Catherine Zeta-Jones Seeks Treatment for Bipolar II Disorder

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Until April 2011, Academy Award-winning actor Catherine Zeta-Jones was best known for stellar performances in Traffic and Chicago, her high-profile marriage to actor Michael Douglas, and his recent struggle with throat cancer. She recently stunned the public by announcing that she suffers from bipolar II disorder and is participating in inpatient treatment for the illness.

Bipolar II disorder is a mental illness that is characterized by mood swings, from depressed or irritable to excessively elevated to a moderate degree (hypomania). While it is thought to occur a in a little over 1% of the United States population, slightly more than the 1% incidence of bipolar I disorder, that translates into millions of people who suffer from the condition. About two-thirds of individuals with manic depression (either bipolar disorder or bipolar II disorder) develop symptoms of the illness by the time they reach early adulthood. People with bipolar II disorder are at risk for engaging in substance abuse.

Bipolar II disorder is thought to be more common in women than in men. As with depression, the hypomanic symptoms of bipolar II disorder can occur in the postpartum period. Children and adolescents with bipolar II disorder tend to experience episodes that are rapid cycling, having at least four mood problem episodes in a 12-month period.

In order to qualify for the diagnosis of bipolar II disorder, individuals must experience at least one episode of major depression and at least one hypomanic episode during their lifetime. Symptoms of major depression last at least two weeks and include depressed or irritable mood and a number of associated symptoms, like change in sleep or appetite, suicidal thoughts, plans, or actions, low energy, tendency to isolate from others, and loss of interest in formerly pleasurable activities. Diagnostic criteria for a hypomanic episode include symptoms like elevated or irritable mood, grandiosity, decreased need for sleep, excessive speech, racing thoughts, trouble focusing, excessive activity, suicidal thoughts, plans, or actions, and behaviors that indicate poor judgment that last for at least four days.

As with most other mental disorders, there is no single cause for bipolar II disorder. For example, it is not directly passed from one generation to another genetically. Rather, it is the result of a complex group of genetic, psychological, and environmental factors. Genetically, bipolar disorders and schizophrenia have much in common, in that the two disorders share a number of the same risk genes. However, both illnesses also have some genetic factors that are unique. Stress has been found to be a significant contributor to the development of most mental illnesses, including bipolar disorder.

As is true with virtually any mental-health diagnosis, there is no one test that definitively indicates that someone has bipolar II disorder. Therefore, health-care practitioners diagnose this disorder by gathering comprehensive medical, family, and mental-health information. The practitioner will also either perform a physical examination or request that the individual's primary-care doctor perform one. Medical testing will usually include lab tests to evaluate the person's general health and to explore whether or not the individual has a medical condition that might have mental-health symptoms.

The treatment plan for bipolar II disorder usually includes psychotherapy, medication, and/or social support. Medications that stabilize mood, like quetiapine (Seroquel), lamotrigine (Lamictal), and valproic acid (Depakote) have been used to treat this illness. While some people with this illness benefit from treatment with an antidepressant medication (like fluoxetine [Prozac], venlafaxine [Effexor], or escitalopram [Lexapro]), practitioners use such medications with care because of the risk of antidepressant medication being associated with the development of hypomania or mania. For some people with severe symptoms of bipolar II disorder whom do not respond well to medications, electroconvulsive therapy (ECT) can be a viable treatment option.