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CNN LARRY KING LIVE
Panel Discusses Treatments for Depression
Aired April 21, 2005 - 22:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
LARRY KING, HOST: It can make you kill yourself. Millions suffer from it. Many don't even know it. Tonight, battling depression, with Margot Kidder, "Superman's" Lois Lane on the big screen. Off screen, she's battled a bipolar disorder for years, and her last manic depressive episode made national headlines nine years ago. Country legend Tanya Tucker. Behind all her knock-down, drag- out tabloid headlines, she, too, has fought depression. Actress Linda Dano. Her husband and mother died within days of each other. She, too, suffered depression, and is now helping others beat it. Chad Allen, the actor and television star, was so depressed he thought about suicide. And Dr. Karen Swartz of the Johns Hopkins Mood Disorders Department.
This is an hour that could save your life, and we'll include your calls. And it's next on LARRY KING LIVE.
We'll start with definitions. We'll begin with Dr. Karen Swartz, co-director of the Mood Disorder Program at Johns Hopkins School of Medicine, the famous school in Baltimore.
What is depression?
DR. KAREN SWARTZ, MD, CO-DIRECTOR, JOHNS HOPKINS MOOD DISORDERS PROGRAM: Well, depression is a medical illness, and it can be defined by the combination of low mood, a change in physical symptoms, like your sleep, your energy and your appetite, but then also how you feel about yourself. Losing your self-confidence and losing your ability to feel positive about yourself.
KING: How does it differ from, I'm in a bad mood today?
SWARTZ: That's a great question. Because I think we have to see the difference between normal sadness, something we all have, and the kind of depression that's a medical illness. So it's the length of symptoms, it's the severity, but it's also the idea that these symptoms come together and stay for an extended period of time.
KING: How more easily treatable with the advent of anti- psychiatric -- of these drugs like Prozac and the like?
SWARTZ: Oh, antidepressants have made an enormous difference. We have so many options, that if we have one choice and it's not successful for someone, we have many options to try. And so it means that most people, thankfully, can be very successfully treated for their depression now.
KING: Do we know the cause?
SWARTZ: We don't know the exact cause. We have some hints that come from neuroimaging, like PET scans or MRIs, and from genetic studies. But now we're still trying to learn those things.
KING: Do we pretty much agree that it's some sort of chemical imbalance?
SWARTZ: Absolutely. Neurochemicals like serotonin and norepinephrine, are very important for the understanding and are important to the biology of depression. Btu their exact role in exactly how the medications work, we're still learning about those things.
KING: We'll talk with each of our guests. We'll be including the doctor throughout, we'll be including phone calls.
Margot Kidder, it's called bipolar. First, before we talk to Margot, what is bipolar, doctor?
SWARTZ: Bipolar disorder is different than depression in that you have two poles, and say, you can have both manic episodes, where you're very energetic, and you have tons of energy, no need for sleep, going a mile a minute. Those are the manic episodes. And then you also have depressive episodes, as I described before, with a low mood, no energy, feeling terrible about yourself, and sometimes having suicidal thoughts.
KING: Margot, when did this all begin? Can you place it?
MARGOT KIDDER, SUFFERED DEPRESSION FOR SOME 40 YEARS: I don't know. I suppose I was always quite moody. And I had my first suicide attempt at 14. I don't know how serious it was, but when you're 14 and you really want to die, something is definitely wrong. So the mood swings continued for me most of my adult life until, actually, about eight or nine years ago, when I had that last big public flip- out. And then I was able to get better.
KING: Refresh us. What happened that day and night?
KIDDER: Well, it was a combination of things starting to speed up way before the flip-out. And I didn't know enough in those days to check that speeding up. I didn't know enough to get the signs that, oops, I've stopped sleeping, this is really bad, I better do something about it. I've stopped eating, and I was actually quite enjoying the lack of need for sleep and food and was knocking back more caffeine. And eventually, you spiral out of control, and the sleep deprivation and the nutritional deprivation plays a great part. And pretty soon, you're psychotic. You can make pretty much anyone psychotic by removing sleep and food and adding a lot of caffeine and who knows what to their systems.
KING: And what did you do that night?
KIDDER: So that was a big crash out. And then, well, I was pretty wacky for a good week. I wondered around L.A. thinking the CIA was after me and found myself living among the homeless in downtown L.A., which is actually an experience I treasure, because I learned a lot from it. And then was able to come down, after I faked sanity in the loony bin in L.A., and flew up to Canada and was able to come down with acupuncture, and then was put in touch with an extraordinary man, Dr. Abram Hoffer, who has been curing schizophrenics with nutritional -- rather complicated but nutritional means, something called orthomolecular medicine, where you remove the toxins from the system and you replenish nutrients.
And so between the acupuncture and the orthomolecular medicine, I have not had an episode for nine years, which is a miracle if you're me. So I feel very good.
