Fetterman’s disclosure is a paradigm shift
The office of Sen. John Fetterman announced last Thursday that the Pennsylvania Democrat had checked himself into the hospital for treatment of depression. This courageous disclosure marks a long-overdue paradigm shift to regard mental health conditions the same way we do physical ailments.
It might surprise people to learn how common depression is. The Centers for Disease Control and Prevention reports that during the pandemic, more than 41 percent of Americans experienced recent symptoms of a depressive or anxiety disorder. The National Institute of Mental Health estimates that 21 million adults — about 8.4 percent of the population — had at least one episode of major depression in 2020.
These numbers are comparable to the proportion of American adults diagnosed with hypertension (about 47 percent) or diabetes (about 13 percent). Yet there is a deep stigma that prevents our society from regarding these mental health conditions with the same compassion and urgency as other common ailments.
Not long ago, a diagnosis of depression was disqualifying for political office. In 1972, Missouri senator Thomas Eagleton was forced to withdraw as the Democratic nominee for vice president after reports emerged that he had been hospitalized for depression years before. And as recently as 2019, Rep. Seth Moulton (D-Mass.), a former Marine, described it as a “political risk” to share his own struggle with post-traumatic stress disorder.
As the crisis of the opioid epidemic and related “diseases of despair” rose to public attention, political leaders have spoken about behavioral health in more personal terms. Still, the stories they told were generally about others — friends, family members and constituents. On the rare occasions they spoke about their own challenges, it was in the past tense as a problem they successfully overcame.
The implication is that if someone has an active mental health condition that requires treatment, they would be unfit for elected office. This pervasive stigma makes Fetterman’s public disclosure all the more commendable.
Fetterman didn’t have to say that he was hospitalized for depression. Just the week before, he was admitted to the hospital for lightheadedness to rule out a stroke since he had already suffered from one during his 2022 campaign, where he was also diagnosed with an irregular heart rhythm and an enlarged heart. His office could have been intentionally vague, saying he was going in for additional tests, continued observation and medication adjustments. No doubt, countless public figures have used such language to conceal their mental health diagnoses.
It’s possible this transparency is an effort to stem criticism similar to what he faced during his Senate campaign that he was not forthright about the extent of his stroke and heart conditions. Nevertheless, in choosing to be open about his depression, Fetterman is educating the public that depression is a medical ailment for which effective treatment exists. Most people with depression can be treated with medications, psychotherapy or a combination. Some require more intensive inpatient care. All have been shown to help control symptoms and give people back their lives.
I think it was also important that Fetterman’s team stated he has had depression “on and off” for years. The easy way out would be to attribute the depression to his recent stroke. It’s estimated that 1 in 3 patients that survived a stroke experience depression, so it’s important to be on the lookout for depression in this high-risk group and other patients with recent hospitalizations. But the mention of Fetterman’s history adds to the understanding of depression as a chronic disease.
Again, this is not dissimilar to physical ailments. Patients with hypertension or diabetes might be doing well for a while but then suddenly worsen and need an adjustment to manage their disease. That’s not a failure, nor is it a reflection of their will or strength of character.
The same applies for depression. Unfortunately, many people suffer from mental health conditions in silence. But these illnesses are not something they just have to cope with any more than people should have to cope with high blood pressure or diabetes without medical attention. There are treatments that work, and it’s okay to ask for help.
For those who want to seek treatment, a good place to begin is by speaking with your primary care physician. They can help you with an initial assessment and referral. Make use of resources through work or school, such as employee assistance programs or school counselors. The federal government has also launched 988, a 24/7 phone and chat hotline specializing in suicide and crisis help that can provide local resources for mental health and addiction support.
Fetterman’s office has said that he could be in the hospital for a few weeks. When he is discharged, I hope he continues sharing his journey. It’s one that millions of Americans can relate to. His path to recovery could give hope and finally normalize treatment for mental health conditions.
Leana S. Wen is a professor at George Washington University’s Milken Institute School of Public Health and formerly served as Baltimore’s health commissioner.