Mental health

Zeta-Jones highlights mental health issues

Many newspapers have reported that Catherine Zeta-Jones is being treated for bipolar disorder. It is reportedly unclear when or where she was diagnosed with the condition, which was formerly known as manic depression.

The condition causes people to experience mood swings between depression and mania that go from one extreme to the other. During these episodes, affected individuals can feel very low or very high for periods of several weeks or longer. Some people will experience episodes only a few times in their life, while others will have regular episodes. The high and low phases of the illness are often so extreme that they interfere with everyday life.

While news of Zeta-Jones’ treatment has brought bipolar disorder into the public eye, the condition is relatively common. Both men and women, and people from all backgrounds, can develop bipolar disorder.

What causes bipolar disorder?

The exact cause of bipolar disorder is not fully understood. However, experts believe that there are a number of different factors that act together to cause the condition. The factors involved are thought to be a complex mix of physical, environmental and social factors.

Chemical imbalance in the brain

Bipolar disorder is widely believed to be the result of chemical imbalances in the brain. Neurotransmitters, such as norepinephrine, serotonin and dopamine are the chemicals that are responsible for controlling the functions of the brain.
If there is an imbalance in the levels of one or more neurotransmitters, it may cause the symptoms of bipolar disorder. For example, episodes of mania may occur when levels of norepinephrine are too high, and episodes of depression may be the result of norepinephrine levels becoming too low.

Genetic factors

As well as being linked to chemical imbalances in the brain, bipolar disorder is also thought to have a significant genetic factor. Bipolar disorder seems to run in families with the family members of a person with the condition having an increased risk of developing it themselves.

However, there is no single gene that is responsible for bipolar disorder. Instead, it is thought that a number of genetic and environmental factors act as triggers for the condition.


A stressful circumstance, or situation, is usually required to trigger the onset of the symptoms of bipolar disorder. Examples of stressful triggers include:

  • physical, sexual or emotional abuse
  • the breakdown of a relationship
  • the death of a close family member or loved one

These types of life-altering events can cause episodes of depression throughout a person’s life. Sometimes, physical illness can also cause persistent periods of depression.

Bipolar disorder may also be triggered by overwhelming problems in everyday life, such as problems to do with money, work or relationships.

How is bipolar disorder treated?

If left untreated, episodes of bipolar-related depression or mania can last for between 6-12 months.

On average, someone with bipolar disorder will have five or six episodes over a 20-year period. However, with effective treatment, episodes usually improve within about three months.

The majority of people with bipolar disorder can be treated using a combination of different treatments.

These include:

  • medicines to prevent episodes of mania, hypomania (less severe mania) and depression - these are known as mood stabilisers and are taken every day, on a long-term basis,
  • medicines to treat the main symptoms of depression and mania as and when they occur,
  • learning to recognise things that trigger an episode of depression or mania
  • learning to recognise the signs of an approaching episode.

How common is bipolar disorder?

Bipolar disorder is a relatively common condition with around one person in 100 being diagnosed with the condition. It can occur at any age, although it often develops in people who are between 18-24 years of age. Both men and women, and people from all backgrounds, can develop bipolar disorder.
The pattern of mood swings in bipolar disorder varies widely between individuals. For example, some people will only have a couple of bipolar episodes in their lifetime, and will be stable in between, while others may experience many episodes.

Preventing bipolar disorder

If you have bipolar disorder, you will not be able to prevent episodes of depression or mania occurring. However, there are steps that you can take to help manage the condition more effectively, such as:

  • avoiding stressful situations that may trigger an episode of mania or depression
  • avoiding drinking too much alcohol or taking recreational drugs, as this may trigger an episode of mania
  • taking prescribed mood stabilising medication regularly and do not suddenly stop taking it because doing so may trigger an episode of mania or depression
  • informing your doctor immediately if you get any side effects from the medication that you are taking. They can alter your dose or change the type of medication you are taking
  • learning about your illness so that you can recognise the signs of an approaching episode, and can take the necessary steps to manage it effectively

More detailed information can be found on the NHS Choices Health A-Z topic from which this article was adapted.

NHS Attribution