Do your moods swing for years — up into... | Georgia Telehealth Therapy

Imagine waking up today feeling like, well, like you could completely conquer the world. You know, you just have this sudden sharp clarity. Oh, yeah. That feeling of just absolute boundless energy. Exactly. So, you take on extra projects at work. You promise your partner you're finally going to remodel the guest room. You make all these massive commitments because in that specific moment, you genuinely believe you can pull it all off, right? Because why wouldn't you? It feels so real. Yeah. But then like 3 or 4 days later, you wake up and it feels like someone has literally poured concrete into your veins. You barely get out of bed, let alone, you know, remodel a room. It's

just a completely paralyzing craft. It really is. And now I want you to imagine living on that exact unpredictable pendulum, not just for a weird one, but for two solid years. God, it's just a completely exhausting reality. And yet, because it doesn't always look like a, you know, a glaring medical emergency, people living on that pendulum often have no idea there's an actual clinical name for it. They just think it's their life. Right. Exactly. They just assume it's normal for them. And that brings us to the core mission of our deep dive today. We are looking at a chronic mood condition that flies so low under the radar, it often goes completely unnoticed. Quietly sabotaging

lives in the background. Seriously, careers, relationships, everything. So, we want to figure out exactly how it operates, how it can be identified, and crucially, how it can actually be treated. And we have some really great material for this. We do. We're pulling insights from a clinical excerpt called studying the swing, understanding, and treating psychothermic disorder. And we're also going to look at the operational details of a modern clinical practice called coping and healing counseling just to see how the actual logistics of treatment work out in the real world, which is so important. Getting from the theory to the practical application. Totally. Okay, let's unpack this because we are diving into a condition called psychothermic disorder

and uh the very first thing that jumps out from the text is the timeline the two years. Yeah. Right. We are talking about mood swings that persist for two or more years. I mean two years is a massive amount of time to be stuck on a roller coaster. It is. But that duration, I mean that's actually the diagnostic anchor here. How so? Well, when you or I have a bad week or even a really stressful month, our baseline eventually resets, right? We go back to normal, but with psychothermic disorder, that 2-year timeline indicates that the instability has actually become the baseline. Wow. So, the roller coaster is the new normal. Exactly. It's a chronic ingrained

neurological pattern. You're constantly shifting between these bursts of high energy and these incredibly low, heavy stretches of depressive symptoms. But here's the crucial distinction, and I think this is where the confusion really lies for a lot of people. These swings, even though they last for years, they never quite reach the level of full bipolar episodes. Right. That's the key nuance. Yeah. They don't hit that full hospitalization level mania and they don't always hit the absolute rock bottom of major clinical depression. They just sort of hover in this middle zone. Precisely. They exist in this subclinical threshold. The brain's regulatory system is struggling to maintain a steady mood. So you swing up and down, but it

manages to apply the brakes just enough to prevent a full manic break or a completely catatonic depression. Right. Exactly. It makes me think of an analogy. It's almost like living in a climate with wildly unpredictable, rapidly shifting weather. Right. You get intense storms, you get blistering heat, but you never actually get a category 5 hurricane. Oh, that's a great way to put it. Yeah. And because there's no hurricane, because there's no full bipolar episode, people might not realize there's a clinical pattern at play. They just think, well, the weather is just weird here. What's fascinating here is how perfectly that weather analogy captures the clinical blind spot of psychotheria. Because the hurricane never hits, right?

Because there is no full manic episode that demands immediate psychiatric intervention, the condition is incredibly easy to mislabel. People just miss it completely, entirely. friends, family, and honestly most tragically the individuals themselves. They just assume they have an inconsistent, flaky personality. They get labeled as moody or unreliable, which is such a heavy burden to carry. You know, to genuinely believe, oh, I am just a flawed, unreliable person. When in reality, you are dealing with an untreated chronic mood condition. It does a massive amount of hidden damage. It really does. And that leads perfectly into the toll this takes. The text specifically highlights that these constant swings quietly erode relationships and work, right? Which makes sense.

It does make logical sense. I mean, if you are constantly overpromising and underdelivering, your boss is going to get frustrated. But I do want to push back on one specific thing we found in the research. Okay, what's that? It talks about how this erodess selfrust. And I get why work suffers, but selfrust sounds, I don't know, a bit dramatic to me. If you know you're prone to mood swings, why would you blame yourself? Why wouldn't you just say, "Oh, I'm having a down week." That's a really fair question, but I think it assumes the person has the clarity of a diagnosis, which, as we just discussed, they usually don't. Oh, right. Because there's no hurricane.

