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Panel Discusses Depression

Aired May 28, 2003 - 21:00   ET


LARRY KING, HOST: Tonight: depression. It can strike anyone at any time. You or someone you love may have it and not know it. It's a disease that can kill or destroy lives in its path. An intense hour on an intense subject by those who know how deadly it can be. Former first lady and mental health advocate Rosalynn Carter; actress Mariel Hemingway, battling the Hemingway curse that saw her grandfather, Ernest, take his own life and her sister, Margo, die mysteriously before her time; actress Mariette Hartley -- her dad took his life, her mom also attempted suicide, and she's battled her own demons; Dr. Kay Jamison, a leading expert on manic-depression, suffering with it herself for over 30 years; and former CNN CEO Tom Johnson. He ran the network while secretly battling depression.
An hour that might save your life is next on LARRY KING LIVE.

Let's first begin with definitions. We'll be including phone calls tonight. Dr. Jamison, you not only write about it, teach it and deal with it, you suffer from it. What's the definition? What is depression?

DR. KAY JAMISON, PROF. OF PSYCHIATRY AND JOHNS HOPKINS UNIV.: Depression is a biological illness that affects an awful lot of people. It's very common. It's very treatable. It's characterized by a real slowing down of everything, a tremendous depression of mood, and hopelessness and disinterest in things that people ordinarily find pleasurable. It's a terrible, terrible illness, a real disruption of sleep. But again, the good news is it's very treatable.

KING: Is it genetic?

JAMISON: It is. It depends on the kind of depression. There are a lot of different kinds of depression, but certainly, there is a very strong genetic component, particularly in the more severe forms of depression.

KING: Rosalynn Carter, what got you interested in this as a topic?

ROSALYNN CARTER, FORMER FIRST LADY, MENTAL HEALTH ADVOCATE: I became interested in mental health issues when I was campaigning for my husband for governor many years ago. And when I said that I might work on mental health issues, I had a handful of advocates just pounced on me and said, We need you. And that was -- oh, that was 1971.

KING: Of all of the mental health illness, Rosalynn, is depression the most common?

CARTER: I think Kay might answer that better than I can. But yes, I think it is. And depression now is the No. 2 cause of burden (ph) disease in the United States. By 2020, it will be the No. 2 cause of burden (ph) disease in the world. So it's so prevalent and it's so important to educate people and let them know what Kay said, that mental illness, depression, is treatable, and people don't have to suffer from it.

KING: Tom Johnson, how did you know you had it?

TOM JOHNSON, FORMER CNN CEO, HAS BATTLED DEPRESSION: Larry, I felt very down over a prolonged period of time. I lost interest in many of the things that I loved doing most. I found myself withdrawing from people and from events. I just -- I felt a prolonged period of sadness. And it took my wife, Edwina (ph), really, to recognize I was not the person I had been and to take me to a medical professional.

KING: While it was happening, did you wonder what it was?

JOHNSON: I did. I did not know what was happening. I tried exercise. I tried dieting. I did not know what it was. I was having a tough time getting up out of bed. And I tell you, it really permeates you in a way, Larry, that can affect almost everything that you try to do.

KING: Mariel, how did you know.


KING: You had depression. How did you know you were depressed?

HEMINGWAY: Well, I have not suffered from depression myself, but my entire family has suffered from depression and...

KING: So you've been around it.

HEMINGWAY: I've been around it a lot in my life, and I spent a great deal of my life trying -- being afraid of it, quite frankly. And I believe that environment and lifestyle and nutrition and things have a lot to do with setting it off, if you don't have it yet. But I think there is the ability to keep it at bay.

KING: Your grandfather died of the ultimate result of depression, right, suicide.

HEMINGWAY: Absolutely.

KING: That's the final blow of depression. Did he know he was depressed?

HEMINGWAY: You know, he'd been at the Mayo Clinic. I think he -- yes, I think he certainly -- I don't know. Does one know if they're depressed? I know that he couldn't write any longer, and his passion in life was writing. And he was no longer able to do that, and so he took his life.

KING: Mariette, how did you know you were?

MARIETTE HARTLEY, ACTRESS, HAS BATTLED DEPRESSION: Well, I, like Mariel, had come from a family that was riddled with mental disorder and depression and manic depression. And it really wasn't until I was in the middle of a divorce, a 20-year marriage, kind of cracked, and I found myself sobbing on street corners in New York and doing a comedy at night -- making people laugh at night and sobbing during the day. And I had no idea what it was, and it really took a friend of mine to say, Get yourself to a doctor. This is something that is treatable.