KING: Now, Dr. Swartz, her description -- that's not, for want of a better term, the kind of normal depression we hear about, right?
SWARTZ: Well, she's describing a manic episode. And...
SWARTZ: ... going up and have tons of energy, going out of control in many ways, as opposed to the depressive phase.
KING: But it is all depression.
SWARTZ: Well, in bipolar disorder, you have two very distinct phases. So it's both -- they're both mood disorders, but a manic episode -- there's very little depressive about a manic episode. Most people feel on top of the world, that they can do anything. They have -- it's the exact opposite of depression, actually.
KING: Chad Allen, the actor -- let me hold it, I'll get back to you, Margot. We will get everybody. Chad Allen is the actor best known for co-starring in the TV series, "Dr. Quinn, Medicine Woman." And he will also appear in "Cold Case" this Sunday night. What happened with you? You attempted -- did you try to kill yourself?
CHAD ALLEN, ACTOR, BECAME DEPRESSED, HAS HAD SUICIDAL THOUGHTS: You know, I never made what would classically be defined as a suicide attempt. My sister -- I have a twin sister -- she made several very real suicide attempts. However, I am familiar with what it feels like to feel suicidal, to want to die, to not be able to wake up in the morning and feel like I can't lift up my head, I can't get out of the house today. What am I going to do?
KING: How long does this go back?
ALLEN: You know, I first started -- since probably 12, 14 years old. I also started drinking alcohol and using drugs right about the same time. So for me, that was my first -- my first sort of coping mechanism I used. And when I finally got sober when I was 24 years old, I finally felt what it was I was hiding from. First, it was anxiety, which is kind of the evil twin sister of depression, and then those feelings of absolute just despair and sorrow, you know, I can't get out of here today, what am I going to do?
KING: You were in the closet, right?
KING: Did being gay, do you think, had anything to do with it?
ALLEN: Absolutely, we started a campaign...
KING: Absolutely yes?
ALLEN: Absolutely, had a lot to do with it. We started a campaign called the talk-about-it campaign, to address the issue of depression in the gay community. The gay community has an almost 18 percent, if not higher, instances of depression than the community at large. You know, people are always asking me, why is that? And I say, you know, I hosted the Tulsa, Oklahoma pride festival last year. I get in my car and I'm all set to go down the street -- Tulsa, Oklahoma is famous for its Christian protesters -- and one man was holding up a sign; the sign said "how come the community that calls itself gay has the highest suicide rate?" With almost no understanding of the irony that maybe it had something to do with him standing there holding that sign, you know.
The fact is, there's a lot of things that we've had to deal with, and coming out and being who I am, that's part of it. But it's been a tough battle.
KING: Dr. Swartz, does depression in the gay person mean they're depressed because they're gay, or they're depressed because of the way they're treated by being gay?
SWARTZ: Well, usually, when you have a stressful thing going on in your life, such as the process of coming out or dealing with the way people are reacting to that, what you're dealing with is the combination of a stressful life event with your underlying biology. And so, certainly not everyone going through that process would necessarily have depression, but it's enough of a stress that if you had that vulnerability that, in you, that it could come out, that the depressive symptom would come out.
ALLEN: In my case, my twin sister is not a homosexual. She had other issues going on.
ALLEN: She still has it. However, it's those societal factors, what's going on in your life, that contributed.
KING: Let me get a break. We'll get Tanya Tucker's story and Linda Dano's. More from your doctor and your calls. Our subject is depression and what to do about it. Don't go away.
(BEGIN VIDEO CLIP)
MIKE WALLACE, CBS NEWS: I've 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, and he did so much for me, through three episodes. 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 hang in there.
(END VIDEO CLIP)
(BEGIN VIDEO CLIP)
DICK CAVETT, MAY 1999: I think I said this in "People" magazine, that so many people said they can 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.
(END VIDEO CLIP)
KING: Linda Dano, the Emmy award-winning actress and television personality was diagnosed with depression following the deaths of her husband and mother. She's now a pain spokesperson for Support Partners, the national outreach program cosponsored by Eli Lilly & Co., and the National Women's Health Resource Center. Eli Lilly makes -- what anti-depressant do they make, Linda?
LINDA DANO, SUPPORT PARTNERS SPOKESPERSON: I'm not -- I don't -- Larry, hi. I'm not here to talk about that as much as I am what has worked for me. You had mentioned earlier about...
DANO: ...my husband and my mother both going, days apart from each other, and I was sad and grief-stricken. And then, all of a sudden, months into that, it became something quite different.
KING: You had no indication before the occurrences of the death?
DANO: No. No.
KING: So it was event-oriented?
DANO: For me, yes, but, as the doctor has said, depression comes in all sorts of ways that I can't even begin to tell you. And, for me, it was a hopelessness, and I didn't care about anything, and I had physical pain, down my neck and back, and my legs. I still have that, and I am in the throes right now of this illness and am working with my doctor to decide what it is I need to do.
