What It Means When Catherine Zeta-Jones Says She’s Getting “Bipolar Maintenance”

The actress has checked herself into a hospital for treatment.

Catherine Zeta-Jones, who has bipolar disorder, has checked herself into the hospital for treatment. Her publicist has explained this a proactive visit, and a source told TMZ the hospital stay is “maintenance.” As a result, the National Alliance on Mental Illness’ medical director has commended Zeta-Jones: “It’s great that she is getting help for herself and serving as a role model.”

And indeed she is, though I’m sure many people have no idea what they’re all talking about when they say the hospital stay is for “maintenance”—as though she’s a car in for a tuneup. Thing is, it’s not too different from an automotive tuneup. A twist of the wrench here, a ribbon of oil there, and things run a lot more smoothly. Only the twists and ribbons are medical interventions.

In psychiatric parlance, the word “maintenance” is most often associated with electroconvulsive therapy (ECT)—what’s colloquially known as shock treatments. Carrie Fisher gets maintenance ECT, as she’s written, and who knows? Maybe Zeta-Jones does ECT too. But it’s just as likely that her tuneup is pharmacological—a few weeks or so to deal with those pesky medications.

The saying “the cure is worse than the disease” must have been coined in relation to pharmacology, because taking medication long-term is a bitch. That’s true for any medication for chronic illness, of course, but psych meds deserve a special place in hell when it comes to potential long-term impact. First-generation antipsychotics cause cardiovascular disease. Atypical antipsychotics increase the risk of diabetes. Lithium can wreak havoc on the kidneys. Benzodiazepines take a toll on memory and cognition. The list goes on.

When one of these long-term effects rears its ugly head, a medication has to be adjusted—either discontinued altogether, or its dosage changed, or combined with another med that has an ameliorating effect. It may not sound that complicated, but it’s a huge project—the kind that conjures the same dread you feel when your mechanic says, “It’s the transmission.”

I’ve gone through many med changes, but my transmission breakdown came when my so-called magic bullet, Seroquel, started to make my legs and arms feel creepy-crawly, like there were tiny worms under my skin, and I couldn’t sit down. That side effect is called akathisia, and in the 10-plus years the medication kept my brain on track, I’d never had to deal with it. So where did it come from all of sudden? My doctor didn’t know. Satan, probably. After a careful evaluation of all the options, we decided the safest thing to do would be to discontinue the medication entirely. You don’t want to mess around with neuromuscular side effects—that’s how people end up twitchy.

But the reasons for med changes aren’t always so dramatic. Maybe you’ve got a new exercise regimen or a new diet; maybe you’re pregnant or trying to conceive; maybe you’ve decided to quit drinking or start smoking pot. A new job, a breakup, moving to a new apartment—life changes big and small can have an impact on how medication works. It’s a delicate balance that needs constant reassessment. Unlike Catherine Zeta-Jones, however, most people don’t have money to go to a fancy looney palace where they’ll be monitored as they come off one medication and then try numerous replacements.

Instead, they taper the meds s-l-o-w-l-y, and at home. It’s frightening and exhausting to be ping-ponging between one side effect and another, to have your mood shift unpredictably, to exercise hypervigilance on your own behalf because there’s no at-home medical supervision. And it’s virtually impossible to explain to an employer what’s going on—and why it’s going on and on for weeks. Frankly, I’d rather not bother. At the moment, I’m taking 60 milligrams of something I only need 30 milligrams of, but who has the time for the withdrawal? Catherine Zeta-Jones, that’s who.

Zeta-Jones has Bipolar II, which means when things go awry, she likely descends into a deep, dark well of physical paralysis and mental anguish. Preventive care—maintenance, a tuneup, proactive hospitalization, whatever a publicist calls it—is essential. What’s better, she’s making a point of being forthright about her treatment, with no apologies. I appreciate her honesty. But most of all, I’m terribly envious. I’ll bet wherever she’s getting her tuneup, the thread count of the sheets is really high.

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  • ADC

    Thank you for sharing this very straight forward and easy to understand explanation. Many people hear the word bipolar and think “crazy, wonky or unstable” . That is so not the case. Someone once said to me “being bipolar is like being diabetic-it is not a disease it just IS”
    You take your insulin to continue to function and sometimes the insulin can still make things go awry, thats why you test your sugar levels. It is the same with bipolar medications. Adjustments need to happen and regular maintenance is the best pre-treatment.

    • liz spikol is so siwwy


  • http://www.facebook.com/people/Jimbo-Ludwig/100001384797331 Jimbo Ludwig

    I have bipolar 1 and I have never heard of anyone going in for a month for maintenance. That’s complete BS! They will give her some meds and see her a week later.
    The ONLY reason a celebrity would go for a 30 day “maintenance” session is because their Monarch Programming needed to be maintained. In fact, most MK ULTRA victims are diagnosed as being bipolar.
    This is obviously NOT for bipolar. It’s to keep her “programming” maintained!

  • Guest

    I heard of her doing this, and in the midst of a pretty serious (and red-flags-abounded-but-ignored-previous-to) breakdown about a week or so ago, I seriously tried to find a similar plan of action. I am incredibly lucky/privileged in many ways, and I recognize and am so grateful for that, so I know what I was seeking is just an impossibility for most. But I do a lot of freelance work, and I am young enough that I am still on my parent’s (really good) healthcare, and have basically hit my deductible for this year which would mean costs would be mitigated… and I just wanted a safe place to go for a few days where I could have therapists and doctors help me out of the pit I had spiraled into. I knew from past experience if things didn’t change rapidly, I could end up in the hospital and not voluntarily within a couple of weeks. I live in a big city, and my mom was considering working with me to find out about voluntary admittance to psych wards in the good hospitals around here. I couldn’t get ahold of my regular doctor (which made my panic/anxiety worse) for advice, so I called the hospital “crisis” line. I was basically told that it might be an hours-long wait to do an intake interview with someone (which I also knew meant they could not have a bed, or someone in more immediate danger would need it etc). Thankfully, my doctor called at about 9:45 p.m. after rounds at his reg. hospital in the suburbs, and he worked with me to come up with a temporary plan to get me to sleep without drinking or abusing whatever sedatives I had, get a temporary prescription the next morning, and see him the morning after to do a re-evaluation of everything. I am so grateful for him, he’s been great to work with. I don’t know what going into the hospital would have done for me, as I’m still struggling at home with med changes and mood stability, but learning (after many failures) to reach out for help when in crisis has been a difficult, but probably life-saving, skill.

    I am grateful Catherine Zeta-Jones is somewhat open about her illness, as we work to combat the stigma that adds another layer of difficulty to those of us suffering from mental illness.

  • Libby Mitchell

    It is laughable how the uninformed and gullible accept the nonsense the media comes out with.
    I think you are spot on with your interpretation.
    I notice following some of these talent shows the winner disappears for up to a year to work on their first album. Yeah right as if it takes a year. They disappear to be worked on themselves.

  • HermeticWonderer

    I agree with Libby and it is refreshing to see people are WAKING UP!