Catherine Zeta Jones and Bipolar II Disorder

Catherine Zeta Jones has become one of the latest public figures to join the ranks of famous bipolar people. Her representative confirmed that the Welsh actress, age 41, recently underwent inpatient treatment for Bipolar II disorder at a Connecticut mental health facility.

This topic interests me personally because I have various friends and family members who are currently struggling with this, or similar mental disorders. Experts say that anywhere from about 1% to 2.6% of the population has some form of Bipolar disorder; and the National Institute for Mental Health (NIMH) estimates that it affects about 5.7 million American adults.

Besides Catherine Zeta Jones, the National Center for Biotechnology Information (NCBI) reports that other famous bipolar people include: Emily Dickinson, Ernest Hemingway, Virginia Woolf, Vincent Van Gogh, Goya, and Handel. Wikipedia has a much more extensive and contemporary listing of famous bipolar people as well.

What is Bipolar II Disorder?

The main types of Bipolar disorder include: Bipolar I, Bipolar II, and a recently identified 3rd category referred to as sub-threshold Bipolar disorder. Bipolar I is the most extreme type and includes dramatic mood swings between euphoria and severe depression. Catherine Zeta Jones is affected by Bipolar II disorder, a less intense form of the illness. David J. Miklowitz, PhD, a professor of psychiatry at the UCLA School of Medicine states that people with Bipolar II swing from severe depression to a milder and briefer manic state called hypomania. They aren’t impaired to the extent that folks with Bipolar I can be.

Bipolar II Symptoms

What does Bipolar II disorder feel like? Essentially, you exist in a constant flux between these 4 states:

1. Bouts of severe depression. According to the Royal College of Psychiatrists, symptoms of depression related to the Bipolar II state include:

a. feelings of unhappiness that don’t go away
b. losing interest in things
c. feeling restless and agitated
d. losing self-confidence
e. feeling more irritable than usual
f. thinking of suicide
g. difficulty in concentrating.
h. losing appetite and weight
i. difficulty in sleeping
j. reduced sex drive
k. avoiding contact with other people

2. Periods of hypomania. Again, the Royal College of Psychiatrists lists the following symptoms of hypomania related to Bipolar II disorder:

a. very happy and excited
b. irritated with other people who don’t share your optimistic outlook
c. feeling more important than usual
d. full of new and exciting ideas
e. moving quickly from one idea to another
f. full of energy
g. unable or unwilling to sleep
h. more interested in sex
i. less inhibited in general

3. The “mixed” state. Some people consider this the most dangerous of the Bipolar II states. This period combines the high energy and racing thoughts of hypomania with the deluded self-hatred and misery of the depressive state. This state is probably the riskiest time for suicide attempts.

4. The “normal” periods between episodes. In between episodes of hypomania and depression, many people with Bipolar II disorder live normal lives, or else they may continue to experience only mild depressive symptoms that are more tolerable.

What Triggers Bipolar II Disorder?

For the most part, emotions related to Bipolar II Disorder may seem to come out of no where, and episodes can strike for very little reason. However, experts also believe that Bipolar II episodes can sometimes be triggered by events that are extremely stressful. For instance, in the case of Catherine Zeta Jones, her husband Michael Douglas had been diagnosed with throat cancer last year. The BBC News reports that Zeta Jones was “furious” that doctors failed to detect the cancer earlier and has been dealing with this very devastating ordeal in her life for the past year.

Bipolar II Disorder Treatments

Medication is often needed to stabilize the mood swings related to Bipolar II disorder. The following are some of the most common medications prescribed by physicians in treating Bipolar II Disorder:

1. Lithium. This naturally occurring salt was the first effective mood stabilizer and has been used as such for over 50 years. It can be used to treat both manic and depressive episodes. Treatment with lithium should be started by a psychiatrist. The difficulty is getting the level of lithium in the body right – too low and it won’t work, too high and it becomes toxic. It can take three months or longer for lithium to work properly. Blood levels of lithium must be monitored to avoid side effects.