But the single thing that has helped me is to reach out to friends. In my case, I have three girlfriends who have been my support partners.
KING: Do you take medication?
DANO: I may. I'm not opposed to that. I'm now, as I said, going through this. I'm sort of weighing that as an option. KING: You are depressed now, then?
DANO: Yes. Yes.
KING: This event-oriented depression, Dr. Swartz, common?
SWARTZ: Often, there's a trigger, that people will look in their life and be able to say, this seems to have tipped the balance and put me into the depression. And, unfortunately, sometimes that can be a major loss, such as a death of a loved one, but, alone, too, being such a large stress.
KING: Tanya Tucker, in Atlanta, the country music legend, has suffered from depression. She's the author of a book, "100 Ways to Beat the Blues." When did this start for you, Tanya? There's the book. When did this start?
TANYA TUCKER, MUSICIAN, AUTHOR "100 WAYS TO BEAT THE BLUES": Well, I have never really spoken about it. This -- this -- writing this book, I think, probably conjured up a lot of that, as I was speaking, a lot of interviews and doing these things, and speaking about it, just kind of brought it all back. And it's been about 10 years. I mean, I was -- I didn't know what was happening to me. I woke up one night and looked down at my daughter, Presley, and she seemed like she was so big and she was growing so fast.
And all of a sudden, I started getting a rash and just a feeling of -- I've never felt it before. I was so upset about it, I ran into the bathroom, and I looked in the mirror, and I looked -- and I had red splotches all over my body. And then I thought, you know, I have got to wake my mother up -- she was visiting with me -- and she'll know what it is. So, I ran in and I said, Mother, what am I going through? Something's happening to me. I don't know what it is. She said, hone -- she said, I know what's happening to you. You're having one of those panic attacks, and she said, but I've got one piece of advice for you. The only thing I can tell you is that it won't kill you. And that was -- you know, she said that's the last thing I can tell you, that it won't kill you.
From there, I got progressively worse. The more people told me that, you know, wow, you should be so blessed. Don't you feel blessed? And you have all this -- mansion and all these beautiful things. And I said, you know -- the more they told me that, the more depressed I got. At one point, I didn't get out of bed for, I think, three months, and I went down to the bottom of the hill one day and I had to call somebody to get me to come back up -- come pick me up because I couldn't physically walk up the hill.
KING: What helped you?
TUCKER: Well, I have a great saving grace, thank you, Dr. Shelton in Nashville. He doesn't see patients anymore. He does all research now, but he put me on some medication, Zoloft, and, I tell you what, a lot of people have had pros and cons about it, but it was my wonder drug. I don't do it any longer. It's been a long time since I've done it, but I'd actually start having one, going on a plane, I would just start to freak out. I was going to Tulsa one time, from New York, and I was going to do a show there, and I just knew I was going to have one on the airplane. And I didn't have any medication with me, so, I called my doctor, and he walked me through it. But it's the most horrible feeling. I've never felt anything so horrible in all my years.
KING: Now, Chad, you don't take any medication? Does it work for you?
ALLEN: No, I don't take medication right now. My sister does, although none of it's ever really been all that effective, and I think, to talk about treating the illness of depression, and leave out both the emotional and spiritual component is a recipe for disaster. I think that recovery from...
KING: But if medication would work, you'd take it, wouldn't you?
ALLEN: But I don't think it can only just be medication. To simply, just think that this magic can come in a pill is not even half the battle, and to go through this and not be able to talk about what's going on in the emotional front, it's not going to happen.
KING: Margot, what do you take?
KIDDER: I take a lot of vitamins. I take amino acids. I take minerals. I try and watch my diet. But, I don't take psychiatric medication. I think that the first thing the medical profession should be doing, when they have a depressed patient, is not immediately prescribing the anti-depressant, but rather, trying to find out if there's an organic cause under lying the symptom of depression -- and both mania and depression are symptoms that there's something wrong with your system. There's not a steel plate that separates your head from the rest of your body. So, that's what I do.
KING: Dr. Swartz, anti-depressants are wonder drugs that have saved many lives, haven't they?
SWARTZ: Anti-depressants are absolutely medications that have saved lives. The best way to prevent suicide is to treat depression, and we know that anti-depressants are, in many ways, the most tried and true treatment for depression, but, I agree that medicine alone is not the treatment of depression. It needs to be combined with psychotherapy, support from your family, learning about what you have, and also being responsible. So, that might mean not using drugs and alcohol, that might mean getting enough sleep and doing other things to reduce stress in your life.
So, it's not about simply taking a medicine. But, for most people with depression, it's a critical part of the treatment.
KING: We'll take a break. When we come back, we'll ask Linda, when she feels depressed, what happens? We'll take your calls in a while, too. Don't go away.