I think one of the problems with people that mask depression with alcohol, which was certainly true of my father, is that he didn't know, really. He had no idea. And when you're the adult child of two alcoholics that are also mentally ill, you are defending against their defense against mental illness. So it took me a long time to even realize that they were struggling with mental illness.

KING: Dr. Jamison, what is the first thing someone should look for? I mean, how do we define it between having a blue day and being depressed?

JAMISON: Well, I think -- it tends -- when it goes on for more than a week or two, for sure, and also just the severity of it. And if you have any question at all, it's a lot better to go to a doctor and get it checked out and find out you don't have it, or that you do have it, and do something about it, rather than to do nothing at all, so...

KING: And what does the doctor do when he checks you -- how does he know?

JAMISON: Well, he or she would know by taking a very extensive history, and that would include a family history because of the genetic basis. It would include a history of the symptoms, what kind of symptoms you had in terms of changes in thinking and sleeping and eating and energy levels. And then they would also check to see how long the symptoms have gone on and what pattern they had been and what kind of history you had of depression beforehand. So there are a lot of things that we know about depression, and a good clinician will be able to, you know, check that out. And it should be a very thorough and expensive history.

KING: No blood test for it, though.

JAMISON: Not yet. I'm sure it's just a matter of time until there will be, but a lot of things in medicine don't have blood tests. It's a question of history.

KING: Rosalynn, in your opinion, is there still a stigma attached to it, or has there been so much awareness that the stigma's erased?

CARTER: Oh, the stigma is still devastating. I think we're beginning to see a little glimmer of understanding among people about mental illnesses, but the stigma's still there. And people don't...

KING: Why?

CARTER: ... go for help, even when they know they may be depressed, because they don't want to be labeled mentally ill.

KING: Why -- with all the knowledge we have, why would a stigma still exist?

CARTER: I don't understand that. And so many people are affected, one in four, I think, in our country. And every family has someone who is depressed or a close family relative or a friend...

KING: One in four!


CARTER: ... who suffers from depression, so I can't understand the stigma.


KING: Tom? Yes? Was it Tom or Kay?

HARTLEY: That was Mariette.

KING: Oh, Mariette. Yes, go ahead.

HARTLEY: I think one of the reasons, from my point of view, is -- certainly, coming from my generation, when there was no help at all in 1963, when my father took his own life -- is that people feel that they can control their brains and should be able to control their brains. Stiff upper lip. Don't talk about family secrets. Don't talk about whatever is going on with you. We can now talk about cancer, which is also a disease. We can now, you know, begin to talk about alcoholism. But I'll tell you, mental illness has a stigma that is deafening. And one of the reasons I've become so visible about it, and I know people like Kay and Rosalynn have become so visible, is to say to people there should not be a stigma. I was sworn to secrecy for 35 years by my mother.


HEMINGWAY: Yes, with my family, it was the same. My sister suffered greatly under depression and bipolar...

KING: Yes, we did...

HEMINGWAY: ... and my parents didn't -- thought that that was ridiculous.

KING: Hide it.

HEMINGWAY: Oh, no. But they didn't even believe that it was happening. KING: We've just skimmed the surface. We'll be including your phone calls. We're going to take a break, and we'll come back with more. Don't go away.


BARBARA BUSH, FORMER FIRST LADY: I could have gotten help, but I was too sort of proud to get help. And when George -- he was the only person I told. I didn't tell Andy Stewart (ph), my closest friend in the world. I didn't tell anybody.

KING: What's depression like?

BUSH: Awful, painful. And it really physically hurt.

KING: It's been described that no news is good news, that nothing can please you when you're...

BUSH: Well, I wasn't maybe quite that bad. I mean, I faked beautifully. I mean, I faked through it.




TIPPER GORE: In the wake of Littleton and the shooting, there were so many kids that said, I know people who are depressed. I know friends of mine who are depressed but who won't come forward because they're afraid of being labeled. And with all of that, I thought that if I tell them that I myself suffered depression, was diagnosed, was treated successfully, then I'll be able to speak very directly to people. And if I can help one person, then it will have been worth it.


KING: Two former first ladies, Barbara Bush earlier and then Tipper Gore.

Tom Johnson, I would have to say anybody who worked for you knows that you were the most jovial, up-front, optimistic employer possible. Were you faking it?

JOHNSON: Larry, I hid from all but my wife, my executive assistants and a few very, very trusted friends my depression, both when I served as publisher of "The Los Angeles Times" and as chairman of CNN.

There is a terrible stigma attached to mental health issues. People are worried about losing their security clearance if they're in government. People are worried about being tagged as mentally unhealthy and not being able to get the job, not being able to get the promotion. We must eliminate the stigma, as we have eliminated the stigma associated with so many other illnesses. People can, as you've heard tonight, seek treatment, get treatment and get much better in 80 percent or more of the cases.

