Should mental illness disqualify a person from serving in high public office? Public perception is a different thing from a clinical assessment, of course. You know that stigma is still alive and well, when a member of Congress takes a leave of absence for treatment of “exhaustion”. Turns out, this time, that “exhaustion” is a quaint term for Bipolar Disorder, which used to be known as manic depression.
Rep. Jesse Jackson Jr. has chosen to clue us in. He is in treatment and getting better, but how are we doing? The media articulate our public anxiety. The AP notes that “there is no word on what this means for his political career.” ABC ran a header on August 14: “Illinois Congressman Could Be Healthy Enough to Return to Congress.” This reassurance only makes sense if we had doubts.
Nobody is pleased to have mental illness. But even today, in an era of abundant self care for stress, addiction, and chakra blockage – for the financially secure, anyhow – getting care for Bipolar apparently still requires greater discretion than, say, a digestive disorder. When Rep. Jackson’s psychiatric diagnosis was disclosed, after much public speculation, the family quickly offered a theory that it had been triggered by gastric bypass surgery.
The message is clear. Physical illness evokes empathy. Emotional illness still scares us. (For the record, clinicians have quickly pointed out that stomach surgery does not cause Bipolar disorder, though of course some people do go on giddy shopping trips afterwards, or get depressed, if they had counted on weight loss to transform their troubled lives.)
Can people with emotional problems be trusted with great public responsibility? Have you noticed that nobody asks this question about people with digestive disorders?
We have had some revealing experiences with politicians and emotional illness. In 1972, Thomas Eagleton was, briefly, the Democratic nominee for Vice President, until his colleagues discovered Eagleton’s history of depression. He was quickly replaced, when a doctor suggested that his depression might one day recur. Eagleton went on to serve 3 more terms as a US Representative from Missouri, and later became a professor of public policy. Ironically, according to Time Magazine at the time, 77% of the public said their vote would not be influenced by his history of depression.
Bipolar Disorder, like depression, is a mood disorder. Bipolar people are sometimes deeply depressed, and sometimes their mood is elevated, aka manic. Untreated, a manic person can experience self importance, racing thoughts, or impulsive choices they may later regret, and go for days with very little sleep. Some have mood swings, alternating between the two emotional states; some have both at the same time. Rep Jackson is apparently mostly depressed. Bipolar disorder is emotionally exhausting, but responds well to medication and therapy.
People with a Bipolar diagnosis, of course, often go untreated, and some of them are praised as creative geniuses, charismatic leaders, and workaholics. The people I worry about are those who don’t accept treatment, because they want to keep their manic symptoms, fearing they will lose their creative edge and our esteem, if medication calms their racing thoughts down. Untreated Bipolar people can overestimate how well they are doing; but then, a lot of people do that.
But can a Bipolar person tolerate the daily pressures of high elected office, and function? One such individual, Winston Churchill, managed a distinguished political career, in an era with little to offer by way of effective treatment. His inner demons were explained away, at the time, as an outcome of early parental neglect. Back then, his disorder didn’t have a scientific name. He was apparently a difficult man.
People with public lives, risk exposure of their private demons. An argument can be made that exposing a mood disorder to daylight is a healthier alternative for Rep. Jackson, than private shame. But going public does expose us to rejection. We banish others who remind us of our own hidden pain, don’t we? Someone intent on public service, never mind the Bipolar or the stigma, needs good personal support. Yesterday, CNN published an article called Going Public with Depression, with excellent links to blogs that provide it.
The National Alliance on Mental Illness (NAMI) offers useful observations about the barriers to success for people with Bipolar Disorder. Stigma leads us to see people only through the lens of pathology, underestimating their capacity to manage their inner lives, and maintain focus for the wild ride of political life. In short, their biggest problem may be our narrow perspective. Somewhere, there’s an app for that.