All About Telehealth for Bipolar Disorder Telehealth allows doctors to care for people virtually over a phone call, text message, or most commonly, video chat. Although some situations require an in-person visit, telehealth is a great option when you can't physically meet with your psychiatrist or therapist. If you're new to telehealth, here's what you need to know. Medicare will cover telehealth visits just like in-person visits, but state Medicaid programs and private insurers vary, so confirm your coverage in advance. With telehealth, even though you're not in the doctor's office, your private health information is still covered by HIPAA, so it will remain confidential and secure. Although you can't receive all forms of treatment via telehealth, you can get prescription refills, quality care, and counseling, especially if you prepare in advance. Before your telehealth appointment:- List any symptoms (both emotional and physical), and include dates and severity- Note any side effects from your bipolar medications or therapies- Document any new stresses or recent life changes- Record your vital signs if you own a blood pressure monitor, thermometer, or another device- Compile a list of your health conditions and all medications- Write down any questions you have for your psychiatrist or therapist- Charge your computer or phone- Make sure your internet is reliable- Download any telehealth apps your specific provider may require- Find a quiet, private space to conduct the call- Be prepared with pen and paper or a note-taking app Turn to Healthgrades to connect with the right psychiatrist to treat bipolar disorder via telehealth. And share this video to spread the word!

Diana Keough: By the time she was in high school, I was already married and staring to have children, and I lived far enough away that I'd only see her two or three times a year. So there were things that were going on in her life. Kevin Keough: I would occasionally hear things about Claudia that maybe in retrospect should have raised red flags. Diana Keough: Had I been closer, I probably would have noticed, but I wasn't. Kevin Keough: The defining moment happens in, I think it's the summer of 2009. Diana Keough: We would get a beach house and my siblings and I and our kids would gather at the beach. Kevin Keough: There was clearly something wrong with Claudia from the very first day. Diana Keough: I had brought probably half a case of white wine and half a case of red wine for the beach. And the next morning I got up, and there were over three bottles consumed. The thing with mental illness, especially when you have someone that is really in a high mania state, is that there's no instruction book on what to do. Kevin Keough: In the fall of 2011, right around Thanksgiving, Claudia essentially incarcerated and put in a couple of different facilities in Virginia but needed permanent help. Diana Keough: There was a point where my older sister and I were having a discussion about the fact that we had to let her go. And I remember saying to her that nothing's going to happen to Claudia on my watch. Kevin Keough: Diana really was able to work a connection that got Claudia into Skyland Trail. Diana Keough: There's two institutions in this entire country that actually do what's called a dual diagnosis program, where they treat the mental illness as seriously as they would the addiction. Kevin Keough: Well, the person that went into Skyland Trail went there because others wanted her, if not forced her, to do it. It certainly wasn't her decision. It wasn't something she was asking to have done. The person who came out of the Skyland Trail had gone to a point of being broken, with a rebuilding process that had started but not been completed. Diana Keough: Most people that are as sick as she is with bipolar, they don't come back. You hear of them wrecking their cars at 100 miles an hour. You hear of them jumping off bridges, or they don't get well. She has worked so hard and I'm phenomenally proud of her. I think if I had anything to say to somebody else, another family that's going through this, remember that the person that you know and you love is in there, so don't take personally what they say to you. Don't take personally what they're doing, do all you can do to get them help, and don't give up.

I had all these interests. The joke is that I love buffets. I want the red cake and the lemon meringue, and the chocolate pie and all this. I just love it all. Life is a big buffet. And that was great, because we live in a society that validates that, that celebrates that. It was really menopause, I believe, that unhinged me. I had no executive function. I couldn't control myself. I was impulsive in my behavior. I couldn't stop saying things that I knew, perhaps, were inappropriate. Instead of always living up here, I had a drop and began to feel very anxious. And then, also, I was more fidgety. Felt that the ground--there was no solid ground under me, that it was just yanked out from under me. Instead of something that you inside, internally, say, "Gee, I'm really contributing to the world. I'm all things to all people," you realize you're nothing to anybody, and you're nothing to yourself. That's part of what I began to feel very, very deeply. But I thought that I could deal with it myself through a combination of journaling and meditation and talking to my friends and going deep inside or going for long walks, or running, perhaps even a drink every night, or maybe two or three. And then other people began to bring it to my attention. "What's happening to you? You were always so optimistic." It was my sister, when I was out visiting her at her ranch in Texas--after my trip there, she called me almost within a day or two, and said, "I insist that you get a psychiatric evaluation." My psychiatrist looked at me and said that she felt that all I had told her was very clear case of bipolar disorder. I burst into tears. And I finally, for the first time, felt heard. I see how much I have been blessed to accomplish and do in the year and change since I've been diagnosed and started medication. I just love to laugh, sing at the top of my lungs. The simple act of breathing. There is that sense of, well, shake it off, you can do it, step up, it's just a matter of your willpower. It's important to ask for help when you need it, rather than to think that you are a complete failure because you yourself were incapable of accomplishing great things. I always was someone who saw the connection between people and, as a result of my mind being calmer, I can actually feel that on a deeper level, and that I can act on that in a more thoughtful and mindful way.