I kept mine secret, quite frankly, because you are expected to be a super-person in the workplace, to be a strong leader. And this is seen as a disease that means that you are in some ways weak.

KING: Yes. Dr. Jamison, isn't it hard, let's say, for the caregiver? You can accept the person with cancer, the person with kidney disease, but someone who's sullen or down, or every time you come into the room is crying or looking away, isn't that hard to deal with?

JAMISON: It is hard to deal with, but I think a lot of what's hard to deal with is if you don't understand it. I think we've come a long way in the last 10 years, the general public having some understanding that people aren't just being awful or lazy. I think there really has been. I totally agree that there's a huge stigma. Anyone who has this illness knows that there's a huge stigma. But I think it's less now than it was, and I think a lot of that is because of public education and that the public is a little bit more aware, at least, that this illness exists and that there are treatments.

And I think the fact that it's a treatable illness has gone a long way to destigmatize it. That's not to say that there isn't, you know, a huge, huge, huge way to go, but it's certainly better than it was.

KING: Does -- Rosalynn -- and by the way, I made Tipper Gore a first lady. She was a second lady, of course.


KING: Rosalynn Carter, does the government focus enough attention on it?

CARTER: No. No. The government does not focus...

KING: Why not?

CARTER: Well, I think it's kind of historical because -- and the stigma also goes back to when we didn't understand mental illnesses, we didn't know anything about the brain. Nobody knew how to treat mental illnesses, and so people were just kind of kept out of sight and shut away. That's totally changed. All that has changed today. And the government still does not focus as much attention on it -- on mental illnesses as it should. But the President's new Freedom (ph) Commission, hopefully, will again focus...

KING: Look at it.

CARTER: But still, Larry, with budget deficits, in states services are being cut back. Now, when we should be so excited because we can diagnose mental illnesses and treat them effectively, the states are cutting back services. It's really tragic.

KING: Do you, Mariel, fear the genetics of it? Do you fear your family got it, you're going to... HEMINGWAY: I no longer fear the genetics of it, but I've battled it through my lifestyle, through not -- I'm not a drinker. I don't -- I've never taken drugs because I've watched...

KING: Because of the fear.

HEMINGWAY: Because of the fear. Absolutely. And I tell my own daughters, who are 15 and 13, that they run the risk of possibly having that in their system, so that they need to have a lifestyle that -- you know, I'm not saying that that will prevent it, but I certainly that think that, in my case, that it helps it because I think, as Mariette was talking about, many people who suffer from depression and bipolar disorder and those kind of things mask it through substance abuse. And that's very -- you know, that's -- which is normal, but it's also -- it's hard to tell when somebody is -- is, you know, depressed or they've got an abusive tendency.

KING: Mariette, we don't understand suicide, do we? Anyone who knows a suicide always says, Why? Do you think we know why people go to that last resort?

HARTLEY: Well, it's always a question, as you say, and I think Mariel probably keeps asking the question. I certainly do. It's not -- I mean, it happened so long ago for me -- although I've had three suicides in my family. And the why is always there. I -- I like what Mariel said about the masking. It's interesting, when one finally does let go of an addiction is often when you realize that you do have this problem. You can't get it until you have gotten -- you know, pushed that away. And then the real terror comes in, which is what happened for me.

But who knows what it is? I know that it is a terrifying prospect. You know, I was there when my father committed suicide...

KING: I know.

HARTLEY: ... so that picture is with me and will stay with me forever. But my great joy now is working with other survivors, and that helps me -- as a matter of fact, I've wanted very much to speak to Mariel because what she doesn't know, I think -- I'm not sure exactly of her father -- of the date of her father's death, but my father had planned that two years after -- it was, what...


KING: It's her grandfather. Ernest, her grandfather.


HEMINGWAY: ... committed suicide.

HARTLEY: So that was what, that was 1961?

HEMINGWAY: It was '61. The year that I was born, actually.

KING: Earnest. HARTLEY: In 1961, July 2, right?


HARTLEY: My father committed suicide in 1963, July 2. He had planned it from the death of your grandfather.

HEMINGWAY: Oh, my God!


HARTLEY: And he even looked like your grandfather. So I've always wanted to meet you...


HARTLEY: ... just to hug you and hold you and say we're one of the same.

KING: Wow! Dr. Jamison, I was told by doctors that the most revolutionary drugs are the statins, with regard to cholesterol, and the anti-psychiatric drugs, the Prozac family.