(BEGIN VIDEO CLIP) MARIE OSMOND, AUGUST 2004: The thing that's fascinating is that you could have depression and it could be your great-grandfather's, but it came through your cells. It just came through your DNA, and so, I think, sometimes people are wandering around so depressed, they don't know why. It's not their stuff. So, you know, who knows. Am I against medication? No. Am I against -- I think there's a lot of forms of nutritional benefits and things like that. That's what I've found.
(END VIDEO CLIP)
KING: We're back. Can you tell us, Linda Dano, what it's like when it hits?
DANO: Sort of like a train that comes around the room. And I hear it. And it's loud and it's violent. And its lights are blaring and I can hear the wheels. And it sort of just slams into me. I let it slam into me. And then I don't know how I really get up and go forward.
I know that, Larry, my support friends -- and that's why I came together with a National Women's Health Resource Center and Eli Lilly to bring this out, because that was a new program they were involved in. And it happened to be the same thing I was doing on my own. And it has made the single biggest difference, because you can do that initially for all those people watching tonight that are alone and so frightened and feel so hopeless, if you could just find someone to talk to.
KING: How do they contact that group?
DANO: They can go on to depressionhurts.com. And they will receive -- they can download three guide books that will absolutely change your life. It's not only for the person who is depressed and to learn about depression, to get resources, but it's also a little guide book if you know someone that you love and you think something's going on. It will show you what to say and how to approach that person so you can help them.
You know, in life, I think the most important thing is to reach out and for other people to reach out to you. And it's the one single thing that we can do that doesn't cost money. It's a matter of time. And it's not just emotional where they phone you and do all of that. A support partner is someone who can come over and bring you dinner or, in my case, my friend walks my dogs for me.
But when it hits you, depression, there is a kind of hopelessness where you just -- like everyone on the panel is saying, you can hardly get up. You have to really force yourself.
KING: So, it's depressionhurts.com?
DANO: Yes. There's also a number, Larry. You want me to give that? KING: Yes, sure.
DANO: Yeah. It's 888 -- toll free -- 818-7988. And I really urge people -- because this is like a little mini step you can do to help -- because it is an illness. And as the doctor said, it can be changed. You can have your life back again if you just make one step.
KING: We'll be repeating those numbers.
KING: Dr. Swartz, Tanya mentioned a panic attack. Chad was telling me during the break that he's had them. Is that part of depression?
SWARTZ: Anxiety and depression often go together. So, a panic attack is actually an anxiety disorder. There's a very high rate of anxiety and mood disorders going together. And panic attacks are terrifying. And just knowing what Miss Tucker's mother told her, which it's not going to kill you and that actually it's something that you can also get treatment for, but it feels like a heart attack.
UNIDENTIFIED FEMALE: Oh, it's so real.
SWARTZ: Part of the reason it's called a panic attack, people are terrified they're going to die or something terrible is happening.
UNIDENTIFIED FEMALE: Exactly.
SWARTZ: It's awful.
KING: Tanya, is that the way you felt? Tanya?
TUCKER: I'm sorry?
KING Is that the way you felt?
TUCKER: Oh, oh, it's just -- you know, I can't even describe the way I felt. Words are not even within me. They're not in my vocabulary to really express the kind of feeling that I had. It just -- I hope that -- I kind of -- with this writing this book, I took a lighter approach in hopes somebody would find -- at least one of the ways out of 100 to feel better in a lighthearted way. I do know it's just an epidemic in this country.
SWARTZ: Right. I agree with that.
TUCKER: And if I can help anyone out, I'm glad to talk about it. But the main thing is that medication, too, is not all the help. It's very important, I think, that you have a very well-educated doctor that knows what he's doing. And I know there's probably a lot that aren't so educated out there, but you've got to find the right doctor and have your family close by.
KING: Margot, you -- it's been nine years.
KING: Do you still feel you're a depressed person?
KING: Are you still bipolar?
KIDDER: No. No. The difference in orthomolecular medicine is -- and standard western psychiatry is that instead of throwing a drug on top of some symptoms, I'm actually have gone in with the help of some extraordinary doctors and found out what was causing the symptoms and corrected that.
There was something that Dr. Schwartz said, though, that was interesting to me, which is that I noticed when I was depressed, I was never depressed if I was genuinely relaxed. I could be sad relaxed and grief stricken, but I never felt depressed. And it struck me as very odd that when I used to be depressed, I always felt quite inert and immobile, but never really relaxed -- heavy, but relaxed. And acupuncture, actually and cranial-sacral manipulation are both really terrific to get me through that.
KING: I have to take a break, but Dr. Swartz, briefly, what do you think of that?
SWARTZ: I think that many people when they're depressed feel an anxiety or a tension. And I think it's true that it would be rare for someone in the midst of a depression to describe themselves as relaxed. It's a torturous ordeal for someone to go through.
KING: Are you saying if that helps her, it works then?
SWARTZ: Each person is going to find things that help them. Obviously, my experience is based on what helps the majority of people. And for the majority of people, it's a combination of medication and psychotherapy.
