Anyone who’s walked past a newsstand this week probably knows that Catherine Zeta-Jones entered treatment for bipolar disorder a few days ago. With all the media attention swirling around Zeta-Jones, we asked Dr. Joseph Shrand, a psychiatrist, Harvard professor, and author of the book Outsmarting Anger, to clear the air on what exactly the disorder is, how to treat it, and how to know if you have it.
“Psychiatric conditions can be broken down into two major categories: One has to do with the way we feel, and one has to do with the way we think,” Shrand says. “Bipolar is really a condition in which our feeling states are truly, truly erratic.” Shrand explains that people with bipolar, as the name suggests, shift between dramatically different poles of feeling: Intense depression, and equally intense euphoria. “They can feel so depressed that it becomes quite dangerous and they want to die or commit suicide,” he says, “or they become manic, which is where they feel incredibly euphoric.”
From that initial description, bipolar can be further broken down into two types. Bipolar 1, the more severe of the two, crosses over into the sufferer’s thoughts, making them delusional or psychotic. Bipolar 2 (which is what Zeta-Jones has) causes mood swings, but without the psychotic element.
But even bipolar 2 is about more than simple mood swings, which Shrand says are normal. “Everyone is going to have some degree of variation in their moods from day to day, but this is outside that,” he says. “This is more extreme.” Shrand explains that those with bipolar have both periods of long-lasting, deep depression and periods of such intense euphoria that it leads to feelings of grandiosity and delusion that can cause rash actions like spending huge amounts of money, promiscuity, and impulsiveness. Plus, Shrand says, there is likely some connection between a person’s genetics or biochemistry and their likelihood to get bipolar disorder.
So aside from biology, what causes bipolar disorder? Shrand notes that it’s hard to say for sure. “What we do know definitively is that there’s a significant disruption in the limbic system, which is where all the feelings are happening, and then in the prefrontal cortex as well, which is where you’re making decisions,” he explains. “But I don’t think anybody really, really knows.”
Despite the questions that still remain, Shrand says bipolar is fairly easy to treat as psychiatric conditions go. Most treatments rely on mood stabilizers, most of which are actually intended as anti-seizure drugs with the exception of lithium. These drugs alter the brain’s neurotransmitters to prevent dramatic changes in mood. “If you’re going to have any major psychiatric condition, you might as well have bipolar because it really is so treatable,” he stresses, adding that mood stabilizers are relatively fast-acting.
And, Strand says, no one should be hesitant to seek treatment, as he applauds Zeta-Jones for doing. “People are so afraid to get help because of the stigma of mental illness,” he says. “You do not need to be ashamed of having a condition that has a psychiatric component to it. It’s not a crime. It’s nothing to be ashamed of. Come and get some help.”
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