Treatment-Resistant Bipolar: Myth, Misunderstanding, or Medical Fact?

Inside Bipolar

Is treatment-resistant bipolar disorder a real diagnosis, just a concept, or entirely made up? It may surprise you, but depending on your perspective, an argument can be made for all three. Join Gabe Howard, who lives with bipolar disorder, and Dr. Nicole Washington, a board certified psychiatrist, as they demystify what “treatment-resistant” bipolar disorder means.

This candid conversation unpacks whether this label is in the DSM, what qualifies as an adequate trial of medication, and why the term can feel so daunting. Dr. Nicole reveals how the concept is rooted in treatment response — not symptom severity — and why patience and persistence are critical to finding stability.

Gabe shares his personal journey of recovery, proving that treatment resistance doesn’t mean hopelessness. If you've ever felt frustrated with your treatment progress or questioned why recovery takes so long, this episode will give you clarity, hope, and a fresh perspective. Don't let this label confuse you — tune in to understand the truth behind the term.

“As we talk about treatment-resistant bipolar disorder, I want people to know that it doesn't mean meds won't work for you. And in fact, I want to give you a little challenge. There are over 250 available psychiatric medications to treat bipolar disorder. The average person with bipolar disorder is taking three medications. Some people more, 4 or 5. But using the 250 available medications, the average cocktail of three, that's over 2.5 million combinations before you can say that it's not going to work for you.” ~Gabe Howard

To learn more -- or read the transcript -- please visit the official episode page.

Our host, Gabe Howard, is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, "Mental Illness is an Asshole and other Observations," available from Amazon; signed copies are also available directly from the author. To learn more about Gabe, or book him for your next event, please visit his website, gabehoward.com. You can also follow him on Instagram and TikTok at @askabipolar.

Our host, Dr. Nicole Washington, is a native of Baton Rouge, Louisiana, where she attended Southern University and A&M College. After receiving her BS degree, she moved to Tulsa, Oklahoma to enroll in the Oklahoma State University College of Osteopathic Medicine. She completed a residency in psychiatry at the University of Oklahoma in Tulsa. Since completing her residency training, Washington has spent most of her career caring for and being an advocate for those who are not typically consumers of mental health services, namely underserved communities, those with severe mental health conditions, and high performing professionals. Through her private practice, podcast, speaking, and writing, she seeks to provide education to decrease the stigma associated with psychiatric conditions. Find out more at DrNicolePsych.com.

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