Acknowledging Depression

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By Kay Redfield Jamison
Sunday, June 25, 2006

This past week Doug Duncan cited depression as the reason for dropping out of the race for governor of Maryland. One hopes that his directness will make it easier for other public figures to be more straightforward about their own experiences with this common, potentially lethal and yet treatable illness.

Most prominent Washingtonians who have depression are not open about their illness, nor do they make any concerted effort to improve the lives of the other 34 million Americans who also suffer from depression. They benefit from their access to the best doctors, researchers and hospitals, but they remain silent. This is understandable, at least to a point. There are risks involved in disclosing mental illness, including potential backlash from wary stockholders, skeptical voters, concerned investors, and unsympathetic employers and licensing boards. These concerns cannot be dismissed out of hand. Nor should anyone feel pressured to discuss in public what they confide to their doctors and psychotherapists. Confidentiality is an ancient and well-warranted social value.

Yet when public figures remain silent about depression there is a cost to the rest of society. Silence contributes to the misperception that successful people do not get depressed, and it keeps the public from seeing that treatment allows many individuals to return to competitive professional lives. Silence also contributes to the myth that people who are brilliant or "full of life" cannot possibly become so despairing as to kill themselves. They do. Every day. In short, silence helps perpetuate the stigma of mental illness. Those in the public eye -- whether in business, journalism, politics or the professions -- have a unique opportunity to lessen this stigma, mobilize research efforts, raise money and educate others who do not have the same financial and educational advantages.

There are exceptions to this general unwillingness of public figures to discuss depression. Some people -- Mike Wallace, William Styron, Art Buchwald, Patty Duke and Dick Cavett, for example -- have spoken out for years. Tom Johnson, former chairman and chief executive officer of CNN, along with other well-known businessmen, athletes and entertainers, has participated in public awareness campaigns about depression. A few prominent individuals in science and medicine -- Sherwin Nuland, Yale surgeon and writer; Leon Rosenberg, former dean of the Yale Medical School; and Mark Vonnegut, writer and physician -- have openly discussed their depression and bipolar illness. Several politicians and wives of politicians have been public about their experiences with depression or bipolar illness, including Lawton Chiles, Patrick Kennedy, Tipper Gore and Kitty Dukakis. Each made a tremendous difference by doing so.

In Europe, Lord Stevenson of Coddenham, one of the most powerful men in Britain, has spoken openly about his depression and the necessity to change the attitude that depression is "self-imposed" and something to be "snapped out of." Alastair Campbell, Prime Minister Tony Blair's former director of communications and strategy, has said that he never tried to conceal his manic break from the public and felt that he was treated well by people and by the press. He also believes that he is a better and stronger person as a result of his breakdown and his openness about it. Former prime minister of Norway, Kjell Magne Bondevik, took sick leave when he became depressed; polls taken at the time indicated that his countrymen overwhelmingly supported his honesty. It may be a long while before a person with a history of depression is elected president of the United States, but we have come a good distance from 1972, when then-Sen. Tom Eagleton (D-Mo.) was compelled to give up his candidacy for vice president.

Doug Duncan has made a difficult decision to disclose his treatment for depression. But, as John Wilson, the late chairman of the D.C. Council, said: "We've got to change the way America feels about depression. We can't put it all in God's hands. God's busy." Regrettably, John Wilson did not feel he could disclose the extent of his own struggles with depression; his suicide was a terrible loss not only for his family and friends but for the city of Washington as well.

On Wednesday Rep. Sue Myrick and a House subcommittee on health will be holding hearings on "Mental Illness and Brain Disease: Dispelling Myths and Promoting Recovery Through Awareness and Treatment." Psychiatric disorders are a bipartisan concern, and many members of Congress have been actively involved in increasing research funding for these illnesses. Like the tens of millions of Americans who suffer from mental illness, I hope the hearings have the kind of influence that they should. Scientists have made extraordinary advances in understanding the brain and its disorders. We know far more about the genetics, neurobiology, and psychology of depression and bipolar illness than we did just five years ago. But research funding needs to keep pace with the promise of the field.

I also hope that those who are in a position to speak out about their illnesses will follow the example of Doug Duncan.

The writer is a professor of psychiatry at Johns Hopkins School of Medicine and author of "An Unquiet Mind."


© 2006 The Washington Post Company

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