Bipolar depression and mixed episodes remain among the most difficult—and highest-risk—conditions in psychiatry. Even when mood symptoms improve, many patients continue to experience significant cognitive and functional impairment.

On NYU Insights on Psychiatry, Dan Iosifescu, MD, explains why standard treatment approaches so often fall short. Dr. Iosifescu argues that symptom suppression is frequently mistaken for recovery, that short-term improvement does not equal durable treatment, and that bipolar mixed episodes expose the limits of one-size-fits-all care.

The discussion focuses on the clinical dangers of mixed episodes, the challenge of recognizing them, and the importance of acute stabilization followed by a deliberate transition to sustainable long-term treatment. Dr. Iosifescu also explores how emerging biological research—including metabolic interventions and personalized experimental models—may eventually help clinicians better match patients to treatments.

Rather than offering quick fixes, this conversation reframes how clinicians think about success, recovery, and personalization in the treatment of bipolar depression.

Guest: Dan Iosifescu, MD, Director of Clinical Research at the Nathan Kline Institute and Director of the Mood Disorders Clinical and Research Program at NYU Langone Health.

Watch Insights on Psychiatry on YouTube
Senior Producer: Jon Earle