Justin Ray in AJMC on Catching Bipolar Disorder Sooner

Justin Ray, MSN, PMHNP-BC, founder of South Chesapeake Psychiatry and Transforming Minds Interventional Psychiatry, is the subject of a new question-and-answer feature in The American Journal of Managed Care (AJMC), published October 30, 2026. It follows AJMC’s World Mental Health Day piece earlier this month, in which Justin was the featured clinical voice, and picks up the thread that drew the most attention: why bipolar disorder so often takes five to ten years to diagnose, and what clinicians and clients can do to shorten that road.

Read the Q&A on AJMC.com →

What the Article Covers

• “Depression with extra.” That is how Justin describes bipolar disorder: the depressive episodes people recognize, plus episodes of mania that can be pure or mixed. Because depression is usually what brings someone in, the manic side often goes unasked about, and the diagnosis can take years. The article cites a 2020 population-based study of nearly 9,000 people that put the average delay at about six and a half years, with some waiting 10 to 15. Learn how we approach bipolar disorder evaluation and treatment in Chesapeake, or read The Role of Neurotransmitters in Bipolar Disorder.
• Screen early, and keep it brief. Justin points to two short, validated screeners, the Mood Disorder Questionnaire and the Rapid Mood Screener, that take only minutes and can move a client toward the right diagnosis much sooner. Our free screening tool includes the Mood Disorder Questionnaire alongside screens for depression, anxiety, ADHD, and PTSD.
• What a missed diagnosis costs. Treating someone for the wrong disorder can make the illness itself worse, one wrong year at a time. Justin lists the consequences he sees in practice: derailed school or careers, strained relationships with partners and children, financial trouble, hospitalization, and in the worst cases death. Getting the diagnosis right is the whole game. One frequent source of confusion is covered in Bipolar Disorder vs. Borderline Personality Disorder.
• A mood episode versus a bad week. Four questions separate the two: Is this a change from the person’s usual baseline? Is the intensity out of proportion to what set it off (being irritated by a flat tire is normal; smashing the windshield is not)? Has it lasted day after day for a week or more rather than an afternoon? And what problems is it causing? The cluster that should prompt a closer look is needing far less sleep for several days, unusual energy, and rapid, pressured speech. This is the kind of history an unhurried psychiatric evaluation is built to take.
• What successful treatment looks like. More than staying out of the hospital: keeping relationships, holding a job, and taking care of oneself. The article names mood stabilizers and antipsychotics, including olanzapine/samidorphan (Lybalvi), among the options, and we have written about another, Caplyta in bipolar depression. Justin talks about the same “recovery beyond symptoms” idea on Mindful Moments with Pedro Morante and in the video Your Mood Is Better. Why Is Life Still So Hard?
• “It’s no different than having diabetes.” On staying with treatment, Justin’s approach is to remind clients where they were before, what it cost them, and that their stability now comes from the plan they are following. It was not a phase, it is not a character flaw, and these are not weak people. He also encourages clients to share everything, without embarrassment, because clinicians have heard it all. If you are preparing for a first visit, see First Psychiatric Appointment: What to Expect.

South Chesapeake Psychiatry provides psychiatric evaluations and ongoing medication management for children, adolescents, and adults, including care for bipolar disorder and depression. You can schedule an appointment online. Justin writes about diagnosis, new treatments, and the science behind them every week in The Neuropsychiatry Brief on LinkedIn, and discussed bipolar disorder on television on KY3’s Mindful Monday. Read the full Q&A on AJMC.com.

If you or someone you know is in crisis, call or text 988 (Suicide & Crisis Lifeline), or call 911 in an emergency.