‘Hidden’ bipolar disorder patients deserve our attention

In conclusion, rapidly accumulating evidence suggests that family members of patients with bipolar disorder experience high rates of depression, anxiety, and psychiatric distress in general. Because of their caregiving role with respect to the affected relative, their symptom level is not fully appreciated – and mental health needs often go unmet.

Most published interventions for family members are psychoeducational and aim to improve their function as caregivers (with the goal of reducing relapse rates in patients with bipolar disorder), rather than to relieve psychiatric symptoms in the family members themselves. Thus, family members of patients with bipolar disorder are often "hidden patients."

In practice, clinicians should directly inquire about and treat mood and anxiety symptoms in family members of their patients with bipolar disorder. New effective family interventions that target BOTH patients and caregivers using a family approach need to be developed and implemented.

Dr. Galynker is founder and director of the Family Center for Bipolar, New York. He also serves associate chairman of the department of psychiatry and behavioral sciences at the Beth Israel Medical Center, in New York, and as director of the division of biological psychiatry at the medical center. Ms. Briggs serves as program assistant at the Family Center for Bipolar.