It's not easy to talk about and she insists on a zone of privacy. That's an odd stance for someone who leads the White House campaign against mental illness--speaking out against the stigma of being "crazy" and urging Americans to treat psychiatric disorders on a par with physical diseases such as heart failure or diabetes.
There are so many myths about mental illness that even Tipper Gore, long a public champion of addressing the issue, is reluctant to discuss the details of her own struggle with it.
It's enough for the wife of the vice president to say she was successfully treated with medication for depression about 10 years ago. Enough to say that she grew up in a family where she watched her mother struggle with periodic bouts of depression. "I knew she was sick. We acknowledged it. She was hospitalized . . . and she recovered," says Tipper Gore in her office in the Old Executive Office Building.
When one member of a family has a mental illness, the whole family has a mental illness--each one trying to help the sick one get well, trying to help the well ones cope, all the while holding on to a veneer of normalcy while dealing with the pain, and sometimes the terror, and the deep confusing love that comes from caring for a person with a "brain disease."
Enough to say that when Tipper found herself with some of the telltale symptoms of depression after her son was in a near-fatal accident in 1989, her mother "understood and that was good," says Tipper. "She said to me--'I'd be worried if you were depressed and not getting help.' "
That, of course, is the main message of yesterday's White House Conference on Mental Health: If you're sick, get treatment. If you're not sick--not at the moment, anyway--wake up and stop ignoring the huge toll of mental illness worldwide.
Depression is very common. About 19 million adults in the United States suffer from some form of depression every year, according to figures cited by the National Institute of Mental Health (NIMH). About 2.3 million Americans have manic depression or bipolar depression that swings between mania and depression. Some people have chronic depression, called dysthymia, with a low level of symptoms lasting for years. Others have acute episodes of severe depression. Still others have both chronic and acute depression. And still others have depression and a substance abuse problem.
Different forms of depression require different treatments. In recent years, new drugs, from Prozac to Zoloft, as well as different psychotherapies, from cognitive and behavioral therapy to support groups, have greatly helped people manage their depression and their lives.
But according to government surveys, most people with depression still aren't getting properly diagnosed and treated. "More than half the people with affective disorders are not getting any care," says physician and epidemiologist Darrel A. Regier of NIMH. In a new report on people who need help but don't get it, 60 percent said they were worried about costs, and more than a third said they had trouble getting a timely appointment.
The most devastating consequence is suicide. "Almost all people who kill themselves have a diagnosable mental disorder, most commonly depression or a substance abuse disorder," states an NIMH fact sheet. And while twice as many women as men have depression, men are more than four times as likely as women to commit suicide.
In 1996, nearly 31,000 people killed themselves in the United States--many more than the 21,000 people who were murdered during the same period. The public has a distorted view because homicides--but rarely suicides--are featured in the news. There is no Agatha Christie writing suicide mysteries, no television program entitled "Suicide, She Wrote." Yet suicide is the greater killer.
All this gives urgency to the White House conference as a way to break down public denial and apathy toward the issue of mental illness.
Tipper Gore was lucky. Her mother's illness led her to pursue a career in mental health and earn a master's degree in psychology from Vanderbilt University in Nashville. "I wanted to learn about human behavior and the function of the brain," she says. "I wanted to be a family therapist."
So she knew about the checklist of signs and symptoms of depression: behavioral changes--for example, changes in eating or sleeping patterns--feelings of worthlessness, constant fatigue, thoughts of death or suicide.
"I knew something was wrong," she says of her experience in 1989. "The stereotypes say it's a weakness of character, but you can't pray yourself out of it, you can't will yourself out of it . . . you can't just snap out of it."
Tipper turned to a social worker and friend. "I'm calling you professionally," she said. "I think I need to see you." She was diagnosed with clinical depression and treated with medication. She won't say what medication or for how long she received treatment. She just says: "I was successfully treated. I recovered. I want the message to be one of hope."
What did it feel like, that time of darkness? "It's not that easy for me to recall it," she replies. "I'm not Bill Styron," she says, referring to the writer who chronicled the harrowing details of his depression.
Certainly we've come a long way since Thomas Eagleton was forced off the Democratic ticket in 1972 after revealing he had been treated for depression. But as Tipper Gore's reticence about her experience shows, we still have a long way to go.