Bipolar disorder presents on a spectrum, with bipolar depression on one end and bipolar I on the other and a host of other presentations in between. As guidelines are updated and new treatments become available, developing individualized treatment regimens is key and collaboration between clinician and patient and family is critical in optimizing patient outcomes. Clinicians should use measurement-based care to assess whether treatment changes are necessary, which requires engaging with the patient to monitor efficacy and manage side effects.