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Panel Discusses Depression

Aired June 12, 2005 - 21:00   ET


BOB COSTAS, CNN GUEST HOST: Tonight, battling depression. It torments millions, driving some to suicide. Here to share their stories, veteran broadcaster Jane Pauley, diagnosed with bipolar disorder just a few years ago after a reaction to treatment for a bad case of the hives. She spent three weeks in a psychiatric hospital.
Dick Cavett, the former talk show host has undergone electroshock in his fight against decades of depression.

Dr. Kay Redfield Jamison, not just a leading expert on manic depression, she's suffered with it herself for more than 30 years and nearly died in a suicide attempt.

And actress Marriette Hartley. Depression led her father to take her own life, her mother to attempt it, and she's battled it too.

They're all next on LARRY KING LIVE.

(on camera): It was profoundly clear to all of you from my first utterance that Larry King is not here tonight. I promise you he will return tomorrow. In fact, with Mary Tyler Moore.

I am Bob Costas, I will be sitting in occasionally for Larry, who has been kind enough to extend that invitation, so we begin tonight and we will bring in our entire panel shortly, but let's get some interesting broadcasting-related issues out of the way here with Jane Pauley, otherwise a good portion of our audience would wonder why we didn't.

You've just concluded a year on your own daytime talk show.


COSTAS: Many people loved it, but ultimately it didn't work out perhaps the way you had hoped.

PAULEY: Well many people still do because it is still on the air until August.

COSTAS: But you have stopped doing knew shows.

PAULEY: That's right. We stopped in mid March.

COSTAS: The experience was ...

PAULEY: Terrific. I really, really like it. Hardest thing I ever did, by far. COSTAS: Why?

PAULEY: Well, it -- you try to get a lot done with not enough people and I think our staff was game but too small to compete with Oprah and Dr. Phil. I was opposite "Oprah" and "Dr. Phil" in two thirds of the country and fortunately I didn't know that.

COSTAS: You didn't.

PAULEY: No, nor ...

COSTAS: Perhaps some research was called for.

PAULEY: Oh what, they would have told me and I would have felt better? No. I really loved working with an audience, I like the topics we did, I liked the demographic of the audience, were people that I would like to spend time with. And I really enjoyed it and actually our ratings -- We did better than Tony Danza. And Tony is picked up, so I hate to say ...

COSTAS: Why wasn't your show picked up?

PAULEY: It wasn't a success but I can't call it a failure.

COSTAS: Why wasn't your show picked up if the ratings were respectable enough?

PAULEY: Because, I think affiliates that bought the show at a premium were promised that we'd be competitive with Oprah. That wasn't going to happen and so very, very quickly, I think the writing was on the wall after six weeks or even a month that that wasn't going to happen and some stations put us on in the middle of the night and once that happens, then it became a matter of dignity and just doing it because you like doing it and that was enough for me.

I really wish they would have picked it up but I don't have any regrets, I loved it.

COSTAS: By and large people love you but even some of your fans thought that you might have been miscast. Can you see that in that role?

PAULEY: As myself?

COSTAS: No, not as yourself.

PAULEY: Jane Pauley as Jane Pauley, I don't buy it.

I think maybe in the beginning there was some daytime TV shenanigan kind of things, you know, your makeovers and so forth that I though we did well enough but it wasn't me. The shows that we did after, I want to say, December, they were me and maybe, by coincidence, the ratings actually went up.

So our ratings started to go up in December. We did a show featuring a cappella groups and my daughter happened to be, by total coincidence, in an a cappella group in college and that show was notable for a ratings spike and it really wasn't the a cappella, it had to do with people being home for Christmas, and the ratings really did from that point start to improve, so -- but, too late.

COSTAS: You will do more television, we assume, in the near future?

PAULEY: I don't know.

COSTAS: You honestly don't know?

PAULEY: I don't know.

COSTAS: If you're not in broadcasting, what might you do?

PAULEY: There is -- I am looking at a paperback version of my book.

