Presidential candidate Rep. Seth Moulton, D-Mass., and Sen. Tina Smith, D-Minn., recently delivered confessions that are rare for members of Congress: They once struggled with and were treated for mental health conditions, he for post-traumatic stress disorder and she for depression.
Discussing such problems out loud is a gamble in politics, and over the years few others in Congress have been forthcoming, but the chances are high that a number of politicians have faced mental health problems. An estimated 47 million people in the U.S. in any given year struggle with conditions such as anxiety or depression. Of those, 11 million have more serious conditions such as bipolar disorder or schizophrenia, according to the National Alliance on Mental Illness.
Among the members of Congress who have shared their diagnoses are Rep. Ruben Gallego, D-Ariz., who started speaking openly about his PTSD after he was elected in 2014, and former Rep. Lynn Rivers, D-Mich., who shared in 1994 that she was successfully being medicated for bipolar disorder.
“There certainly are more than three or four national legislators who have problems, and I’m sure that there are many who suffer silently because they worry about political backlash,” said Darrell West, vice president and director of governance studies at the Brookings Institution.
Mental health-related epithets are sometimes still used by politicians against their enemies. President Trump has called his critics “crazy,” “psycho,” and “nut job,” and Democrats have dismissed the president as mentally unfit for office. For example, House Budget Committee Chairman John Yarmuth, D-Ky., is planning an event in July in which psychiatrists and experts in other disciplines will testify about how they believe Trump’s mental state makes him dangerous to the country.
“I’m very much shocked when a lot of my fellow Democrats level that kind of attack against the president because I think that plays unwittingly toward the whole stigma around mental illness,” said Patrick Kennedy, a former congressman from Rhode Island. “No one wants to really be compared to the president.”
The cautionary tale about mental illness that haunts politicians is that of Thomas Eagleton, who was dropped from George McGovern’s presidential ticket in 1972 after only 18 days because it was revealed he had received electroshock therapy for depression.
Politicians who don’t seek treatment for mental illness have struggled to keep up with the demands of their careers. Last year, Democrat Jason Kander had to drop out of the Kansas City mayoral race to focus on treatment for PTSD. Former Rep. Jesse Jackson Jr., D-Ill., resigned from Congress in 2012, saying he needed to focus on treatment for bipolar disorder, in addition to the federal investigation into his misuse of campaign money, for which he later pleaded guilty. The late Rep. Karen McCarthy, D-Mo., sought treatment in 2003 after she fell down in a House office building while drunk, and her family revealed after she died that she had bipolar disorder that had gone undiagnosed.
“It’s a very stressful job even under typical circumstances,” West said. “If you put mental health issues on top of all the other job pressures, that is very challenging.”
Kennedy, son of the late Sen. Ted Kennedy of Massachusetts, knows how difficult it is to be in office with an untreated mental health condition. His constituents had long known about his struggles, but the Washington crowd learned about them in 2006 when, in a prescription drug-fueled haze, he crashed his car at 2:45 a.m. into a barricade by the Capitol.
“I never chose to be out,” Kennedy said, reflecting on the diagnosis of addiction and bipolar disorder. “I thought I kept my illness under wraps, and that’s the big problem with stigma today is that we shave the truth here and there, and next thing I knew I was getting another DWI. … Secrets make you really sick.”
After that, however, something unexpected happened: People were cornering him regularly on the campaign trail, whispering that they were on the antidepressant Prozac and swearing him to secrecy. Kennedy believes this was probably because he not only had a mental illness, but he had long been working in Congress to pass legislation that would help others who were affected.
Though he was easily reelected after the accident, Kennedy had to resign a few years later after his father’s death.
“It just became untenable for me,” he said. “I was fortunate to have enough insight to know that I wasn’t going to be able to continue on.” He was able to get sober, receive treatment, and continue advocating in the field.
Psychiatrists interviewed for this article agreed that most people with mental health conditions who get treatment can do well, but noted that many people don’t seek help because they’re worried about how they’ll be perceived. As a result, their condition can get worse.
For politicians, there’s always the risk that seeing a therapist or taking an antidepressant will become a liability if it gets out. Smith faces an election in 2020 for her seat, which she filled after Al Franken vacated it amid sexual misconduct allegations.
“People use anything they can find against their opponent,” said Arash Javanbakht, assistant professor of psychiatry at Wayne State University School of Medicine. Most insults, he said, are “rooted in ignorance or misinformation.”
He added, however, that he believes substance abuse or having a personality disorder would be most worrisome for a leader because they impair judgment.
Charles Nemeroff, acting chairman of the psychiatry department for Dell Medical School at the University of Texas at Austin, said he thinks public attitudes would still pose a significant obstacle to anyone with a history of mental illness seeking the presidency.
“I don’t think it would do any presidential candidates a lot of good to say, ‘I suffered from depression, and I have thought about suicide,'” he said. He warned that deciding whether a candidate qualified for higher office because of a certain diagnosis, as some experts and policymakers have proposed, was a slippery slope.
“We all agree if you were hearing voices or seeing things that weren’t there, that would be a problem, or if you were in bed all day, every day, because you were depressed and you only thought about suicide,” he said. “But between those two extremes there is a lot of ground there. That’s why it’s so complicated.”
Kennedy said ultimately mental health still doesn’t get the funding and attention it should, which builds into public perceptions.
“There is still a feeling that these illnesses are not well managed, and that makes it difficult for people to admit they have one of these illnesses,” Kennedy said. “The impression people will have is that someone is still really sick.”
Asked whether he could see someone with bipolar disorder openly running for president, Kennedy replied: “I can’t, I’m sorry to say. … I think it may take a little time.”