KING: We'll take a break. And when we come back, we'll go to your phone calls. I'll reintroduce the panel if you joined us late. Don't go away.
(BEGIN VIDEO CLIP)
KING: When you say you heard voices, can you describe what that's like? Because we read stories like that about people who -- what happens?
BRIAN WILSON, SINGER: Well, the voices say I'm going to hurt you. I'm going to kill you. I said please don't kill me.
KING: It's an actual voice?
WILSON: Yes, actual voice in my head.
KING: Not your voice?
WILSON: No, no.
MELINDA WILSON, WIFE: They're called auditory hallucinations. And if somebody's depression is deep enough, that's what happens to them.
KING: And at the same time, you're still writing songs?
B. WILSON: Yes. I can still write songs, yes, during that period.
KING: Write hit songs?
B. WILSON: Yeah.
(END VIDEO CLIP)
KING: Before we go to your phone calls, let's reintroduce the panel. In Pittsburgh is Margot Kidder, the actress who played Lois Lane in "Superman" movies, suffers from bipolar disorder, previously knows as manic depressive disorder, and has come through it extraordinarily well. In Atlanta is Tanya Tucker, the country music legend suffering from depression, the author of "A Hundred Ways to Beat the Blues." Here in Los Angeles, Chad Allen, the actor best known for his co-starring role in the TV series "Dr. Quinn, Medicine Woman." He's also been diagnosed depressed. He'll appear on "Cold Case" Sunday night.
In New York is Linda Dano, the Emmy Award-winning actress and television personality, diagnosed with depression following the deaths of her husband and mother. She's a paid spokesperson for Support Partners, a national outreach program, co-sponsored by Eli Lilly & Co., and the National Women's Health Resource Center. If you want more information on that, you can go to DepressionHurts.com, or call 1-888 -- it's toll free -- 888-818-7988. In Washington, Dr. Karen Swartz, MD, co-director of the Mood Disorders Program at Johns Hopkins School of Medicine.
Before we go to calls, Chad, you recently lost a close friend, right?
ALLEN: I did, yeah.
KING: He died suddenly of a heart attack at age 31.
ALLEN: Correct. Yeah.
KING: How did that affect what you already have?
ALLEN: Well, you know, it was a horrible event, you know. And the fact of the matter is, I know now that when stuff comes up for me that is going to create an emotional response, what I have to first focus on is not running away from my feelings. And that took me a lot of years to learn, that, A, it's OK for Chad to be sad. And this is what it feels like. And it sounds odd, but for me being sad was not OK, and I think a lot of times, the world that we live in, we're taught being sad, being angry, these so-called negative emotions, they're not OK. So, I started going, you know what, I'm going to take good care of you today, Chad. You're going to be sad for a while, and that's all right. Whatever it looks like, I'm going to take good care of you, and I'm not going to leave your side, I'm not going to run away from you. It helps.
KING: Is it doubly depressing, Dr. Swartz, when a person in depression gets bad news?
SWARTZ: It can be. It's interesting, because sometimes when people are in treatment -- I have had patients on medication that get very serious news, such as a cancer diagnosis, and sometimes it will trigger another depressive episode, and sometimes they do well through it. And so each time, you have to be vigilant, to pay attention to see if the symptoms are going to come back.
KING: Is it true that over 20 million people have it?
SWARTZ: It is. It's about 5 to 10 percent of men and 10 to 20 percent of women that some time in their life, will have a depressive episode, the kind of depression that's an illness.
KING: Albuquerque, New Mexico. Hello.
CALLER: Yes. I was wondering if the doctor or someone there on your panel could comment on chronic depression? I've suffered from chronic depression most of my life, off and on. My mother suffered from manic depressive illness -- now we know, but at the time, we didn't. And I just wondered if somebody could comment on that.
KING: Dr. Swartz, what's the difference between chronic and manic?
SWARTZ: Well, manic depressive illness is bipolar disorder. So it's having two kinds of mood changes, either up or down. Chronic depression, another word we use for it is dysthymia, that's having a low grade of depression all the time. Now, sometimes people have what we call a double depression. So they'll always have a low grade of depression, and then it can worsen for periods.
And so, the chronic depression is that it's always with you. Maybe not as severe as some of the descriptions we've heard earlier tonight, but that it's always there, interfering with your activity and your ability to function.
KING: Margot, when you're having a bipolar problem, is it happy when it's up?
KIDDER: Well, it is at first. It is until you start thinking the CIA is after you and trying to kill you. Then that's not terribly pleasant.
The initial part of it, the hypomania, which it's called in the textbooks, is often pleasant and often very attractive to other people. So you can make a case for all of our entrepreneurs, for example, our really successful politicians, for being somewhat hypomanic.
There -- and then it escalates and escalates as the system really gets seriously out of whack, and crashes into often a psychotic episode, which is what I had, where there are auditory hallucinations and a complete lack of sleep, and your reality fractures into a million pieces.