COSTAS: Why, here it is, ladies and gentlemen.

PAULEY: But I write -- and at the age of 17 I had already coined a phrase, the things falling out of heaven theory, which in part explains the subtitle, "A Life Out of the Blue."

When I had reached some moment where I thought nothing good would ever happen to me again, and this was at 17, mind you, so some great things had happened to me even then. It was at that moment that something amazing would happen.

Well, I am kind of that moment where I believe that nothing great is going to happen. It is over. So it could happen.

COSTAS: What do you make of the present state of the morning TV wars?

PAULEY: I've been there, done that.

COSTAS: You went through it, teamed with Tom Brokaw and Bryant Gumbel against David Hartman and Joan London and whomever but if anything it seems even nastier and more intense now.

PAULEY: Well, the stakes are millions upon millions of dollars higher. But I have been on both sides, with the "Today Show" with Tom Brokaw -- there came a point where I felt like I had little dash marks across the back of my neck because David Hartman on "Good Morning America," which was new, was coming on strong and it was inevitable that they were going to topple the giant, which was us, and the enormous attention which was paid at the prospect of a giant falling -- Well, it did happen. We did become number two. A little scariness when we might have been close to number three.

Some years go by, Bryant Gumbel becomes my partner and "Good Morning America" has been number one for years and they are doing great only Bryant and I can feel the momentum and other people start to sense the momentum is turning and I think the happiest year of my life on the "Today Show" was the year before we were number one again and it was inevitable. It was so much fun being the number two horse and everybody knows we're coming on strong.

COSTAS: But it isn't going to be fun for Katie or Matt if they should fall to number, because that isn't number two coming on, that's number two with the arrow going the other way. No matter how successful and how much good work they've done all those years, that's the spin.

PAULEY: I think the fascinating part is that it features a duel between two women, arguably there isn't a news program kind of format more important than morning now. It's always been important, but what's new is that there isn't a more important, in terms of cutting edge of the news, in terms of being competitive and it's women, basically, at the top of both of those shows. Who would have figured that?

COSTAS: It's a good thing that women are at the top of both of those shows.

PAULEY: I think it's great.

COSTAS: But the way that those shows are analyzed and sometimes the commentary on the personalities or motivations of the people involved might have a tinge of sexism to it. A many might be hard- driving, a woman in that position is a diva, right?


COSTAS: I mean characterized that way.

PAULEY: Yeah. Though I have seen a picture of a man and he was called a diva, but it was kind of joke. The reason it was a joke was because of your point, proably.

COSTAS: But he was playing Vegas, it really didn't matter.

PAULEY: Yeah, but I mean, I'm not going to defend the people who write horrible things in the press, I mean horrible things were said about me too but these two women are at the top of the industry and I didn't think that I would ever see that and they are both very formidable competitors. I think they are tough personally but they are tough in a way that is still appealing to the audience. That's a trick. That is such a trick.

I guess it has to be. You have to be real to pull it off.

COSTAS: Last thing before we take a break and then we'll bring in the panel.

What do you make of the present state of what is still called television news, but more and more is dependent on the latest person from "The Apprentice" or "Desperate Housewives" or "Survivor"?

These shows have always had a light touch, Dave Garroway had a chimp. But this present dependence on the shallowest aspects of pop culture, this relentless pursuit of the most mindless and empty celebrity, that can't be good, can it? PAULEY: We aren't just talking about the morning shows.


PAULEY: We are talking about virtually all of them and we are driving people away from the news. I think we are eating our young. I read the newspaper. Newspaper you can read selectively. You can choose the paper you want to read and then you can choose the pieces you want to read.

With television you got to take what they are dishing out and I don't much like it and I know an awful lot of people who are losing the habit of watching the news.

When it also became -- When bias was defined as that which I disagree with, so unbiased met a television outlet that says absolutely nothing I disagree with. I mean, the news has always been -- there have always been newspapers that championed a point of view and I don't disagree with that. It's just not a pretty time. It's the things falling out of heaven theory. We are ripe for positive change.

