Catherine Zeta-Jones Hospitalized for Bipolar Disorder

Academy-Award winning actress Catherine Zeta- Jones has voluntarily checked herself into a hospital for treatment of her bipolar disorder.

This is Zeta-Jones’s second hospitalization for the disease. The first was 2 years ago, when she revealed that she was diagnosed with bipolar disorder type 2. At that time, she had been dealing with a lot of stress, not the least of which was her husband, Michael Douglas’s fight with Stage 4 throat cancer.

Publicist Cece Yorke announced that:

Catherine has proactively checked into a healthcare facility. Previously Catherine has said that she is committed to periodic care in order to manage her health in an optimum manner.

How do you treat bipolar disorder?

We’ve previously covered other aspects of bipolar disorder:

• Symptoms
• Mania
• ECT (electroconvulsant therapy)
• Stigma associated with bipolar disorders
• Dissociative Psychotic Reaction
• Psychomotor Retardation

So a little bit about treatment seems in order.

To date, there is no cure for bipolar disorder. But proper treatment helps most people with bipolar disorder gain better control of their mood swings and related symptoms.This is even true for people with the most severe forms of the illness.

Because bipolar disorder is a lifelong and recurrent illness, people with the disorder need long-term treatment to maintain control of bipolar symptoms. An effective maintenance treatment plan includes medication and psychotherapy for preventing relapse and reducing symptom severity.

Medications

Bipolar disorder can be diagnosed and medications prescribed by people with an M.D. (doctor of medicine), usually a psychiatrist. Not everyone responds to medications in the same way. Several different medications may need to be tried before the best course of treatment is found.

Mood stabilizing medications are usually the first choice to treat bipolar disorder. In general, people with bipolar disorder continue treatment with mood stabilizers for years.

Except for lithium, many of these medications are anticonvulsants. Anticonvulsant medications are usually used to treat seizures, but they also help control moods. These medications are commonly used as mood stabilizers in bipolar disorder:

• Lithium was the first mood-stabilizing medication approved by the U.S. Food and Drug Administration (FDA) in the 1970s for treatment of mania. It is often very effective in controlling symptoms of mania and preventing the recurrence of manic and depressive episodes.
• Valproic acid or divalproex sodium (Depakote), approved by the FDA in 1995 for treating mania, is a popular alternative to lithium for bipolar disorder. It is generally as effective as lithium for treating bipolar disorder.
• More recently, the anticonvulsant lamotrigine (Lamictal) received FDA approval for maintenance treatment of bipolar disorder.

Antipsychotic medications are sometimes used to treat symptoms of bipolar disorder. Often, these medications are taken with other medications.

• Olanzapine (Zyprexa), when given with an antidepressant medication, may help relieve symptoms of severe mania or psychosis. Olanzapine can be used for maintenance treatment of bipolar disorder as well, even when a person does not have psychotic symptoms.
• Aripiprazole (Abilify), like olanzapine, is approved for treatment of a manic or mixed episode. Aripiprazole is also used for maintenance treatment after a severe or sudden episode. As with olanzapine, aripiprazole also can be injected for urgent treatment of symptoms of manic or mixed episodes of bipolar disorder.
• Quetiapine (Seroquel) relieves the symptoms of severe and sudden manic episodes. In that way, quetiapine is like almost all antipsychotics. In 2006, it became the first atypical antipsychotic to also receive FDA approval for the treatment of bipolar depressive episodes.
• Risperidone (Risperdal) and ziprasidone (Geodon) are other atypical antipsychotics that may also be prescribed for controlling manic or mixed episodes.

Antidepressant medications are sometimes used to treat symptoms of depression in bipolar disorder. People with bipolar disorder who take antidepressants often take a mood stabilizer too. Doctors usually require this because taking only an antidepressant can increase a person’s risk of switching to mania or hypomania, or of developing rapid cycling symptoms. To prevent this switch, doctors who prescribe antidepressants for treating bipolar disorder also usually require the person to take a mood-stabilizing medication at the same time.

Psychotherapy

In addition to medication, psychotherapy, or “talk” therapy, can be an effective treatment for bipolar disorder. It can provide support, education, and guidance to people with bipolar disorder and their families. Some psychotherapy treatments used to treat bipolar disorder include:

• Cognitive behavioral therapy (CBT) helps people with bipolar disorder learn to change harmful or negative thought patterns and behaviors.
• Family-focused therapy includes family members. It helps enhance family coping strategies, such as recognizing new episodes early and helping their loved one. This therapy also improves communication and problem-solving.
• Interpersonal and social rhythm therapy helps people with bipolar disorder improve their relationships with others and manage their daily routines. Regular daily routines and sleep schedules may help protect against manic episodes.
• Psychoeducation teaches people with bipolar disorder about the illness and its treatment. This treatment helps people recognize signs of relapse so they can seek treatment early, before a full-blown episode occurs. Usually done in a group, psychoeducation may also be helpful for family members and caregivers.

Lifestyle changes

Successful management of bipolar disorder also includes living a healthier lifestyle:

• getting more sleep
• eating healthier
• getting more physical activity
• yoga and/or meditation

Hospital Based Treatment

Hospital based treatments can be done an an inpatient or outpatient basis. As Bipolar Disorder I tends to be more severe, hospitalization is more common than for Bipolar Disorder II.

It is especially important for patients after suicide attempts, or for those with suicidal thoughts. Never ignore comments about a friend or relative harming himself or herself.

Hospital based treatments can also be used for periods of medication adjustments.

For more information, go to the Resounding Health Casebook.