JAMISON: Well, certainly, the antidepressants and the mood stabilizers like lithium and the anticonvulsants and all the antidepressive...

KING: Aren't they great?

JAMISON: They are great. They're extraordinary. They work extremely well with relatively few side effects. Sometimes people have bad side effects, but they're remarkable drugs and they are truly miraculous drugs. If you went to the back wards of state hospitals 40 or 50 years ago, they would have been filled with people who were just unremittingly psychotic and in agony. And we have medications now and psychotherapies that can really help people.

KING: Let me get a break and come back with more. We'll be including your phone calls shortly. Don't go away.


MIKE WALLACE: I recovered. And by golly, I figured I owed something. I have a remarkable physician here in New York by the name of Dr. Marvin Kaplan (ph) and he did so much for me through three episodes. Well, I owe it to let people out there understand, Larry, it can be treated. You can get better. And it is not all that difficult, if you will hang in there.


KING: Before we get to the phone call, Mariette, you witnessed your father's suicide two years after Ernest Hemingway, committed suicide, on the same day. What did that do to you?

HARTLEY: Well, it obviously changed my life forever. And oddly enough, in an extraordinary way -- I mean, Kay knows my story. So do you, actually, Larry. But I was, as I said, sworn to secrecy, but I also didn't really talk at all. And I was doing Westerns, so I heard nothing but gunshots all day long, and I knew nothing about post- traumatic stress. Nobody told me anything about post-traumatic stress. And I was very grateful on only one level, and that was the Vietnam war, for discovering and, you know, uncovering post-traumatic stress syndrome.

And it wasn't really until I did "Silence of the Heart," the movie about suicide, that I began talking to other people who were survivors, and that totally changed my life. And I really do say that, you know, many of us get to heaven by backing away from hell, and that really has happened for me.

KING: Yes.

HEMINGWAY: I really though I was going to die. I only wanted to die when Dad died. I only wanted -- and it wasn't just his death, it was also my mother's suicide attempt -- my mother's suicide attempt after that. And I was on the verge of a nervous breakdown and didn't know it. I had no idea. I was so unconscious about who I was and where I was, and that's changed.

KING: The subject is depression. Let's start to include some phone calls. London, England. Hello.

CALLER: Hello. I suffer from manic-depression, and over the years -- I was diagnosed about five years ago. And actually, because of the stigma, actually, (UNINTELLIGIBLE) with manic-depression (UNINTELLIGIBLE) actually (UNINTELLIGIBLE) friends and family from me -- from me. And so I have a feeling of isolation right now, which actually makes the depression worse. So I'm just wondering, how can we actually go about educating people about depression?

KING: Rosalynn?

CARTER: Larry, I've been working on that for a long, long time now, trying to let people know that mental illnesses can be diagnosed, can be treated, and people can live a fairly normal life, living at home, working. I see...


KING: It's a daily battle. Shows like...


KING: Go ahead. I'm sorry.

CARTER: I think the thing that would help more than anything for depression is to get parity passed through Congress in our country. That would legitimize the mental illnesses and...

HEMINGWAY: Don't you think also that...


KING: What were you going to say, Mariel?

HEMINGWAY: Don't you think also that it would be very beneficial to also get a program that -- in schools because I think there's a lot of young people that suffer from depression.

KING: Yes.

HEMINGWAY: And that is -- that's really when it hit our...

KING: Good thought.

HEMINGWAY: It hit our family when my eldest sister, Joan, was in high school. And it was triggered by some drug abuse, but there's a lot of depression in schools.

KING: Tom Johnson, should it be taught?

JOHNSON: Yes, it should, Larry. We need to do much more with our young people in the schools and through the various media.

KING: Because depression can hit at an early age, can't it?

JOHNSON: Depression can hit at a very early age. And I think, frequently, children don't understand what is happening to them.

KING: Yes.

HEMINGWAY: And parents don't understand it...


HEMINGWAY: ... when it hits the family.

HARTLEY: Yes. They're very hungry for it. I mean, I speak at schools all the time, and I know the everybody on the panel does, and they're hungry, they're starving to hear other people's stories. It's like sitting around a campfire and telling stories and having the fire get warm on your -- you know, on your face. It -- they so want to hear about it.

KING: Dr. Jamison, before I take the next call -- Doctor, what is manic depression?

JAMISON: Manic depression is when, in addition to severe depression, you also have mania, which is characterized by a very elevated mood or extremely irritable mood, paranoia very often, racing thoughts, very high energy level, not needing to sleep, buying a lot of things, a lot of very bad judgment. It's as speeded up as depression is slowed down, and it's even more associated with drug abuse and with alcoholism. I wanted to just say...