COSTAS: Are you happy you are apart from it?


COSTAS: For the time being.

PAULEY: Yeah, I am very happy.

COSTAS: Had enough for a while?

PAULEY: Well, it's really one of the reasons I got out of the news magazine business was that celebrities as too much a part of the diet and I didn't think I was very good at that.

COSTAS: Jane Pauley is with us tonight. The rest of our panel, which includes Dick Cavett, Dr. Kay Jamison and Mariette Hartley will join us right after this break.


COSTAS: Bob Costas in on this Sunday night for Larry King on LARRY KING LIVE. We are joined in the studio here in New York by Jane Pauley and Dick Cavett, both of whom, in addition to their considerable achievements in broadcasting and elsewhere, have suffered with depression at various times in their lives, as has actress Mariette Hartley, who will join us by satellite and Dr. Kay Jamison from Johns Hopkins University in Baltimore.

And so we begin with you, Mr. Cavett, for the moment.


COSTAS: This has been a decades long battle with you and at times it's had you on the mat. It's been debilitating. CAVETT: Well, yeah. There are people that have had it much worse and at greater length than I have, surely, but it came as an utter total surprise when it first happened.

COSTAS: How long ago did it first happen?

CAVETT: You know I'm not sure I know. I think it had to be about the late -- early '70s, right in there. Maybe mid '70s. But I don't know when anything except Pearl Harbor was in my life so you're not being discriminated against. An inexact answer, but it came and it came in stages. It got harder to get up. It got harder to read. To read a paragraph and think -- I couldn't tell you a word that was in that.

I don't want to do much, what became of my desire to do all the things I like to do. They are empty, stale, flat and unprofitable.

COSTAS: Does that experience ring true to you, Jane?

PAULEY: The reading part. Before I was diagnosed, before I knew anything was wrong, I was still working at "Dateline" it became harder to prepare for interviews because reading was complicated and then after I was diagnosed, my husband gave me a copy of Kay Jamison's book and I couldn't read it.

Now I literally could read, but concentrating -- I could write. I could write nonstop but reading was a problem.

CAVETT: Well, we may differ in more ways than one but a strange form it took with me is that I could read with total comprehension a book on depression, but if I put it aside for Charles Dickens or Jacqueline Susann again, I could not tell you one thing. My eyes would have to go back to the first of the line. I couldn't tell why it wasn't going in, was the door shut to reading?

And the disease will do opposite things to people. Some go to bed for a month, almost literally, get up to pee perhaps. Rod Steiger talked about the fact that if he brushed his teeth it was a big day and other people can't sleep, and both the big "D" so you've got to have somebody who really knows what he is talking about and practicing the medicine part well.

COSTAS: Well, that would be Dr. Kay Jamison. Dr. Jamison, what Dick Cavett was speaking about and Jane Pauley, that's fairly common, the inability to concentrate, being constantly distracted.

DR. KAY JAMISON, JOHNS HOPKINS UNIVERSITY: Yes, and certainly what Dick Cavett was saying about just losing interest in all the things that ordinarily give you pleasure in life, the tiredness, the exhaustion, the lack of just pleasure, the inability to concentrate, real changes in sleep, and as Mr. Cavett was saying, also, when people have bipolar depression, very often they just sleep and sleep and sleep and people who just have major depression alone have difficulty falling asleep or staying asleep.

But you can see all kinds of varieties of problems with sleep and energy.

COSTAS: Make the distinctions for us if you can so that the layman will understand, depression is a generic term ...


COSTAS: But there are many different particulars.

JAMISON: Right. Well, depression, like everything else in life kind of moves along a continuum of severity and there are different kinds of depression. When we say bipolar depression or manic depression, we are talking about very severe depression along with a history of mania or mild mania where you have periods of extreme irritability, a lot of ideas, fast moving, fast talking, a lot of energy, not much need for sleep, whereas depression is characterized by almost exactly the opposite.

