patients achieve remission from crises, and stay well without further episodes. Even though there is always the risk of relapse, we consider the patients who achieve recovery and stop their relapses essentially treated. So yes, we can successfully treat most forms of bipolar disorder, and help our patients to focus on their recovery, and life long development.
  • 2. How long does it take you to treat a bipolar disorder?
    This depends on what phase someone presents with, the stage of their bipolar disorder, other problems that may co-exist (comorbidities) and the previous treatment response. Usually acute phases/crises need a good 3 months to be dealt with but acute treatment may be even quicker on an inpatient or residential setting (1 month or less). For patients who are relatively stable but wish to stay well, and continue their lives with a relatively low probability of relapse, we recommend a weekly course of treatment that will usually last 1 to 2 years. This gives us enough time to clarify all diagnostic issues, and to engage in more systematic therapies that provide maximum prophylaxis. Long term monitoring and prophylaxis for some patients is recommended for life.
  • 3. Are there cases that you cannot treat?
    Yes and No. Unfortunately there are patients with long standing bipolar disorders who have a long history of relapses or have difficult to treat co-existing conditions that may take much longer than usually to treat. These patients are considered treatment resistant. Before you despair however or rush to put yourself in that category let’s have our initial consultation first. We are fortunate to live in an era that has an abundance of therapies. Chances are that you have not tried all the different treatments, and most likely you did not have the opportunity to work with a specialist bipolar team.
  • 4. What is the best setting to treat bipolar disorder?
    This depends on what phase you are in. For most patients outpatient (Telehealth/office-based), weekly treatment is fine. For some but not all acute crises that need immediate treatment in a safer environment a hospital or residential setting may be preferable. For outpatient treatment, therapy can be delivered equally well locally or remotely (online) For patients and/or families who wish to have more personable individual care we can create bespoke treatment programmes delivered at your own home. See
  • 5. How much does it cost to have the treatment?
    The cost of treatment depends on many different factors. It is far more expensive NOT TO TREAT or NOT TO TREAT WELL a bipolar disorder as in cases like that the episodes will continue. Episodes can and will become very expensive. They can even cost you more than money. They can cost you your own life. We advise to make a small major investment as soon as possible in order to get the best and most specialist care that you can early on. In general, you should estimate that you will need 300-500 euros per month for prophylactic specialist treatment in the first year of your treatment. In later years, and provided we do not have to deal with any active relapses, the monthly cost can be reduced in half. In cases where we have to deal with an active episode, and the treatment may need a hospital or a residential setting, the cost can go up into thousands of euros per month. In most cases however, the majority of our patients make a small but significant life long investment in the first year of their treatment (5000-6000 euros). This gives us the time to address most clinical issues, and to provide a very comprehensive treatment that will usually guarantee life long stability and long term productivity. Request our financial guide that has a breakdown of different costs per programme and type of therapy.
  • 6. Do I have to take medications?
    This will really depend on the stage of your bipolar disorder that will be determined by your history, and your current state. We never force anyone to take any treatment (medication or not) that they may not agree with. We always make best informed treatment suggestions that we hope they will be listened to in order achieve the best long term treatment outcome for you. Nevertheless, in most cases of bipolar disorder, medication treatment is an integral part of the treatment. However, it is a part of the treatment. We almost never recommend to have medication treatment alone. We actually consider this (medication alone) a form of malpractice. In our experience Bipolar patients who are treated only with medications end up having a worse course, and they end up becoming even more reliant on medication treatments alone. The studies support our experience and treatment philosophy on this. In some cases we can even try to offer treatment without medications. Medication treatment does not have to be for life for all cases, and also medication treatment when it is applied and used properly does not mean long term, consistent and persistent side effects. In fact, the majority of our medicated patients, who also engage in psychotherapeutic treatment, tend to do very well with their meds and they have no side effects at all. For our patients medications are a small but integral part of their treatment, and their main focus is on living a life worth living.
  • How can I be bipolar II and still have severe psychosis?
    You cannot really have Bipolar II and psychosis at the same time. Given that these diagnostic definitions are descriptive really by definition one excludes the other. The presence of psychosis even if it’s in the depressive phase would categorise you as having Bipolar I disorder (if not schizoaffective or other psychotic disorders). Keep in mind that psychiatric diagnoses may change over time. So maybe early on you were diagnosed with Bipolar II disorder and later for whatever reason you developed psychosis. This would then change your overall working diagnosis. If your bipolar disorder is mostly dominated by depression as most do and your psychotic episodes are not combined with grandiose euphoria (happiness) then again you are likely to think that you have Bipolar II disorder. Another possibility but this would require very careful assessment of your psychotic symptoms experiences may be that you indeed have a Bipolar II disorder but at the same time you also have Borderline personality disorder or something equally traumatic from your past. Borderline pds and also traumatic experiences from your childhood years may lead to severe intrusive memories that will exacerbate during depressive episodes. For some patients these intrusive memories may be so vivid and real that can be reported as psychotic symptoms. On this occasion the treatment would have to be modified and be directed more towards the issues of your traumatic experiences and possible personality disorder (Structure).