KING: Las Vegas. Hello. I'm sorry. Who wanted to say something? Hold it, Las Vegas. JAMISON: Oh, I just wanted to say something about education, that one of the things that Mrs. Carter's doing, that -- in addition to programs in the schools and colleges, which are much more common now than they used to be, though, again, a long ways to go, is that Mrs. Carter has a very effective journalism program, where young journalists come down or all different ages of journalists come down to the Carter Center and get fellowships to write about or present...


JAMISON: ... programs on television or on the radio. And it's been a hugely successful program. And Mrs. Carter, along with so many other things that she's done, has just done that so beautifully.

KING: Las Vegas, I'm going to put you on hold, and we'll come to you right after. I'm going to take a break, and come back. I'll reintroduce the panel, and then we'll get to as many calls as we can on the very important topic of depression. You're watching LARRY KING LIVE. Don't go away.


ART BUCHWALD: I get very lucky on the "Primetime" show because I was talking about my depression, and I looked in the camera and said, If you're out there, don't do anything. Don't do anything to hurt yourself because you're only going to hurt all your loved ones. And there was a lady who wrote me and said she had taken an overdose of pills, and she rolled over her clicker and I came up on the screen saying that, and she decided it was a sign. And she went to the bathroom and put her finger down her throat and whooped up all of the pills. Well, that's pretty good.



KING: By the way, one note, tomorrow night we were supposed to do a special 100 birthday tribute to Bob Hope, but his wife is under the weather so we're not able to do. That tomorrow night's guest will be Damon and Brenda van Dam, the parents of Danielle van Dam. Sunday night on LARRY KING WEEKEND a special tribute to Bob Hope, with highlights of past interviews. Let's reintroduce our panel.

Rosalynn Carter, is in Plains, Georgia. The former first lady, a prominent advocate for mental health, active for more than 20 years. Recently hosted from the Carter Center, "The Infinity Mind," a special broadcast about mental health airing on national public radio stations nationwide.

Here in L.A. is Mariel Hemmingway, her famous family has battled with mental problems. She's the author of new book, a memoir, called "Finding My Balance."

In New York is Marriette Hartley, the award winning actress now performing on "Cabaret" on Broadway. Her father committed suicide, her mother attempted suicide and she is co-founder of the American Foundation of Suicide Prevention.

In Washington is Dr. Kay Jamison professor of psychiatry at John Hopkins, she's one of the world's leading experts on manic depression. Her ground breaking book, "An Unquiet Mind" a major best seller.

And in Atlanta, Tom Johnson, the former CEO of CNN, former publisher of the "Los Angeles Time," last year publicly disclosed he's battled depression since the late '80s.

Let's go back to the calls. Las Vegas, hello.

CALLER: Hello, Larry and panel. I have two questions and just a short history. My parents committed suicide approximately 11 years ago. And I found them and my sister had committed suicide before that. I went into a deep depression so I know what the depression is. I know the post-traumatic stress syndrome and how you can stay in bed for months on end. And feel as if you're never going to get any better. My two questions, one is to Mrs. Carter and that is with all of the antidepressants and the ways of dealing with it and doctors helping, so many insurance companies either do not cover, have mental health coverage or it's minimal and with so many people...

KING: The second question?

CALLER: Pardon.

KING: And the second question?

CALLER: And I was going to say, with so many people without health insurance, they don't get any medication. So is there a way of dealing with, that with the government and the...

KING: Rosalynn. I'm sorry, I didn't mean to cut you and we have a lot of calls. If we stay with one subject -- I want to move through as many people as we can.

How about insurance companies and the antidepressants?

CARTER: That's why we are working so hard in the mental health community to get (UNINTELLIGIBLE) insurance. So insurance companies will cover mental illnesses just the same as they cover other illnesses. It's really important. And she can write to her Congress people. In fact, I hope everybody that's listening tonight will write to their congress people to legislators and senators, House members and the senators and to ask them or tell them to vote for (UNINTELLIGIBLE) insurance. Not only will it help people to need help, but also it will help overcome stigma because I believe if insurance covers mental illnesses, it will be all right to have them.

KING: Plainfield, Connecticut. Hello.

CALLER: Hi, Larry.

KING: Speak up!

CALLER: I would just like to ask the panel what they think would be one of the best medications for depression.

KING: There was any you recommend, Dr. Jamison or is that medicine on the air?

JAMISON: I think that it's a bad idea to do that. I think what's important to say is that there are a lot of medications. There are a lot of very good medications. There are a lot of very good psychotherapies. The combination of medication and psychotherapy is often better than either one alone. But we've got a lot of medications out there. And it's important to get to somebody who knows what he or she is doing.