And again, particularly the tiredness. Many people who are depressed don't think of themselves as depressed but they will go to a doctor because they are exhausted and they feel fatigued.

COSTAS: Mariette Hartley, in your experience with depression, did you have those sorts of mood swings, the inability to concentrate, that sort of thing?

MARIETTE HARTLEY, ACTRESS: You know, mine came on suddenly also, as Dick was talking about. I was divorced in 1994, I was 54 and I was sobbing on street corners. I could hardly lift my head up. I was in New York, I was doing a comedy and not feeling very funny and I became -- I had suicidal ideation at the time because my father had committed suicide, there was a part of me that said, no, my kids aren't going to go through this and I finally got help and I had resisted help for a long time but the problem, and one of the things that is so important, is diagnosis.

When I went in sobbing, right, this doctor particularly thought it was only depression, so I was treated only for depression and some of those medicines are slightly dangerous for bipolar disorder. It took me a full year to get the proper medication.

COSTAS: What medication, Jane, has proven effective for you?

PAULEY: Well, what Mariette was saying about certain medications being dangerous for bipolar and I was 50 years old and had no history of bipolar to my knowledge in my family. I think it had to have been there. I think it almost always is genetic. But it just was never described. I didn't experience mania, I experienced that milder form, but the concentration, the ideation, many ideas, a lot of energies and then it segued into that irritability.

But mine was actually triggered by this treatment for hives. I had a very aggressive form of hives. Twice in the emergency room with potential -- this asphyxia, so I was treated with steroids for six months.

COSTAS: The anti-inflammatory kind. PAULEY: Exactly.

COSTAS: Not the kind that help you hit more home runs.

PAULEY: Anti-inflammatory.

Now, one doctor described steroids as a mood-loosener. If you have ever known anyone on them, there is this energy rush up and then you ladder down carefully and it can propel you into depression and it did me, not a major depression, just significant. That was treated with antidepressants for the first time in my life.

The combination of steroids and antidepressants in a person who had an unrevealed vulnerability to bipolar was not a good cocktail and that's what whipped me into the experience of bipolar, which I don't guess would ever have happened otherwise.

COSTAS: Dr. Jamison, I would guess that this is one of the most crucial but tricky aspects of this situation. People respond differently to different modes of treatment, sometimes therapy is part of it. Sometimes medication is part of it. Some combination of the two, and it is tricky to calibrate, isn't it?

JAMISON: It is tricky to calibrate. I think the most important thing is to say that depression in general, whether it is bipolar or just regular depression, is very treatable, and we know a lot about treating these illnesses. There are a lot of medications and there are very specific psychotherapies and particularly the combination of psychotherapy and medication is very effective but there is no question that it is very important to get the diagnosis right because if you don't get the diagnosis right, not only can you make someone manic or extremely irritable, but you can also set them on a course where the illness becomes very rapid cycling and much more difficult to treat.

But again, I think the important thing is first of all get treatment and secondly really check out who is treating you and the qualifications that the person has.

COSTAS: We have to ...


COSTAS: Go ahead. Go ahead, Mariette, quickly before break.

HARTLEY: Just a quick thing. It is so important for people to educate themselves, too. Kay's book is brilliant. Because we need to know what questions to ask when we go into a doctor's office. There are four stages of bipolar disorder. I am way down on -- I am probably on number three, which means the mania isn't high, high, and the depression for me was not -- I don't go into a deep, deep depression.

But what Kay talked about so bravely in her book was the hypersexuality, which I think very few people look at, which can happen, I think at a very early age, often. It is never diagnosed. It is not looked at. Gambling. Alcohol. There are so many ways that a mania will present itself that we often don't look at.

COSTAS: Mariette let me as you to hold that thought right there. But we'll pick up on the point that Mariette Hartley was making when we continue on LARRY KING LIVE after this break.


COSTAS: Bob Costas back, sitting in for LARRY KING LIVE. Dick Cavett, Jane Pauley, Mariette Hartley are with us, along with Dr. Kay Jamison from Johns Hopkins University School of Medicine. Professor of psychiatry there.

