“That’s why it’s so important to have the family involved.”ĭr. “Because the mania feels so good, there’s no way for me to know that I’m doing it,” Mr. Patients often do not recognize the symptoms. “Only a person who knows them very, very well would know.” “It can be something as subtle as a change in lipstick shade,” Dr. Igor Galynker, said their experiences with patients showed that families are in the best position to catch early warning signs of a manic or depressive episode. Nonetheless, he and the founder of Beth Israel’s clinic, Dr. Miklowitz said, though the difference was found to be statistically insignificant. The study also showed that family therapy had slightly better results than other types of psychotherapy, Dr. But his most recent study, reported a year ago in the Archives of General Psychiatry, showed that long-term therapy of 30 50-minute sessions over nine months, with medication, cut median recovery time to 169 days, compared to 279 days for those receiving short-term therapy of three sessions over six weeks. Miklowitz said, the extreme mood swings of bipolar disorder had been thought of “as sort of an exclusively genetic, biologically treated illness,” to be managed primarily with medication. “So the relapses are less common, and their functioning improves, including relationship and family functioning.”įor many years, Dr. Miklowitz, a professor of psychology and psychiatry at the University of Colorado, whose pioneering research on the topic inspired the Beth Israel clinic. “We’ve tested it in a number of different trials against different types of therapy, and consistently find that if you combine medication and family-focused therapy, you get quicker recoveries from episodes and longer intervals of wellness,” said David J. In family therapy, the family might be treated as part of the problem in contrast, in family-focused therapy the point is not to treat relatives, but to enlist their help in managing the patient’s illness. The clinic, the Family Center for Bipolar Disorder, was set to be formally dedicated on Wednesday, though it has evaluated some 60 families since 2006, in a program that doctors say is unique in the city and based on a model developed at the University of Colorado.įamily-focused therapy, as it is called, breaks the image of the psychiatrist sitting in his chair, alone in a room with the patient, as well as the traditional wisdom that patient confidentiality is sacrosanct. Cunanan said, half understanding, half resentful, as her brother listened, his eyelids drooping from exhaustion.Īdrian’s brother and sister, as well as the woman he is dating, are critical components of his therapy at Beth Israel, where a fledgling clinic aggressively treats people with bipolar disorder by involving their family members. “All of us would like someone to sweep up after us,” Ms. He would go two days without sleeping, she said, then become so frazzled that he depended on his family to carry out life’s daily chores, like shopping and cleaning. It was Jennifer Cunanan, 27, who did most of the talking, describing life with Adrian, 30, a computer consultant who has bipolar disorder and who went through a severe manic episode in March. It was hard to tell just who was the patient, as the Cunanan siblings - Jennifer, Adrian and Anthony - sat in a row on three chairs in a sparsely decorated therapist’s office at Beth Israel Medical Center in Manhattan.
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