Exactly. Think about the internal psychology of the upswing. When you are in that burst of energy and confidence, it doesn't feel like a symptom. It feels like the real you. It feels like you finally figured life out. Oh, wow. I see. So when you make those massive promises to your partner during the high, you aren't faking it. Not at all. You genuinely deeply believe you are capable of doing it all. Exactly. You are entirely sincere in your commitments. But then the neurological pendulum swings back. The low heavy stretch hits. The energy just vanishes. And you inevitably have to break all those promises you just made. Yes. And when this happens repeatedly over the course of

two years or more, it creates a profound cycle of internal betrayal. You learn that you cannot trust your own moments of ambition because the heavy stretch is always coming to wipe it out. Right? You stop believing your own bursts of confidence because brutal experiences taught you that they aren't going to last. You literally lose trust in your own mind. That sounds absolutely agonizing. you are basically being held hostage by your own shifting energy levels. And uh it actually brings to mind a very specific phrase from the clinical material that I think perfectly captures this. Oh, the white knuckling phrase. Yes. White knuckling the swings. It's an incredibly visceral term, isn't it? It really is. You

can literally feel the tension just saying it. And it implies that someone isn't just floating through these moods. They are gripping the steering wheel of their life so tightly their hands are cramping. like spending massive invisible amounts of energy just to maintain a baseline of functioning just to keep the job kept the marriage together. And that invisible effort explains why there is nothing left in the tank. If 90% of your daily energy is spent just trying to mask the internal chaos, you have zero reserves for actual joy or deep connection. Absolutely none. But and this is the crucial pivot in our understanding of psychothermia. This white knuckling does not have to be a permanent state.

Yes. The turning point. The research emphasizes a very simple yet profound shift. Naming it changes everything. Naming it changes everything. Exactly. Because once a licensed clinician actually diagnoses this. And just to be clear for you listening, you cannot diagnose this yourself from a deep dive. It requires a professional. But once it has a name, it moves from being a character flaw to being a medical condition. And medical conditions have treatments, right? And the treatment approach detailed in the text focuses on mood focused care combined with therapy. They list specific acronyms like CBT, cognitive behavioral therapy, which is great for helping people recognize the onset of the swings. Exactly. But there's another therapy specifically highlighted for

this and the acronym is IPSRT. Yes. Interpersonal and social rhythm therapy. It is a highly specialized, incredibly effective intervention for mood disorders like this. Let's break that down because the text explicitly states that the goal of IPSRT is to steady daily rhythms. I want to try an analogy here to see if I'm grasping the mechanics of it. Go for it. If IPSRT is about steadying daily rhythms, is it essentially like setting an external metronome for your life? A metronome? Yeah. Like imagine your brain is an orchestra and the internal tempo of the music is just swinging wildly. The strings are rushing. The brass is dragging. Total chaos. Okay, I'm with you. So by using this

therapy to establish incredibly rigid steady daily rhythms like waking up at the exact same time every single day, eating meals at the exact same time, you are basically bringing in an external metronome to force the biological music back into a steady beat. That is a phenomenal way to visualize it. If we connect this to the bigger picture, that is exactly the mechanism at play. Human neurochemistry is deeply tied to circadian rhythms. So the chaos is actually biological. Yes. And when your sleep, wake, and eating cycles are erratic, it severely exacerbates the mood swings. IPSRT basically trains the patient to rigorously protect those biological anchors. But wait, there's also the interpersonal half of that acronym. What

does that part look like in practice, right? So that addresses the fallout we discussed earlier. The therapy doesn't just regulate your sleep schedule, it helps you navigate the immense guilt of those broken promises. Oh, the self-rust and relationship erosion. Exactly. It teaches you how to rebuild the self-rust and repair the relationships that were damaged by years of unpredictability. So, you get the biological metronome and you get the relational repair tools. The ultimate goal, as the text so beautifully puts it, is to help the person find solid ground. Solid ground. Yeah. I mean, if you've been on a pitching boat for two years, the feeling of solid ground under your feet must be just indescribable. you

can finally loosen your grip on the steering wheel. You don't have to white knuckle it anymore, right? But here is where we have to pivot from the theoretical to the intensely practical because knowing what you need, like knowing you need IPSRT or a clinician to give you that metronome, that's only half the battle. The logistics of actually getting that help is the other half. Exactly. And that brings us to the specifics of coping and healing counseling or CHC because knowing where to go is vital. Yes. Because clinical reality tells us that access to care is often the single largest hurdle. You could have the best therapeutic protocols in the world, but if the patient can't

actually reach you, it's irrelevant. Let's think about the friction of the healthare system for a second. If you are someone dealing with psychothermia and you are currently in the depths of one of those low heavy stretches, your energy is essentially at zero. You're completely depleted, right? The absolute last thing you are capable of doing is navigating a maze. You don't want to get in a car, merge onto a highway, hunt for parking, and then sit in a waiting room. Just getting to the appointment requires more energy than you actually possess. Exactly. And what stands out to me about the model at CHC is how it's structurally designed to dismantle that exact friction. They operate a