I've always been very outgoing, everyone says I'm very happy and spunky and sparkly. But that spunkiness seemed to be spiraling out of control. Wrecked my car, driving fast, talking fast. The inability to focus on things, and not in an attention-deficit kind of way. But complete inability even to complete an entire sentence. I did do a lot of paintings. I painted on anything I could get my hands on. And I'd think, okay, what's next, what's next? What can we do next? It's like this little wind up toy was just bouncing against the walls and sort of leaving a mess of art things in its wake. I guess I had what they call a break. And I went and saw a psychiatrist. I really wasn't sure if it was just a phase. And I was diagnosed bipolar. There was some medication that I was prescribed, that did make me, what my family and myself say, "I was a bit of zombie." It just made me flat. So there's the perky flower, and then the one that droops. And I was like this. And I needed to be Marcy again. And it was the right medication. Over the years, there have had to be fine tuneups, small tweaks. It's a matter of eating right, sleeping right, and exercising--taking care of myself. I would not take the mania. Because it is so addictive. I think that is why so many people who are bipolar do relapse. Or they don't take their medication properly. Because they're afraid they'll lose their creative edge. They'll lose the high. They'll lose the feeling that they're totally hot and sexy, and own every room when they walk into it. I don't miss that time. I don't miss it at all. Because it was so destructive. And it was so hard on so many people around me. I could not have made it through without my friends and family. My daughter, my family, my friends help me maintain. When someone is in a depressive cycle, or in a manic cycle, they don't necessarily realize where they are or know where it is that they need to be. But the best thing a family member can do is stand by them and help them stay alive. Bipolar is part of me, but it's not going to break me. It doesn't make me. It is just part of who I am.

Bipolar disorder has two different types of moods involved with it. One can be the depressed side, and the other can be the upside where people may experience an increase in energy, an elevated mood, or euphoria. Patients will describe feeling really energetic. Sometimes they can go for several days in a row without sleeping. They have a lot of ideas. Sometimes their thoughts go through their head so fast that they can't even keep up with them. Creativity is often elevated during episodes of mania with bipolar disorder. Really, what defines bipolar disorder as a disease is the fact it is a chemical imbalance in the brain, and so it can cause problems with relationships, it can cause other problems in functioning with jobs or school. It interferes with your ability to live your life the way you want to and that it can be prolonged, and that's really what defines it from the normal ups and downs that everybody goes through. A lot of people in the manic phase of bipolar disorder will be very impulsive, which means they do things without considering the consequences of their actions. A lot of times we see alcohol or drug use as part of that impulsive behavior, and also people who are going through mania will be hyper-sexual. In psychiatry, the unfortunate thing is that doctors don't have tests that they can run to make a diagnosis. When a new patient comes to see me, I interview them for at least an hour on their first visit. I ask them lots of different questions about their behaviors, about their moods, about their functioning, and there are some targeted questions that I ask to try to determine whether or not the patient may have bipolar disorder or a depressive disorder. Most of the time, patients in the manic phase don't even recognize that anything is wrong, and because they have such a positive outlook on life, they don't want any help. It's very important to encourage patients to come into treatment because the longer the manic episode goes untreated, the more risk there is of the patient harming themselves. With the right medication and the right treatment program, symptoms can be controlled, and a lot of people can live very normal lives with bipolar disorder.

I had a business, and it was a graphic design firm, and so I thought my mind racing and those kind of racing thoughts were just because I was an artist, so I exercised a ton to keep my mind focused, but then that didn't work anymore, so I started drinking white wine, at least a bottle a night, just to keep my mind from racing. It wasn't until I was in my 30s, where I was breastfeeding my third child, and I was drinking martinis, and that progressed into partying too much, that progressed into leaving the kids when I shouldn't have, that progressed into having an affair with a drug dealer. I couldn't really stop myself. I was with these people that I just met at a bar at a hotel. They talked me into going back to their hotel room to smoke pot, a guy and a girl, and so I did, and it was laced with something, and then when I walked out the door, I'm like, "What? What am I doing? Who am I? Why am I in this situation?" At the time, it really scared me. When I got to treatment, I knew, "okay, I can't get out of this place without support from my family." I did get support from my family, and I accepted it and knew that they wanted the best for me. I think a huge trigger would be drinking. So that's why I don't drink. I see a doctor every other month, take my medication every day. The lifestyle stuff, eating at the same time or trying to every day, and not getting too tired, not getting too stressed. Not getting too stressed is hard sometimes. You have to go to the right doctor that you're comfortable with. You have to get the right cocktail, and you have to be extremely honest about how you feel. I feel like I'm mostly happy. It's just being stable. It's telling the truth, where, before, maybe I would have told a half truth. With this disease, you have to push yourself. It's basically getting up every day and being disciplined enough to do what you have to do even though you don't want to do it.