KING: Without naming them. Do you take medication.

JAMISON: I have to name mine because it's not a brand name as it were, it's lithium, but I've taken lithium for decades. Yes.

KING: That's a salt derivative, right?

JAMISON: Yes. It's an element. It's out of the earth, right. It's organic.

KING: Tom, do are you on medication?

JOHNSON: I do, Larry.

KING: Do you think it will for the rest of the your life.

JOHNSON: I think I will. I mean it's given me enormous improvement. I find it no different than taking a medication for any other illness but this really helps.

KING: Marriette, you do?

HARTLEY: You get bet, do I. And mine was hard to find because I found out that I was also mentally bipolar, so antidepressants did not work for me. It took me a good year to find a combination of medications for me.

KING: Can some prescription, Dr. Jamison, lead to depression, taking the wrong one?

Not necessarily antidepressants but other prescriptions.

JAMISON: Certainly, there are some medications or some medications that are used with heart disease, for example, that can cause depression, Yes. And that's one reason why you should really go to somebody who knows a lot about the interaction of various drugs, but it's...

KING: Pharmacological.

JAMISON: Yes. Puzzle definitely to sort it out. It's just important to get a good doctor.

KING: Toronto, hello. HARTLEY: Larry.

KING: Yes.

HARTLEY: I just wanted to say one thing and I think the panel will agree with me, one of the things that I see when I speak to children or even people who are struggling with depression, that then get off of their medication because they're feeling much, much better. and i urge them not to do t. Not to do it because...

KING: Went off.

HEMINGWAY: Yes, my sister went through periods, actually Margo was never on medication, unfortunately. My eldest sister used to do that. She used to feel better and she'd feel that the medication she was take was not good and then she'd go off it. And she's have horrible episodes that it would make it worse to get back on the program.

HARTLEY: Well, there are side effects are sometimes difficult. , But I think what's happening today as a result of the research at the that we're doing at the AFSP and that many people are doing all over the country. Is that medications are becoming much, much more specifically oriented to that particular American person's brain and problems.

HEMINGWAY: That's why it's so dangerous to have poor diagnosis, it's like seeing a lot of bad medication, you know, good medication, Wrong...

KING: Toronto, hello.

CALLER: Hi, Larry.


CALLER: My mom is suffering from depression from a marriage breakup. She attempted suicide. Is there symptoms should I watch for to make sure that it doesn't happen again? I mean, I can't be there with her 24 hours a day, seven days a week. How can I help her overcome this?

KING: Doctor, what do you recommend?

JAMISON: I would recommend -- I think a great advocate of learning as much as you can about the illness if your a family member, and encouraging your mother to read as much as possible. There are a lot of good support groups out there. A lot of mental health advocacy groups and I'm sure there will be in your mother's community. So she can get support from those people.

KING: Can an event cause depression? A divorce cause depression?

JAMISON: Sure. It's usually in a person who is sort of biologicly predisposed to depression and then they get a second hit. They have a combination of stress and previous disposition to depression and that sets them off into a major episode.

KING: Let me get a break and come back with more phone calls. Don't go away.


MARIE OSMOND, ENTERTAINER: All I know is that anybody who goes through it, I have such incredible empathy and I don't know that I would have ever had that. I mean, I've had baby blues -- I mean, it's like you don't know what somebody goes through when they go through a divorce until you've gone through a divorce. And I'm telling you that depression is something that is is -- it's a very scary, dark place. It's dark. That's all I know how to say is that you see no light. There is just hopeless.



KING: By the way, I should note that although you may hear several drugs mentioned tonight, CNN is not promoting the use of any of the medications. You consult your doctor about medical use. Depression is a -- world health report says that depression is the leading cause of disability worldwide. Memphis, hello?

CALLER: Yes, hello, Larry.


CALLER: Hi, and hello to your panel.

KING: Hi. Go ahead.

CALLER: Yes, I have a question for Dr. Jamison.

KING: Go ahead.

CALLER: I was originally diagnosed with major depression in 1989, and has been on several antidepressants, and they seem to work for a while and then they stop. And I do a lot of reading and research on depression, and I recently ran across a term that I am not familiar with, and I was wondering if you could elaborate on it. And it's called drug resistance depression. Are you familiar with that, or have you heard that term?

JAMISON: Sure. It means pretty much what it says that a particular kind of depression is not responding to a particular kind of medication, but it can be misleading because one of the most common things that happens, for example, is that people are not taking enough of the medication, and one of the things in the consultation clinic, for example, doctors often find -- specialists find that the medication level is too low.

