The public face of Catherine Zeta-Jones has long been one of elegance and more recently, one of quiet bravery in the face of her husband Michael Douglas's throat cancer. So the announcement this week that the actress had sought treatment for bipolar disorder came as a shock to many.
Zeta-Jones' publicist CeCe Yorke released the short statement suddenly Tuesday, stating: "After dealing with the stress of the past year, Catherine made the decision to check in to a mental health facility for a brief stay to treat her bipolar II disorder."
She added that the actress is "feeling great and looking forward to starting work this week on her two upcoming films."
It's not clear what prompted the statement, but the National Enquirer says it came within hours of their exclusive report on Zeta-Jones spending time in a Connecticut psychiatric hospital.
Since the news broke, some media outlets have said Zeta Jones, 41, had been diagnosed following her husband's cancer struggles. Others suggested the disorder was triggered by the stress of the events with her husband.
Unfortunately, the publicist's statement was short and shone no light on when Zeta-Jones actually told her she had bipolar disorder.
While it's possible the diagnosis is new, it is also quite likely that Zeta-Jones was diagnosed with the mental illness many years ago and has kept it under wraps until now.
According to the U.S. National Institute of Mental Health, the symptoms of bipolar disorder – also called manic depression -- typically begin to appear in a patient's late teens or early 20s. At least half of all cases start before age 25.
But it's also possible that Zeta-Jones' diagnosis could have been missed for years, depending on her illness' severity.
The publicist's statement revealed that Zeta-Jones had bipolar II disorder, which is a form of the illness characterized by more frequent and more intense depressive episodes than manic episodes.
Identifying bipolar II is often difficult because the mood swings are not as intense, so patients are often misdiagnosed with clinical depression, rather than the mood disorder.
Like other mental illnesses, there is no clear-cur way to diagnose bipolar disorder. There is no blood test or brain scan; diagnosis is made on the basis of symptoms, course of illness, and family history, since the disorder has a strong genetic component.
The most telling symptoms of bipolar disorder are the mood swings, going from highs to extreme lows.
With bipolar II, the "up" periods would be less intense. Instead of full-blown mania, bipolar II patients would seem unnaturally upbeat during an "up" period. They might also seem jittery or agitated or hyperactive.
The "lows" of bipolar are marked by long periods of feeling depressed or worthless, a loss of interest in activities once enjoyed, difficulty concentrating and remembering, and sometimes thoughts or attempts at suicide.
Bipolar disorder has no cure and usually lasts a lifetime. But it can be managed with mood-stabilizing medications and psychotherapy, both of which can reduce symptom severity. If untreated, bipolar disorder tends to worsen, with more frequent and more severe episodes.
