Treating Bipolar Disorder: It Takes A Family

Treating Bipolar Disorder: It Takes A Family

Director of Mt. Sinai Beth Israel Medical Center program stresses treatment not done in isolation.

Editor & Publisher of The NY Jewish Week.

When Carol Levin first encountered Dr. Igor Galynker, a prominent psychiatrist in New York, several years ago to discuss her adult son’s ongoing mental health issues, she was uncomfortable with the doctor’s analysis. He had said that her son had been misdiagnosed and was taking the wrong medication.
Levin and her family sought treatment elsewhere for her son, who has bipolar disorder.

But many months later, when the situation worsened, “I was inconsolable, and out of desperation I called Dr. Igor again,” she said during a recent interview.

He readily agreed to take her son into treatment, offering a unique regimen that involved dealing with the whole family. Over time, all agreed, there has been much improvement.

“I am forever indebted to him,” Levin said of Galynker. “Our family was shattered. If not for him…”

The sentence remained unfinished but the message was clear. And Levin, who together with her husband, Jerry, is a major philanthropist in the Jewish community, has committed to speaking out not only about Galynker and the Family Center for Bipolar Disorder at Mt. Sinai Beth Israel Medical Center he founded and directs, but also about the need to counter the shame of mental illness publicly.

During a recent interview, Galynker, 60, described his approach, one that he sees as the vanguard for the future, and how he came to it.

Born to assimilated Russian Jewish parents, he grew up in Moscow and came to the U.S. at the age of 23. He received a Ph.D. in chemistry at Columbia University and taught at Purdue, but after a few years he decided to go to medical school. He became a biological psychiatrist (as opposed to an analyst) and, expressing confidence in his insights and technique, says “I can change a person’s life in five minutes” through diagnosis. But it may take several years for the patient to show marked improvement through proper treatment. And Galynker notes that since a bipolar condition is chronic, the treatment can be life-long.

While more and more medical practitioners are involving families in the treatment of a patient, Galynker said his research center’s program is unique in that family involvement is a requirement. His approach came about in part, he says, after his experience dealing with a couple, then recently divorced, where the husband was severely bipolar, one of their four teenage children was bipolar and two others were suffering from severe depression. Each of the six family members had a different psychiatrist.

In addition to the enormous financial cost, the situation was chaotic, Galynker recalled, but the various health professional involved did not consult with each other due to medical, legal and ethical issues concerning privacy.

He concluded that since family members are so directly impacted by living with a loved one with a bipolar condition, it made sense to conduct treatment by bringing the members together regularly. At least one designated family member — often a spouse or child — acts as the first-line caregiver, learning about medication and therapy. More than that, though, since the illness is genetic, group discussions allow the doctor to interact with family members, looking for symptoms in possible carriers, and possible treatment, while dealing with problems that result from the family dynamics.

“The family is affected by the highs and lows and disruptive nature of the primary patient,” Galynker said. “We often find depression and anxiety in the children and spouse, and we deal with communication and problem-solving techniques.”

The doctor, who is a professor at Mt. Sinai and author of a highly praised 2010 book, “Talking To Families About Mental Illness: What Clinicians Need to Know” (W.W. Norton and Co.), said family therapy is common in India, but not in the West.

He noted that some Jewish families tend to have issues of “emotional over-involvement,” similar to the stereotype of the overbearing Jewish mother. The patients often are “very caring people who make others dependent on them, interpreting people’s behavior without invitation,” or assuming, for example, that a child will fail without the parent’s help.

“It’s the dark side of a close-knit family,” Galynker observed. The optimal parent, he adds, is one who cares a great deal but displays low control, allowing loved ones to make mistakes, even fail, but is always there for them.

One of his goals is to “overcome the stigma” of speaking publicly about mental illness, and he credits Carol Levin, who addressed a fund-raiser for the Family Center, for agreeing to tell her family story.

The center is funded through grants, billing and private donations.

“He can be tough,” Levin said of Galynker. “He expresses his opinion, and he has called me a drama queen. But he makes himself available and gives you sound clear advice.

“You walk out with solutions.”

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