But the way up is often incredibly seductive. And boy, can you get your house cleaned fast.
KING: Dr. Swartz, lithium treats a lot of bipolar, doesn't it?
SWARTZ: Absolutely. Lithium is the treatment we've used for 50 years, so it's the most proven...
KING: It's salt, though, right?
SWARTZ: ... and the one we know the most about. It's a basic salt, not unlike table salt.
KING: Yeah. To Williamsburg, Virginia. Hello.
CALLER: Yes, hello.
CALLER: Larry, thank you for taking my call. Without much background, I would like to know from your guests, several of your guests have mentioned that there are non-medical methods to deal with depression. I have been dealing with depression for -- severely for four years. Please, can you ask what dietary methods and others that your guests are doing to help their situation?
KING: Chad, what do you do?
ALLEN: Dietary-wise, I avoid caffeine. Caffeine was a huge trigger for the anxiety that was coupled with my depression. Anything that brought me up was going to drop me right back down again.
The other methods that I'm specifically talking about are therapeutic methods, emotional things. I learned how to write and use those as a tool; communication was a great tool. There are herbal remedies that have been talked about a lot. I don't have a lot of experience with, but I have talked to friends that have had success with some of those ideas.
KING: Does psychoanalysis still work, Dr. Swartz, on the couch?
SWARTZ: There's a small group of people for whom that's probably the treatment of choice. But for most patients with depression, they're so severely affected that they're not able to really engage in that kind of intensive psychotherapy.
The other issue is that for some people that are taking medication, it's often a problem if they don't get an adequate dose of the medicine for long enough for it to really get a chance to work. Often, people have side effects, or they give up on the medication before they've had a chance to see if it's really going to be successful.
KING: We'll take a break and be back with more. Don't go away.
(BEGIN VIDEO CLIP)
KING: President Carter, have we come a long way?
JIMMY CARTER, FORMER PRESIDENT OF THE UNITED STATES: Well, I think we've come a long way. Certainly in research on the brain and providing medicines that were not available back when I was governor or even when I was president, Larry. But what this country needs most, and I hope what the next president will espouse and support, and what the Congress will do, is to have equality of mental health with physical health. There's no distinction between them. And so, this is something that needs to be done by the Congress with the full support of the president.
(END VIDEO CLIP)
KING: Before we take our next call, Tanya Tucker, there are a lot of celebrity types in your book that you mention that helped you. For example...
TUCKER: Well, many. We have about 70 different celebrities, from all walks of life, not just the entertainment industry, but the sports industry as well. I mean, Garth Brooks, Gretchen Wilson, Willie Nelson, Charles Barkley -- there are just so many different ways. I didn't -- I mean, I knew there was a lot of ways to get the blues, but I didn't know there were so many ways to get rid of them, and one more way -- if I can help somebody get rid of them -- have another way to get rid of them -- for them, that works, great.
KING: You mean, they all gave you their little insights...
KING: ...for what they do?
TUCKER: Mostly my friends, you know. Jeff Bodine was saying that when he gets depressed, that he cleans house. And, so, it's amazing, the different things that people will do, and what was so funny to me is that I really could relate, because I seemed to be doing these things that they were doing, actually, and without even knowing that I was doing them, because I was depressed. But I, you know, I wanted to say, too, that, I know Linda and Margot and both are really beautiful ladies.
UNIDENTIFIED FEMALE: Thank you.
UNIDENTIFIED FEMALE: Thank you.
TUCKER: They've always been such a vibrant spirit for me, and have always been so wonderful, and I wish them all the best. Come down to Nashville and I'll take you fishing.
DANO: Oh, I love it.
KIDDER: I'd love to, Tanya. I'm a big fan.
TUCKER: Go get 'em a cutting horse or two.
KING: Another call. Las Vegas, hello.
CALLER: Thanks for taking my call.
CALLER: I think it's fabulous that you're doing more and more shows about this. I'm a 30-year sufferer of depression.
DANO: Oh, gosh.
CALLER: And it's really for the doctor, my question is really for the doctor. There is absolutely no way that I cannot be on medication. When I go off, it cycles down. I'm high. I'm great, and then it's a spinning cycle down. Can you become immuned to like -- I was on Paxil for a long time and it just wasn't working anymore, and I really had to fight my doctor to change that medication, and I think other people should know out there, if that's a fact.
KING: Doctor, do you switch medication often?
SWARTZ: Well, you make sure you've given the medication a good chance, in the sense of getting to a full dose and staying on that, usually for four to eight weeks. But, if something has stopped working, it's as important that you try something else. You don't want to just keep with something that's not helping you, and there are so many good options now that it's important to move on to something -- to try something else. And it can happen that a medication that's been helping for, even a few years, can lose its effectiveness.
KING: Columbus, Ohio, hello.
KIDDER: Larry, sorry.
KING: Yes? Hold on. Go ahead. Go ahead, Columbus.
