Zeta-Jones puts public face on mental illness


When celebrities such as Oscar-winning actress Catherine Zeta-Jones, 41, announce they are receiving treatment for bipolar disorder, it helps reduce the social stigma of mental illness, experts say.

Personal revelations like her disclosure this week shed light on mental health disorders and treatments that can help, says David Miklowitz, professor of psychiatry at UCLA's School of Medicine. "People can live successful lives with bipolar disorder," he says.

About 2% of the population has bipolar disorder, says the National Institutes of Health. Miklowitz says there are four subtypes of the condition. The two most common are bipolar I and II.

Zeta-Jones says she suffers from bipolar II disorder. It is a less extreme version of type I, says Alan Manevitz, a clinical psychiatrist at Lenox Hill Hospital in New York. In bipolar II, he says, bouts with depression are much more common than manic bouts, which are characterized by high energy, sleeplessness, grandiose thoughts and irritability. When mania does set in, it's "hypomania," a lower level, yet still higher than an average person's upbeat days.

"We all have mood swings. They're normal. You wake up on the wrong side of the bed, or you're excited about going to a Mets game," Manevitz says. He says bipolar II sufferers in hypomania may be "the life of the party" but also impulsive. When they seek medical help, they're more likely to come in when depression is manifesting itself, Manevitz says. If a medical expert is unaware of the manic phases, antidepressants may be prescribed to treat depression.

The problem is that if a person with bipolar II takes antidepressants, the medication can cause a sudden shift to a manic state. He says mood stabilizers, such as lithium, can be prescribed first. An anti-depressant can be introduced later if depression persists, he says.

While no one knows for sure the cause, Miklowitz says there are theories about what's going on in the brain chemically, including abnormal activity in the gaps between cells, called synapses. There's a genetic link, too.

Bipolar disorder is a very treatable illness, says Manevitz. "It's not a character flaw."

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