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By Newsweek Editors
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IN HIS LIVING ROOM ON MARTHA'S Vineyard, in the summer of 1985, CBS newsman Mike Wallace sat and listened to his friend, the author William Styron, talk about how depressed he was. He was so low, remembers Wallace, ""I was worried about him taking his life.'' But Wallace, who had landed in a New York hospital for depression just months before, didn't say a word about his private agonies. ""I was still in the closet,'' he says, ""even with my friends.'' This February, Wallace was on Capitol Hill, testifying about his mental illness with what is now his customary aplomb. ""I will take Zoloft every day for the rest of my life,'' he said in an interview last week. ""And I'm quite content to do it.''
In the last few weeks, talk of illnesses like depression and medicines like Zoloft have become almost routine on the Senate floor, as Congress debates a bill intended to make insurers cover mental illness the same way they do traditional ""physical'' illnesses like heart disease and cancer (page 23). Senators from across the political spectrum have told the stories of suffering that have prompted them to support the legislation: Sen. Alan Simpson about a niece who killed herself, Sen. Paul Wellstone about visiting his brother in a psychiatric ward.
Whether or not the bill becomes law, it is a landmark in the history of this stubborn, centuries-old stigma. Elected officials now feel safe discussing mental illness in the family -- though seldom their own problems. Even more powerful are the first-person accounts of patients themselves who have been there -- and back. While cheap confessions have become a staple of afternoon talk shows, many prominent Americans have now taken to telling their stories in the hopes that ordinary citizens can face their families, friends and, finally, the boss. In the last few years, Wallace and Styron have been joined by a growing list of those who've not only ""come out'' about their illness but have gone on the hustings. Since 1994, Academy Award winner Rod Steiger has traveled across the country, speaking about his eight years of depression, about pain ""so brutal, it flays you. It skins you alive.'' Singer Naomi Judd, Heisman winner Earl Campbell and ""Baywatch'' star Vince Van Patten have described panic disorders that trapped them inside their homes. Ted Turner has talked about his manic-depressive illness.
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The message: mental illness is a disease, not a failure of character. And a disease that, in many forms, has proven to be a tractable enemy. From chronic, low-grade depression that can quietly steal a life to the terrifying hallucinations of schizophrenia, there are answers. Life can become not only possible but pleasurable. The hope, says Bob Boorstin, a former Clinton staffer who has talked about being hospitalized for manic-depressive illness, is that the 1990s could be for mental illness ""what the 1980s were for alcoholism. That people will realize that it is a disease ... that, in fact, seeking treatment would almost become chic. [In the '80s,] Betty Ford was the place to be seen.''
That day may still be far off. But the climate is certainly changing. In 1972 Sen. Thomas Eagleton was knocked off the Democratic presidential ticket when he acknowledged that he'd been depressed, and treated with electroshock therapy. But when Newsweek, among others, reported last fall that Alma Powell, wife of a could-be presidential candidate, suffered from depression, she and her husband appeared at a nationally televised press conference and casually said it was so. ""My wife has depression. It is not a family secret,'' said Colin Powell. ""It is very easily controlled with proper medication, just as my blood pressure is.''
The new candor about mental illness is not just a product of our increasingly confessional society. As scientists have found ways to photograph the brain's activity and have developed more effective pharmacology, they have convinced much of the public -- and patients themselves -- that brain disorders are more a matter of genetics and biochemistry than of willpower or child rearing. In addition to Prozac, which treats depression and panic disorder and is now a household name, there is Anafranil for obsessive-compulsive disorder, clozapine for schizophrenia and, most recently, Depakote for mania. The National Institute of Mental Health says, for example, that 60 percent of people medicated for schizophrenia improve, compared with only 41 percent of patients given angioplasty for heart disease. Therapy has changed, too, from the daunting idea of endless years on a couch to a variety of treatments, often short-term, and as accessible as your friendly, talk-show shrink.
Still, going public is a complicated business. The support of family and friends is critical, says Boorstin, now a top aide at the State Department, as is successful treatment. Then ""you can say, 'I have this illness; watch me function.' You're sitting there in a suit and tie, looking normal.'' It also helps to be in the right field. The arts and Hollywood are probably the most tolerant. When Rod Steiger decided to go public two years ago at 69, he says, ""my agents went berserk. In this town, if people are unsure of you, your career is over. Everybody thinks, 'He won't be salable; he won't be marketable'.'' But Steiger wasn't blacklisted. His next feature is Tim Burton's ""Mars Attacks!''
Hollywood is cake compared with more traditional territory. Corporate America may be the least forgiving. ""Men go so far as to drive their secretary's car'' to an appointment ""and pay with cash for fear of being detected,'' says Steven Berglas, a Boston psychologist whose patients are high-powered business types. In the macho cultures of law and investment banking, he says, ""if you admit vulnerability, you're a pariah.'' For politicians, ""it's very realistic not to come out,'' says Kay Jamison, a psychologist and leading authority on manic-depressive illness, who spoke out for the first time about her own mania and depression in her memoir, ""An Unquiet Mind.'' Florida Gov. Lawton Chiles revealed that he was taking Prozac during his 1990 campaign only because his opponent insisted he release his medical records.
But for someone who has told lies and kept secrets for years, going public can give a stunning sense of freedom. ""I can say what I'm thinking. It's exhilarating,'' says Jamison. It can be almost as momentous for those who feel they can't afford the truth. Every celebrity who comes out is the instant confidant of thousands of strangers who write or call. After Naomi Judd appeared on ""Larry King Live'' recently, the reaction was ""unbelievable,'' she says. Locals gathered at her Nashville restaurant, Trilogy, even though she was out of town, her husband told her. ""He said you could see it in their eyes, the desperation. I've had people come up to me on the streets, in the airports, even one of the security guards backstage,'' all want- ing to share their stories.
Many of those stories will remain untold. Yes, the ""stigma'' is fading, says Styron, likening it to the once unmentionable cancer. But slowly. One best-selling author in his 40s with obsessive-compulsive disorder told News- week about losing years of his life, of leaving his apartment 20 times in an evening to go down and check the locks and lights on his car, prompting the curiosity of police. Now much improved, he has come out to family and friends. But, he notes, the only public figures who have revealed that they have OCD are Howard Stern and Rose- anne, ""not the ideal poster children.'' The problem: ""OCD looks weird. [The image of] a depressed person is just someone sitting around, looking sad. It's not like anyone wants to picture [their hero] standing in a shower for 16 hours'' because he feels contaminated. The best-selling author is an expert at what some in the mental-illness underground call ""passing.'' He plans to do it for the rest of his life.
A landmark federally funded study reported that about one in five Americans suffered from some form of mental illness during the course of a year.
NUMBER PERCENT OF MENTAL DISORDER (IN MILLIONS) POPULATION Anxiety: phobia, panic disorder, 23.0 12.6 obsessive-compulsive disorder Depression: manic-depression, 17.4 9.5 major depression, dysthymia Severe cognitive impairment 4.9 2.7 Antisocial personality 2.7 1.5 Schizophrenia 0.4 0.2 Somatization (hypochondria) 0.4 0.2 TOTAL: 40.4 22.1
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