Mariette Hartley was making the point just before the break, Dr. Jamison, that various compulsions are part of this. Hypersexuality, gambling, a predilection toward alcoholism. Can you expand on that?

JAMISON: Well, yes. I think in general it is just a very uninhibited state. I mean there is a huge energy state and there is a sense of expansiveness and grandiosity and that anything is possible and that there aren't really consequences to what you do. It is a very dangerous state and if things like, classically spending a lot of money that people don't have. These things get people in a lot of trouble.

Telling people off, getting in fights, arguments, physical violence, there are a lot of things that go along with mania that are very disruptive and potentially damaging to other people as well as one's self.

CAVETT: Road rage.

COSTAS: Road rage, you were saying?

HARTLEY: Anything where -- I mean, if you do a PET scan, which I had to have, finally, of one's brain, is there is an enormous amount of blood that rushes to -Kay is it the left lobe or the right lobe, I always get confused ...

JAMISON: It's safe to say the whole brain is ...

HARTLEY: The whole brain. Okay.


HARTLEY: Right, the whole brain goes on fire. It's this rush. And someone in the studio asked me if I thought I had always been bipolar. I don't know. I always had problems with impulsivity. Always. And I also discovered at a late age that I was ADD/ADHD. Another member of my family is and what they are discovering now, and I'm sure Kay will correct me, they are finding out now that many children who are ADHD are also bipolar. There is something that is in there in the brain.

And listen, I am so grateful that there is help now.

COSTAS: Back here in the studio ... HARTLEY: But I have never felt more normal, more balanced ...

COSTAS: So you are doing well?

HARTLEY: I am doing better than well. I am doing wonderfully. Yeah.

CAVETT: Can I ask Kay a medical question? I read in somebody's account of his depression that the worst part of it was in the hypomanic state how badly his judgment was off.

JAMISON: Yes. Yes.

CAVETT: Decisions about life, I suppose that means. And I can beat this car to the corner, even.

JAMISON: Right and that is sort of a classic aspect of mild manner and severe mania. I think what makes it particularly dangerous when you are only mildly manic is that you don't have enough judgment to know that your judgment is off so people get really in a great deal of trouble, both with their husbands or wives, at work, in almost every aspect of their lives because they just -- the judgment simply goes.

COSTAS: Dick, what is the worst example of poor judgment that you can think of that you can now attribute to a depressed state.

CAVETT: Both in hypomanic, which I have had, and incidentally, one has to admit many patients say I am cured now, I am fine. But I must say I miss those hypomanic states. They are better off where they are.

I remember crossing Park Avenue and thinking the light has turned but I'm not even going to look to the right, I am just going to walk and assume that everything is going my way.

COSTAS: Is that bad judgment or is part of that maybe some sort of feeling that suicide wouldn't be so bad?

CAVETT: It didn't feel like suicide then. I remember driving into a two lane highway and thinking if I just steered into that oncoming car -- and what's amazing about that kind of feeling is that there is no morality to it. You don't think, but maybe that's a family of five.

What you think is it'll be better. Just utterly irrational. If I jump over the falls, it will be better.

PAULEY: That is why suicide is dangerous, because it is a total impulse. I got -- you said at the opening that I was three weeks in a psychiatric hospital. My ticket was punched when I told a doctor that I understood why a young woman I interviewed that Sunday thought she could jump off the Chesapeake Bay Bridge, and her family wouldn't miss her. She came from a very close family, and they came on "Dateline" to tell about this experience. And I explained to him, the doctor, that I -- I had imagined that something that -- the sky just opening up, and a person, not me, I wasn't talking about me, a person could go through it and just not be missed, that that's what she must have been thinking.

And the doctor is thinking, Jane is thinking about suicide. He didn't hear me say, "I'm thinking about killing myself," and I wasn't. He knew I was too close to the topic.