2. Lamictal. This drug is approved by the FDA for the maintenance treatment of adults with Bipolar disorder. It has been found to help delay bouts of mood episodes of depression, mania, hypomania, and mixed episodes in people being treated with standard therapy. This drug has received pretty good reviews from users at the Drugs.com website.

Importantly, Lamictal sexual side effects are few, if any. The reason is that Lamictal doesn’t affect serotonin like the SSRI antidepressants which often causes sexual dysfunction. Instead it works through an independent mode of action acting as an antagonist at the NMDA receptor. This in turn limits Lamictal sexual side effects in most patients.

3. Other Anti-seizure Medications. These include Depakote, Gabitril, Neurontin, Tegretol, Topamax, and Trileptal.

4. Antipsychotics. For severe manic episodes, newer antipsychotic drugs may be necessary. Abilify, Risperdal, Seroquel, and Zyprexa are often used. Antipsychotic medicines are also used for preventive treatment.

5. Benzodiazepines. This class of drugs includes Xanax, Ativan, and Valium and is commonly referred to as tranquilizers. They are used for short-term control of acute symptoms of mania.

Antidepressants WARNING: Common antidepressants like Prozac, Zoloft, and Paxil can actually set off a manic episode in a person with Bipolar disorder. Therefore, they should not be the first line of defense in treating this illness. In an essay appearing in The Lancet, Franco Benazzi, MD, PhD, writes that because Bipolar II is so often misdiagnosed, patients are often wrongly treated with antidepressants alone, which can make the problem worse. “These patients need to be on mood-stabilizing drugs, and if depression persists an antidepressant can be added,” Benazzi says. He goes on to state, “Treating these patients with antidepressants alone can actually increase the manic episodes and worsen the disorder….[which]… may explain the reported increase in suicides among patients on these drugs”.

10 More Ways to Cope with Bipolar II Disorder

The following common-sense steps for dealing with Bipolar II disorder are also recommended:

  1. Eat a well-balanced diet and eat regularly.
  2. Drink unsweetened fluids regularly. This helps to keep your body salts and fluids in balance.
  3. Learn to really accept and love yourself despite your battle with Bipolar II Disorder. One of the best books I’ve ever read regarding learning how to love yourself is Louise Hay’s You Can Heal Your Life .
  4. Watch out for psychoactive substances such as alcohol and caffeine (as found in tea, coffee or cola).
  5. Consider tracking your mood and energy levels throughout the day on paper or on the computer. Try to identify any specific mood-altering events or foods. This can assist your doctor in prescribing you the correct medications.
  6. Practice mindfulness meditation. This is done by focusing on your breathing and attempting to think of nothing else. If your thoughts wander, re-focus your attention on your breathing. Your thoughts will wander less and less over time. Mindfulness meditation is an excellent way to control racing thoughts and/or depressive episodes.
  7. Try to exercise daily.
  8. Work on improving your social skills. Bipolar people can sometimes feel like they are not part of the mainstream crowd. They can tend to isolate themselves and have a hard time relating and socializing with other people. Self-help books can help (such as Leil Lownde’s How to Talk to Anyone which provides easy-to-apply techniques that work quickly).
  9. Keep a regular schedule. Try to work a full-time 9-5 schedule if possible. And make sure you have fairly consistent times to wake up and go to sleep.
  10. Schedule in some fun hobbies, clubs or sports into your life. These types of activities can help take you out of your mind for a while.

Famous Bipolar People Help Reduce the Stigma of the Disorder

Famous bipolar people like Catherine Zeta Jones certainly do much to reduce the stigma surrounding mental illnesses such as Bipolar II Disorder. It takes great courage for famous bipolar people, and even regular people, to reveal to others that they have this illness. As Mark Davies of the mental health charity Rethink commented regarding Catherine Zeta Jones’, “Although she’ll be feeling pretty fragile and vulnerable, she will have, in a sense, given some comfort to a lot of other people who are probably suffering in silence and probably feeling a great deal of fear.”

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