Sometimes it's just not the right drug. Sometimes the drug genuinely stops acting, though that's pretty uncommon, but usually most depressions are very treatable and they may just take a while to get the right combination, like Mariel was saying about herself, that it took quite a while for her to get the right combination of medications.

KING: Someone here mentioned how sometimes the word can be used casually, like I had a bad day, I'm depressed, but that can take away from focusing attention on real depression, don't you think?

CARTER: Probably. Yes.

KING: You know, people say casually, I had a bad day, I'm depressed. Northville, Michigan, hello?

CARTER: And you...

KING: I'm sorry, go ahead.

CARTER: You probably know they're not because say they wouldn't say it if they were.

KING: Correct. If you say you're depressed, you're not depressed. Northville, Michigan, hello?

CALLER: Hello?

KING: Yes, go ahead.

CALLER: Yes, I would like to know, I have two grandsons that have depression. One was smart enough to go to a doctor and is being treated and doing very well, playing golf and he's painting and doing so forth and so on. He can't -- they will not allow him to work because he can't work. Now, the other one is in denial, and I would like to know how I can help him to understand that he is depressed. He's taking alcohol to sort of hide this depression, and he's a beautiful, wonderful young man and has a lot of possibilities and, but I don't know what to do.

KING: OK, we get the gist. Tom, do you have any thoughts?

JOHNSON: I think the caretakers are so important to us, and in this case, I would just urge that either the caller or somebody close to him take him to a medical professional.

I was taken almost against my will, and I just think it's so important to get to that medical professional and do it as soon as you can.

KING: Mariel?

HEMINGWAY: The problem that I think is it's very difficult when somebody's in denial to make them believe, even though Tom said that he was taken almost against his will. Sometimes their will is very, very strong, and it's, you know, is it your place to -- and sometimes it leads to a rebellion. It's a very difficult issue to find that right way to get somebody to pay attention to their mental health, because there's the stigma and because possibly they've been on medication before, or they have some sort of substance abuse that prevents them from getting to the real source of their problem.

KING: Coburn, Virginia, I'm sorry, was someone going to say something?

HARTLEY: It's me, Larry. Marriette. It's devastating to watch a loved one go through this. It's equally as devastating to go through it, but to actually watch it happen is awful, and one of the things that I suggest because I also run groups through Didi Hirsch (ph) in Los Angeles, and one of the things that I suggest, because depression can run in the family, and one person can catch on and the other person can be in denial is to go some ALANON meetings, to substitute alcohol for depression if they're not alcoholics, and I found it to be deeply helpful.

I've had to really watch my own children, and I have intervened with them a couple of times when I've been kind of worried about it, are you depressed? Do you think you're suicidal? And to say the words out loud often to them to them kind of cracks them into ...


KING: Coburn, Virginia, hello?

CALLER: Yes, I had a question for the panel. I was wondering, I went through the state to get the health care, to get the mental health care, and they had put me on prescriptions, and I went to my therapist and stuff, and then they kind of stopped my medication for months, because I was getting it, you know, through the clinic. And you have such low self-esteem and so low self-worth that I felt that they didn't care.

KING: Why did they stop?

CALLER: For me, I had no clue.

KING: This was the state of Virginia?

CALLER: Yes. This was the state of Virginia.

KING: Did they cut back, Rosalynn?

CARTER: I imagine they have, because most every state has cut back. If it's the public health clinic, they probably just cut back on everybody.

KING: Are you getting it now, ma'am?

CALLER: It was just odd to me. I isolate myself. I'm more or less considered a hermit. I stay in. I don't deal with the public. I deal with the depression every day and...

KING: You don't go out?

CALLER: No. I don't go out.

HARTLEY: Do you know, there are support groups that are not just public support groups. There are also computer support groups, and for those of us who do isolate, often that's a very, very helpful way.

KING: Isolate is common?

HARTLEY: Oh, of course.

JOHNSON: Yes, we have a tendency to do that, and I just can't urge her to get out of there, get with friends, get with family, get with a medical professional, or to get to support groups. There are organizations that provide, without cost, support. Here in Atlanta, for example, Skiland Trial (ph) is a terrific resource, and others are being built. You are not alone. There's one out of every four women and about one out of every eight men, adults, suffer with this. And I just urge you to realize that those of us who have experienced it care about you. There are so many people in denial and dealing with this in secret. We need to do a lot more for people like you, and that's what many of us are trying to do tonight.

KING: I'll take a break and come back with our remaining moments. I have got to take a break. We'll be right back. Don't go away.


DICK CAVETT: I think I said this in "People" magazine, and so many people said they could identify with it, when you've got it, if there were a magic wand across the room on the table that would make you happy and give you everything you want, it would be too much trouble to cross the room and pick it up.