100% teleaalth IPA compliant practice, which is huge. And they serve all 159 counties in Georgia. So they have entirely eliminated the physical commute. It's such a critical design choice for mental health access. By removing those geographic and physical barriers, Tella Health makes it possible for someone who is completely exhausted to still access professional care from their own living room. And they have the infrastructure for it too. The source notes they maintain a diverse roster of 15 plus licensed therapists. Yeah. And that includes LCSWS, LPCs, and LMFTs. Okay. Let me challenge this for a second. From the perspective of a patient just looking for help, why do those letters actually matter if I just want someone

to help me stop feeling exhausted? Why should I care about the difference between an LMFT and an LCSSW? That's a great point. It matters because of the quiet erosion we talked about earlier. Cyclopia doesn't just happen inside a vacuum. It detonates across different areas of a person's life and different licenses are trained to put different fires out. Okay, that makes sense. So, break that down for me. Well, an LMFT is a licensed marriage and family therapist. If the primary damage of your mood swings has been to your spouse and your kids, an LMFT is specifically trained to navigate the complex dynamics of repairing that family unit. Ah, so they are the relationship experts. What about

the others? Right? So, an LCSW is a licensed clinical social worker. They are uniquely trained to look at the systemic environmental factors of a patient's life. Like if the mood swings caused you to lose your job. Exactly. An LCSSW helps navigate that broader socioeconomic fallout alongside the therapy. And then an LPC, a licensed professional counselor, is highly skilled in the direct individual psychological interventions like the CBT we discussed. Yes. So having all these disciplines in one practice means a patient isn't getting a generic one-sizefits-all approach. They're getting a tailored intervention. And it seems that tailored approach extends to cultural context as well. The text notes, they are a culturally competent team, which is vital. The

way mental health is perceived and treated varies wildly depending on your cultural background. You definitely need a therapist who understands your specific lens on the world. And honestly, their clinical specialties align perfectly with the fallout of living with psychotheria. They specialize in treating anxiety, depression, trauma, grief, relationships, and chronic stress. Well, I mean, if you have been white knuckling your life for two years, you are undeniably experiencing chronic stress without a doubt and almost certainly dealing with clinical anxiety as a byproduct. They also see clients starting at age 13 for teen therapy all the way up through adults, offering individual, couples, family therapy, and even life coaching. But, okay, we have to address the giant

looming elephant in the room whenever we talk about American healthcare. The financial barrier. Yes, the money. You can build the most beautifully accessible tellahalth platform in existence, but if a patient sees a $200 co-ay per session, that door slams shut instantly. And financial stress is a massive trigger for mood swings anyway. Exactly. So, the insurance details for CHC aren't just administrative trivia. They are a core part of the clinical accessibility. The source highlights that CHC accepts Medicaid and for Medicaid patients, they have negotiated a 0 co-pay. Z. The importance of that simply cannot be overstated. It fundamentally alters the reality for individuals relying on Medicaid. It completely removes the financial barrier for an incredibly vulnerable

population. It ensures that their socioeconomic status doesn't disqualify them from finding that solid ground. And for those with commercial insurance, it's still remarkably accessible. They accept Etna, Sigma, Blue Cross, Blue Shield, United Healthcare, and Humanana. Okay. And what are the co-pays looking like for those? They range from just $10 to $40 per session. That's incredible, right? And think about why that matters here. If you are already paralyzed by a heavy, low mood, discovering that your therapy session only costs $10 is often the exact gentle push needed to actually book the appointment. The geographical friction is gone and the financial friction is heavily mitigated. It really demonstrates a practice model that is deeply empathetic to the

lived reality of the patient. The pathway to treatment needs to be as clear and unobstructed as humanly possible. So to bring this all together for you listening, we started today by shedding light on a condition that basically hides in plain sight. Psychothermic disorder. Yes. We unpacked those two plus years of chronic subclinical mood swings, the bursts of energy that lead to overcommitting, followed by the heavy depressive lows that lead to broken promises. And we explored how it damages relationships, work, and your own selfrust because you spend 90% of your energy just white knuckling the steering wheel of your life. But the core takeaway here is that the white knuckling doesn't have to last forever. Naming

it changes everything. Exactly. interventions exist with mood focused care, therapies like CBT, and the biological rhythm studying power of IPSRT, you can actually stop the pendulum. You can find solid ground. And as we've seen with models like coping and healing counseling, accessible avenues exist to connect with those interventions. If this resonates with you or maybe sounds exactly like someone you know in Georgia who might be quietly struggling, the contact info for CHC is super straightforward. You can find them online at 404-8320102. That's 404-832102. Right. Or you can even email them directly at supportstapy.com. The path to a steadier life is right there. This raises an important question though as we wrap up. One that extends

far beyond just the specific clinical diagnosis we've unpacked today. Oh, what's that? Well, we look at a treatment like interpersonal and social rhythm therapy, which relies profoundly on setting external metronomes. Yeah. Steadying daily routines, predicting sleep, anchoring the body's clock. Right. To literally tame a chaotic mood disorder. Exactly. It's highly effective. But it makes you wonder if simply stating our daily rhythms can so powerfully stabilize a diagnosed psychiatric condition, how much of what we all consider to be our fundamental moods or even our personality flaws. Exactly. How much of what we casually label as our deepest personality flaws are actually just the result of our own chronically mismanaged biological clocks? Wow, that really flips the

script on how we view ourselves, doesn't it? I mean, are we are we inherently flawed, flaky people, or are we simply just out of rhythm? It's definitely something to think about. It is an absolutely fascinating thought to leave on. Thank you so much for joining us on this deep dive today. We always appreciate you bringing your curiosity to the table. Until next time, keep asking questions and keep learning.