  • Does bipolar disorder require manic episodes to be diagnosed as such? Can fluctuation between normal and depressive be just depression?
    Good question. NO it does NOT. Strictly speaking the bare minimum one would need for a diagnosis of bipolar disorder would be one hypomanic episode and one depressive episode (bipolar II subtype). However there are bipolar subtypes that fall in the bipolar spectrum that may only have fluctuations in the depressive pole. For some this may be a debatable practice and critics argue that this leads to an inflation of the bipolar diagnosis but in practice in the hands of a bipolar expert this is helpful. Atypical depressions or depressions that may have highly relapsing courses can be improved greatly if they are treated as mood episodes of a bipolar condition. The alternative route may often lead to a worsening of these “depressions”. If one is lucky they may develop a manic episode, and very soon realize that their depression was more than just a simple depression. The unlucky ones end up with depressions that don’t respond to treatment, they become mixed states, they fluctuate more and continue relapsing. So all in all in many ways not needing a manic episode or even a hypomanic episode for ending up with a bipolar diagnosis can be lifesaving.
  • How do I survive a bipolar 1 mixed episode?
    Great question and indeed mixed episodes can only be survived as they are horrible to experience. I will try to be brief and concise. It is very important to understand mixed episodes. You have the worst of a depressive episode and the worst of a manic episode together. First it is important both for the patient and their clinician or treatment team to understand that this is a mixed episode. These tend to be very confusing states. On one hand you may have the energy and hyperactivity of a manic episode, and on the other hand you have the dysphoria of the depressive episode. Once this is identified correctly, it is important to make sure that the bipolar patient is safe. Mixed episodes usually come along with suicidal ideation, and it is the most risky bipolar state for someone to actually act out on these thoughts and feelings. The hospital setting is usually the safest place to treat initially the mixed episode (I am not referring to mixed states here - I am referring to much more extreme mixed episodes). Then treatment. Fortunately we have a number of good medications that treat quickly and very effectively the acuteness of the mixed episode. Depakine, Quetiapine or their combination are usually the best candidates. The medications need to be able to “burn out” the manic side of the mixed episode first. The use of antidepressants or other stimulant medications is always a big NO. Anxiolytic medications may be used but only for a short period of time. Once the manic side has been burned the patient needs to be aware that the next phase of the treatment will target the underlying depression of the mixed episode. Again it is always best for the patient to know this in advance so they can realise how the treatment is progressing well. “If this is helping me then why am I depressed? Answer: Because that’s the natural treatment cycle of a mixed episode. We will slowly start treating the depression too, but we will also make sure that we don’t make you mixed/manic again.” If the patient has understood this process in advance there will be some level of trust to accept that a depressive phase is good progress towards recovery. Third step. Treating the depression. We go slowly. We use psychotherapy. We use medications that do not have the potential to re-activate the mania. We avoid antidepressants. Good options would be CBT, Behavior activation therapy with mindfulness and relaxation training, and medications like lamotrigine, and seroquel xr. A slow and steady recovery is always best than a fast and unsteady recovery. Once the depression resolves then it’s also the end of the mixed episode. Again the patient needs to continue with prophylactic treatments that have a very low probability of re-activating mixed states or increase the mood instability. The lifestyle also needs to be prophylactic friendly (low stress, no stimulating substances). Life may not be as exciting but with time life will be stable and valuable once again. The mixed episode will only be, and rightly so, a nightmare of the past.
  • Are the awareness programs of mental disorders like OCD, bipolar disorder, ADHD, BPD and depression a marketing stunts by doctors and psychiatrists?"
    Of course there are corporate interests, no one can or should deny of this reality. There are many scientists in our field who are doing great work in discussing and researching these corporate interests (see Dr David Healy’s and Dr Joanna Moncrieff work). But at the same time, the short answer is that despite any type of corporate interests, these labels refer to people who have problems in their life and suffer a lot. The spectrum of mental disorders is wide enough to accommodate people who can handle things on their own, but also others who need to have continuous treatment to get and remain well. This is the case also with the whole range of Bipolar disorders. Awareness programmes hep people to start learning about these problems, and to make informed decisions about their treatment choices. I believe that most of our patients are in a good position sooner or later to understand what’s is best for their health, and to distinguish between corporate stunts and sound psycho-educational campaigns. If you have been given a diagnosis but you can still make it on your own, then this is great news for you. Unfortunately, not all people can do it on their own, and this is where our help is needed and requested. Good luck with your scepticism. I hope it becomes constructive for you.
  • My psychiatrist has said I have had major depressive episodes and a hypomanic episode, but no mention of bipolar II. Isn't this the definition of BPII?"