CALLER: Mr. King, I really want to appreciate -- I want to tell you I appreciate your show.
KING: Thank you. CALLER: First of all, it's 2005: is it hereditary?
KING: Dr. Swartz, it is, isn't it, we think?
SWARTZ: There's strong evidence -- for many people -- that there's a strong genetic component. We know that this will run in families, but it's more complicated than that, because, even with identical twins with bipolar disorder, if one identical twin has the illness, only about 50 percent of the time will the other twin have it.
So, it's genetics, but it's also interacting with the environment and life stresses. So, genetics are very important, and I have colleagues at Johns Hopkins that are working to find the genes behind these illnesses. But it's going to be a complicated story.
KING: Margot, is it you that wanted to say something?
KIDDER: I did. I wanted to say a couple of things to the woman who talked about going off her Paxil. There is a withdrawal from anti-depressants. It's well-documented, and it's documented also by the companies who make them, although they don't like to publicize it. They don't call it drug withdrawal. They call it discontinuation syndrome, but you will get depressed, unless you withdraw really, really slowly from any psychiatric drug, in particular, antidepressants.
And it's really important to know that, because it's quite dangerous, so, what I want to say is, I don't want anyone out there getting the idea that, oh, Margot got better without her medication, so I'll just throw mine out. If you throw your medication out and try and just -- like an alcoholic -- you will end up in the bin.
KING: Mike Wallace told me, Dr. Swartz that he doesn't have side effects. He'll take his medication for the rest of his life.
SWARTZ: You know, most people that have had a good experience say similar things. For many people, it literally is life-saving.
KING: Why not?
SWARTZ: Well, I'm a psychiatrist, you're going to get me to agree to that. For many people, especially people that have recurrent episodes of depression, we think that it may even protect them from future episodes coming back. And so, it's an individual decision, but there is a group of patients that really do the best, without question, by staying on medication long term.
KING: The Linda Dano method, doctor, of using friends, do you like that idea, kind of AA concept?
SWARTZ: I think that it's a wonderful supplement. I think when you are looking at what gets you through a day when you're feeling that way, that there is a combination of things, and I think that friends can be life savers. But I think it's that idea that there's a whole team. DANO: Right.
SWARTZ: So, you have a psychiatrist.
DANO: Right. SWARTZ: You have, perhaps, a psychotherapist or the psychiatrist doing the psychotherapy. You have friends. You have family. You pay attention to other healthy habits. So, I think they're critical. I just think it's very important to stress that they're not usually enough on their own.
SWARTZ: And, so, you want to do everything possible to help yourself feel better.
KING: One last...
DANO: I just want to add to that, what the doctor is saying, as well. See, I think there's millions of people out there right now who are so afraid to admit that they might have depression, that they don't know who to turn to, and I know if they take that first, initial step -- going to a doctor, getting a diagnosis and then reaching out and talking about it with someone.
TUCKER: They think it's a sign of weakness.
DANO: Yes, they do, Tanya. I agree.
TUCKER: That's the era we grew up in. It's weak to go to a psychiatrist.
DANO: Right. Exactly.
TUCKER: But you do need help.
KING: It might be safe to say -- it might be a good tip to say, if you think you have it, you probably have it.
KING: We'll be right back. Don't go away.
(BEGIN VIDEO CLIP)
MARIETTE HARTLEY, MAY 2003: 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 to some Al-Anon meetings to substitute alcohol for depression, if they're not alcoholics. I've found it to be deeply helpful.
KING: Take another call. Seattle, hello.
CALLER: Hello, Larry. Thank you for your show.
CALLER: My question, I guess, will be directed toward Dr. Swartz. I just wondered what the comparison to the United States' percentage, number wise, is to other nations in the world, particularly Europe, and does our lifestyle -- how much does our lifestyle in the United States contribute to these high number of depression and mood disorders?
KING: Excellent question. Doctor?
SWARTZ: That's a very good question. There are -- depression is a condition that's throughout the world. And while there's variation from country to country, it certainly -- it's not something that is dramatically higher in the United States compared to other countries.
SWARTZ: You could argue -- you could argue that our lifestyle may contribute and that there's a lot of stress or expectation, but I think that the issue is that it's a very common illness, the same way that high blood pressure is a common illness, or diabetes is a common illness. And so, when I think you have something common, it's easy to turn to our society and say that's the answer. I think biology is going to be more of the answer.
KING: Tanya how important is the caregiver? I know you have your daughter with you. She was important for you in this fight, right?
TURNER: Yes, she's very important. In fact, I have three kids. My 15-year-old Presley and 13-year-old Bo Grayson and, of course, Layla, who is with me now. They just -- come here. Say hi, say hi to Larry. They just make my life everything. Come here. Can you say hi?
UNIDENTIFIED FEMALE: Hi.
TURNER: Can you get her? Can you see her?
KING: I see her.
TURNER: Come up here.
