Depression and Political Campaigns Don't Mix

The Washington Post has a mildly interesting href="http://www.washingtonpost.com/wp-dyn/content/article/2006/06/22/AR2006062201952.html">article
about Douglas M. Duncan, who just dropped out of the gubernatorial race
in Maryland. Reportedly, he was diagnosed as having depression earlier
in the week, then decided to withdraw.

"It's time for me to focus on my health"

The decision was taken as an opportunity to discuss the problem posed
by the illness, the stigma, and the difficulties posed by the decision
to go public with the disclosure.  

"There is an enormous amount of stress to keep quiet,
and you just aren't able to get the same amount of support," said Johns
Hopkins University professor Kay Redfield Jamison. As a psychologist
who has battled bipolar disorder, she empathizes greatly with Duncan...



"We should applaud Mr. Duncan for what he's doing," not just in
recognizing his symptoms and need for help but in publicly discussing
them, said Oscar Morgan, a spokesman for the National Mental Health
Association. "It's not only a bold statement for him, but for others."

I couldn't agree more.  The more we see such public
disclosures, the easier it will be for others to get appropriate
treatment.



Self-disclosure is difficult for many people, even in the best of
circumstances.  When one is depressed, it is not the best of
circumstances.  Furthermore, there is likely to be a
relationship between difficulty with self-disclosure, and suicide risk.

href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=21403479">Relationship
between self-disclosure and serious suicidal behavior.

Apter A, Horesh N, Gothelf D, Graffi H, Lepkifker E.

Department of Psychiatry, Geha Psychiatric Hospital, Petah Tiqwa,
Israel.



The ability to predict which suicidal patient is at high risk for a
serious attempt is an important clinical problem. On the basis of our
clinical research, we hypothesized that self-disclosure may be an
important personality variable differentiating suicide attempters and
completers. We assessed 80 patients with depressive disorder, divided
into four groups of 20 each: suicidal ideation only, nonserious suicide
attempts, severe suicide attempts, and no suicidal behavior.
Comparisons were also made with 20 healthy controls. All subjects
completed Jourad's Self-Disclosure Questionnaire (JSDQ), as well as
scales measuring depression/anxiety and hopelessness. The lack of
willingness for self-disclosure significantly differentiated the
serious attempters from the suicide ideators and mild attempters. The
relationship of self-disclosure and more lethal suicide attempts did
not appear to be mediated by depression, anxiety, or hopelessness. This
preliminary study indicates that self-disclosure may be a promising
field for assessment, therapy, and prevention in suicidal patients.
Further studies are needed to investigate related variables, wider
patients groups, and the use of different instruments.

I am somewhat hopeful that high-profile disclosures such as Duncan's
will help in this regard.