    Yes indeed this is the definition of Bipolar II disorder - unless your hypomanic episode was drug/medication induced in which case your diagnosis would remain a major depressive disorder (or the informal bipolar 3 disorder). On the other hand if your hypomanic episode was not a hypomanic episode but some interpersonal - personality crisis, then again your diagnosis would not necessarily be a bipolar II disorder. But you do have a valid question for your psychiatrist. You can always ask him to clarify his thoughts about your diagnosis. Remember to discuss with him the pros and cons of pursuing therapy for a major depressive disorder if you have a bipolar II disorder. In most cases you need to be extra careful with antidepressant medications that may complicate the course of bipolar II disorder. In our specialist practice if we have any hints of bipolarity we tend to avoid these medications and to work with mood stabilisers and/or meds that have a very low risk of triggering mixed states, manic/hypomanic episodes or rapid cycling.
  • I was scheduled by mental health, then diagnosed with bi-polar. Isn't there supposed to be an extensive evaluation before diagnosis?"
    A diagnosis of a Bipolar disorder is indeed something that needs to be evaluated extensively and very carefully. However, a working diagnosis may be reached at a much earlier stage depending on your current state. We have one of the most comprehensive diagnostic programmes for Bipolar disorder, and this evaluation usually takes approximately 10–15 hours of clinical evaluations along with psychometric testing. Nevertheless there might be situations when we will get to the diagnosis of Bipolar disorder right after a single consultation - especially if a patient has a very definite, and clear history of a manic episode (or manic episodes). In most complicated cases our diagnostic programme will give us all the necessary information, but there may be more hidden and sub-threshold bipolar disorders that need to be evaluated in real time over a period of a year or so. It is often difficult to detect-diagnose reliably hypomanic periods - episodes, mixed states or personality traits (borderline, narcissistic etc) by self-report. If you add to to this cocktail of problems, substance use or abuse or side effects from psychiatric medications, the diagnostic picture may become more complicated. My two cents would be to try to work with your team, and to understand why you were given this diagnosis so quickly. They may feel it is urgent to proceed with your treatment or they may not have had the time to start explaining things to you. Try to talk to them and also it doesn’t hurt if you start reading about bipolar disorder. Even though it may not be your diagnosis, it will not hurt you if you learn a couple of things about it. In the future you may have a relative or a friend with the disorder, who would most likely find your knowledge useful.
  • How can I deal with (or prevent) bipolar rage?
    Thank you for your question. My experience with my bipolar spectrum patients is that they usually misinterpret the symptoms of their bipolar disorder with the typical reactions of their personality traits. Provided that you do not get into such rages while you are hypomanic or mixed, then the issue would be with psychotherapy to address the underlying cognitions that give rise to such anger outbursts. CBT, DBT, and Schema therapy are all good approaches for dealing with such behaviours. Therapists who employ such methods will slowly help you to break down the automaticity of this behaviour. In we invest a considerable amount of time clarifying your diagnosis and individualising your treatment plan.
  • Suspended from work for sleeping. I am type 2 bipolar and forgot to take my medication I was very tired. Looks like it's time to find a new job?
    It’s difficult to exactly advise you what’s best to do in your situation, especially if we do not know your full clinical history. But in principle yes, getting a new job would be a great long term goal, but if you are currently still depressed my clinical advice would be to take it slowly. It would be important first to address your depressive symptoms in therapy and to set goals with your therapist in order to become more active. Then once you see that you can still be functional enough it may be a good time to start looking for a new job. Keep in mind that the majority of bipolar patients even when they are well are likely to suffer from low-grade depression and depressive symptoms (what we like to call sub-syndromal depression). So, take it one step at a time. Address your depressive symptoms in your therapy first, and then start looking for a new job. In we always start our new patients with an initial diagnostic consultation, and then depending on each patient’s clinical state we continue with either our full diagnostic programme (for those who are currently well) or with our CBT programme (for those who are currently depressed/mixed/hyper).
  • What's your contact details?
    You can call us on +306971813232 (this is also a WhatsApp number) email us at or leave a message here and we will get back to you!
  • How can I book an appointment?
    It's best to call us directly +306971813232 or use our website to book an appointment directly. We do the best we can to schedule an appointment by next week. If it is an emergency please let us know about it. We have a few hours every week for emergencies only (patients who may need hospital treatment).
  • What's the cost of the initial consultation?
    We have a standard fee for everybody of 120 euros for the initial consultation. The later cost of your treatment will depend on your clinical needs and the programmes that may be suitable for you. See also our FAQ about the overall cost of treatment.
  • Where do you conduct the ONLINE consultations/sessions?
    We have a dedicated Zoom line for all our ONLINE consultations. You will need to remember one ZOOM ID only our local number 2108816137 You need to download and install only once the Zoom app from the website or the Apple app story (for iPhones) or the google playstore (android phones). If you need help to set this up let us now so we can help you.
  • What's your local address?
    We have 3 local sites in Greece. During the covid period we give local access to our offices only for patients who are in crises (may need hospital care). Glyfada hub: 12 Zisimopoulou str., 11674, Glyfada, Greece Athens hub: 3 Asimaki Fotila str., 11473, Athens, Greece Rafina hub: 9 Nikiforou Mandilara, 19009, Rafina, Greece If you need more bespoke private local care, we also do home visits in Greece or abroad provided you can cover the extra costs involved.

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