This is what gets me out of depression really quick.
I think that's very important, family is so important. My parents were very important as far as helping me. My mother, she -- I hope that I can help my daughter if she ever has this kind of a problem, that I can help her the way my mother helped me.
KING: Chad, who helps you?
ALLEN: I've got a really close knit family. I got a great close group of friends, I got my friends and fellows in recovery that are a very important part of my life. And, you know, we love each other. We take good care of each other KING: Your gay friends, do they share a lot of this depression?
ALLEN: Yes, several of them do. Not everybody. My closest friends are my friends in recovery, because we can talk to each other about what we feel today and help each other through it.
KING: Margot, how important are the caregivers -- the relatives, friends of the people who are depressed?
KIDDER: Very important. And it's a very scary position for the caregivers to be in.
KING: No kidding. It's hard to deal with.
KIDDER: I think very difficult, particularly for parents of children. And I would pray they would resist the urge to initially put the kids on drugs without finding out what else is going on with the children.
But I think for parents and family members, it's very baffling. We're just coming out of the dark ages and we're just stopping seeing it as being possessed by the devils. So, I think given that, it's very scary for people. And they tend to go to an authority figure without questioning the authority figure and take what they say as God's truth and go with it as supposed to doing a lot of homework.
If I could, Larry -- if I could just say, if anyone is interested in how I've done it, please go to orthomolecular.org. Ortho means correct in Greek, molecular.org and there will be a lot of tips on there.
But family is really important. My grandkids keep me happy all the time.
KING: Linda, we know about friends who have depression. What about friends who don't, but have to live with you or be around you?
DANO: I bet it's hard. I can't even imagine how generous this is. And yes, being a caregiver or support partner is a job you just can't sort of do one day and then forget about it. You can't make a couple of phone calls and then drop that person.
Everyone said after my husband and my mom died that, you know, people would be around me for a while and then that would start to fade away. And it would be much harder, because I would be alone. That's just not happened in my case. I'm grateful to my friends.
UNIDENTIFIED FEMALE: You have been so great to your friends.
DANO: In such a profound way. TURNER: Linda, you're a great girl. You've been so inspirational to us.
DANO: Oh, Tanya, you're so sweet to say that.
TURNER: Really, it's true, though. You're just like a light in the room.
DANO: Well, I have to tell you something. I'm doing this campaign, because I've always spoken out for women, in particular. And I've always cared so much, because I think we have such a tough, tough road. We do so many things.
And I realized I was on another talk show right -- about three months after my husband died. And I spoke about him. And I got thousands of e-mails. And it was staggering to me how many people are suffering from depression. And I want to be there to say, hey, I've got it to, do what I'm doing, at least do that for your first step. OK. I'll be quiet.
KING: Hold it. I have to take a break. We'll repeat those numbers, by the way. Chad Allen is going to leave us. The panel, will remain. We only have a few minutes remaining.
You were able to act through the depression, though, right? You were able to act.
ALLEN: I was, absolutely. I still am. And it comes and it goes. And I have learned deal with it. And actually getting up and going to work and doing what I had to do. As long as I was being honest with what was going on with me, it helped me through it.
KING: And you'll be on "Cold Case" this Sunday?
ALLEN: This Sunday. I have a Web site, too, it's chadallenonline.com. We've just put up a page that deals with depression. It has some nationwide numbers you can call and to get some information on that too. So go ahead and check it out.
"Cold Case" a new series of detective films on TV coming out in the fall.
KING: Thank you, Chad.
ALLEN: Thanks, Larry. You're a good guy.
KING: You're a good guy.
KING: We'll come back with the rest -- with the panel for a few more moment right after this.
KING: Before we close shop, Margot Kidder, that's orthomolecular.org, right for more information?
KIDDER: Orthomolecular.org, right.
KING: Linda Dano, depressionhurts.com.
DANO: Correct. KING: And the toll free number for more information is 888-818- 7988?
DANO: Correct. Great. Thank you, Larry.
KING: And then the title of your book -- the title of your book Tanya, is "100 Ways to Beat the Blues."
DANO: Yes. And, also -- by the way, I want all three of you in my next book. We'll have a sequel.
I'll fly to Nashville to do that.
KING: More ways to beat the blues.
TURNER: But I'm also involved right now with building an orphanage in Sri Lanka with the Welcome Home International, our new organization.
TURNER: And also I'm involved with Larry Jones and Feed the Children over in -- we're going to Indonesia in June. And I'm looking forward to making my first Christmas album. So, that's what I'm doing.
KING: Thank you all very much.
Dr. Swartz, one other thing. If we've proven one thing tonight, there is hope, right?
SWARTZ: There absolutely is. Depression is a treatable, medical illness. There's a lot to do. It's a very hopeful message.
KING: Thank you all very much.
Margot Kidder, Tanya Tucker, Chad Allen earlier, Linda Dano and Dr. Karen Swartz of Johns Hopkins.
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