KING: Greshman, Oregon, hello?

CALLER: Good evening, Larry and the panel.


CALLER: I have been diagnosed with manic depressive illness and active bipolar. I've been on lithium for 19 years. It's nice see Marriette Hartley and the doctor again. Six years ago -- my goodness, a lot of questions I've been listening to the show have been answered. Larry, you asked the doctor if there was any foreseeable cure for manic depressive illness and she said nothing in the future. Do you foresee anything in the future now?

KING: Dr. Jamison, do you?

JAMISON: Yes, I hope I didn't say nothing in the future. I hope I said nothing in the near future because...

KING: That's what you said.

JAMISON: ... I think that there -- because it's a genetic illness, there's every reason to have a lot of hope that in fact there will be certainly much more specific diagnosis probably before too long. There are a lot of laboratories around the world that are trying to isolate the genes responsible for manic depressive illness.

And once that's done, then much more accurate diagnosis will be possible, and then after that, much more specific and accurate tailor- made, as it were, treatments. And then ultimately, probably a cure. I don't think that's out of the question at all. It just will be quite a while from now.

KING: A cure.

St. Clairville, Ohio, hello.

CALLER: Hello.


CALLER: Yes. I'm hoping that somebody can give me an answer here. I was diagnosed with depression when I was 30, I am now 43, but have been suffering from it most of my life. Through a divorce and the death of my father I wasn't able to handle things and cope can with them like I did before. I have not been able to work. I don't want to say I can't, I haven't been able to, I've tried. I've been on many medications, different doses. I've tried counseling, different counselors. I just -- I have not been able to get better yet. Is there -- what more I can do?

KING: Doctor?

JAMISON: I would just keep at it. I would get as many second opinions as you can. And I know that's easier said than done, but call your local university hospital, the medical school in your area. Call the department of psychiatry, the chairman of the department's office and ask for people who are super specialists in the area. And get a second or third opinion.

Now I know that is not always financial possible, but to the extent that you can do that, I would do that. And again I would take advantage of the support groups like the National Alliance of the Mentally Ill and the Depression and Bipolar Support Group because they will very often know the doctors in the community.

KING: Rosalynn, are you confident you are making headway?

CARTER: I hope so. I know that research is working and we know so much more about the brain now than we did and new medications and so forth.

As far as stigma, I think it is beginning to lift just a little bit. The program for fellowships, for journalists that Kay mentioned is one of the most successful we've ever had because the media has such an influence on what people think about mental illnesses and people with mental illnesses, we thought we'd try to develop a codry (ph) of journalists who knew the issues, could report accurately about them and have some influence on their peers. And this year we've had over a hundred applications. One is a Pulitzer Prize winner. We've been so pleased with the status of the people and more article and newspapers and magazines and so we're trying to educate people.

And, Larry, I would like to invite you to come to the Carter Center in September when this group of journalists report on what they've done. It's the most exciting day. Kay can tell you about it.

KING: I'd like to come. I'm fascinated.

We only have a minute left. Are you confident, Mariel, making headway in this whole field?

HEMINGWAY: Confident that they're making headway? I think they are.

KING: Are you optimistic?

HEMINGWAY: I'm optimistic. I would like to see people also focus a holistic health in regards to this issue as well. At least as preventative medicine, not necessarily to deal with the...

KING: Got 30 seconds.

You optimistic, Mariel -- I mean, Marriette?

HARTLEY: Yes, I am. I mean, the idea, the fact that suicide has gone down 10 percent within the last year, I think it's very very helpful.

KING: Thank you.

And, Tom, are you?

JOHNSON: Larry, I'm concerned. I'm particularly concerned when I see the cutbacks that are taking place at local, state and federal levels. I mean, we must not back away from the momentum that is building to try to address and successfully deal with depression.

KING: Thank you all very much. Rosalynn Carter, Mariel Hemingway, Marriette Hartley, Dr. Kay Jamison and Tom Johnson.

I'll be back in a minute to tell you about tomorrow night and the nights ahead. We'll add a little birthday wish too. Don't go away.


KING: Sports fans, it's Wednesday, don't forget to read my column, "Sports a La King." It's posted every week on CNN "Sports Illustrated" on the Web. The address get right to it is And it's interactive, so give it a read and send me your e-mails and I'll write you back in the weekly mailbag. Once again, the address, Log on tonight and let's talk sports. Happy birthday wishes today goes out to Rudy Giuliani, the former mayor of New York, recently married. I couldn't make his wedding. I was invited, but little Canon celebrated his third birthday and that held priority but, happy birthday, Rudy.


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