By Neely Tucker
Washington Post Staff Writer
Friday, June 23, 2006
A politician with clinical depression? What kind, the staggering bipolar variety? The fluttering veils of gray known as dysthymia?
He's on medication? Is it a mild dosage of Prozac, a few milligrams of Zoloft? Heavyweight dosages of lithium?
Twenty, thirty years ago, it wouldn't have mattered. Any open admission of an illness associated with asylums would have been the kiss of political death. It was "One Flew Over the Cuckoo's Nest" territory. Ask Tom Eagleton.
But much has changed about the stigma around mental illness, mood disorders and their role in American politics since Eagleton was dumped from the vice presidential spot on the 1972 ballot after it was learned he had undergone electroconvulsive therapy. Back then, they said it was for "nervous exhaustion."
Montgomery County Executive Doug Duncan's announcement yesterday that he was dropping out of the Maryland governor's race because of clinical depression startled observers, but mainly because the 50-year-old Duncan had been in public office for more than a dozen years with little indication of depressive behavior.
He said yesterday that his family has a history of depression, but he did not elaborate on details of his condition or treatment. He said he had begun medication on Monday.
It made for dramatic politics, changing the shape of an election. But too much has changed for it to be a political obituary. Call it a political asterisk.
"Without knowing more about him, his illness or the medication, it's just impossible to say what should happen next," says Bob Boorstin, who held several senior positions in the Clinton administration while on medication for bipolar illness. "There's been a sea change in public attitudes [toward politicians with depression], but that doesn't necessarily mean it's the right thing for a particular person to continue in public life."
Jennifer Duffy, editor of the Cook Political Report, said perhaps the only sign that things might not have been well in the Duncan camp was that his campaign had not been as aggressive as many had expected.
"I kept waiting for him to shift this thing in high gear," she said yesterday. "They started with some ads, but that's not really him, his energy. I'm going to say that this [diagnosis] explains some of that."
Still, she said, that did not mean that it necessarily cast a larger shadow.
"Depression is one of these issues that can be dealt with. You have to sort of figure it out, the whys and the treatment, and then you can be okay. . . . I don't think it disqualifies him from future public office, if that's what he wants."
Depression has always been with us, of course, whether in the contemplative quiet hours after midnight or in the bright light of the campaign trail. Politicians from Lincoln to Churchill functioned with extraordinary capability despite medical conditions that might today be classified as clinical depression.
The difference was that mental illness was not then a topic of public discussion. In 1972, in Eagleton's case, the admission of the illness seemed to equate it with personal weakness or a character flaw. Such perceptions could not stand the weight of scrutiny, and presidential candidate George McGovern dropped him immediately. (Eagleton, years later, said he harbored no bitterness and, had the roles been reversed, would likely have done the same thing.)
In the intervening years, politics and the art of openly managing medical infirmities changed. Lawton Chiles retired from the U.S. Senate. He later acknowledged that he was suffering from depression, but Florida voters elected him to two terms as governor after he said he was treating the condition with Prozac.
Rep. Patrick Kennedy told Rhode Island voters he suffered bipolar depression but was on medication. They returned him to office with 67 percent of the vote.
There are ads for antidepressants on television and in the glossy magazines. There are little orange prescription bottles in family medicine cabinets. So many people take antidepressants that a book titled "Prozac Nation" became a national bestseller a decade ago.
Still, familiarity with an illness does not diminish the need for medication, or minimize the severity of the disease. Mental illness can kill.
"I would not want an untreated depressive to be an airline pilot, a CIA agent or a bartender," says Boorstin.
In 2002, an advocacy group called the Depression and Bipolar Support Alliance released a poll that showed that 24 percent of all Americans would not vote for a political candidate with a mood disorder. An equal percentage said they "might not vote" for such a candidate.
Sue Bergeson, president of the Chicago-based advocacy group, said yesterday that it is likely those poll numbers would be lower now, as more people learn more about the illness. People understand that not everyone with a heart condition should be the vice president of the United States, but they also acknowledge Dick Cheney seems to handle it with the right medication and treatment, she points out.
"The pressure of holding office is intense, and whether heart disease or depression, it's going to be hard" for candidates with any sort of infirmity to manage both the job and the condition, she said. "It's not always good for people with terribly disabling diseases to hold these offices, but many do a wonderful job anyway. Where would we be without Lincoln? Without Churchill? The point is, it's an individual issue."