CAVETT: And you're not thinking about the other people. And so those who say, how could he do it? The suicide is always aimed at someone, someone said once. Not at all, no. If I'm gone, so what? Because nothing is any good.

COSTAS: We'll be gone, but only for a few moments. Larry King is not here, but thankfully, Jane Pauley, Dick Cavett, Dr. Kay Jamison and Mariette Hartley are, and we'll continue with our panel right after this.


COSTAS: If you're just joining us, I'm Bob Costas, and even if you're not just joining us, I'm still Bob Costas, filling in for Larry King tonight, and our guests in the discussion of depression and the various reactions to it and the ways that one might effectively treat it are Jane Pauley, whose memoir is now out in paperback, "Skywriting: A Life Out of the Blue." The former great talk show host, Dick Cavett, who has suffered from bipolar depression for quite some time. Dr. Kay Jamison, professor of psychiatry at the Johns Hopkins University School of Medicine, co-director of the Johns Hopkins Mood Disorder Center. Her books are, "An Unquiet Mind," and soon to come, "Exuberance: The Passion for Life." And the actress Mariette Hartley, who has also suffered from bipolar depression and is an honorary director of the American Foundation for Suicide Prevention.

Dr. Jamison, during the break, Jane and Dick were talking about how many acutely effective people soldiered on despite suffering from depression. Churchill dealt with depression. Abraham Lincoln dealt with depression. The people on this panel have gone about their business and done it very well, while suffering from depression.

JAMISON: Well, I think I don't know how well people do what they do. Sometimes they deal very well, and sometimes they don't. I think one of the things that's most terrifying about depression is how well you can look to the world. You can look like you're doing quite well, and in fact, be absolutely devastated and alone with feeling just dreadful. And it's one of the most deceiving things about depression, is that, I mean, all of us are brought up to present a good face to the world, and it's horrifying.

I mean, I worked in -- I have worked in academic psychiatry departments all of my professional life. My colleagues didn't know I was ill, so severely ill. And it wasn't a reflection on them; it's a reflection on the fact that people can be very, very ill indeed with depression, and if they try and keep it to themselves, to some extent some people can. And it's a very frightening thing. COSTAS: Well, Jane, you would be a classic case -- just one second, Mariette, we'll get to you in one second. Jane, you would be a classic case. The onset of your bipolar, at least the diagnosis of it, is fairly recent, but if you were ever having any troubles, you kept it pretty well disguised. None of your colleagues at NBC were walking around saying, hey, what the heck is wrong with Jane?

PAULEY: No. No, I was probably just embarrassed that I was not productive. And I never had -- the hyper mania I experienced was never of the kind that I would like to go get some more of that, and I'm sorry, you know, some people do. I've never felt that way about it.

So before this treatment, medication treatment flipped me I think is -- is actually the expression, flipped me into hypomania, I was suffering from depression significant enough that I would spend two, three hours a day napping, and I knew they weren't naps. And I just felt, why am I -- why am I not working as hard? Why am I not living up to expectations of people who didn't know I wasn't, but that's how -- how I felt about it.

But yes, I tried to keep it extremely private. I didn't -- I certainly didn't want my kids to know something was wrong with mommy.

COSTAS: But they didn't they pick up on it, in some way?

PAULEY: You know what, it's funny, everybody has times of the day when they may be better or worse. You know, the fog deepens or it lifts. And I would just need to take these naps during the depressive period. But too, by 5:00 o'clock, I would hear kids coming home from school, and I would feel better.

CAVETT: When you apparently snap out of it.

PAULEY: And I would get up. The rest of the evening, I was fine.

COSTAS: Mariette Hartley, you were about to say something. Go right ahead.

HARTLEY: Yeah, Bob, I -- I just wanted to say that one of the reasons that I've become visible and have been visible for so long, because I've been in the trenches of suicide prevention since about 1985, I believe there is no shame attached to this. I believe that there is no shame attached to mental illness or suicide, for that matter. And you know, I also work with a lot of sober alcoholics, and I discovered through my years of doing that that many people are biochemically different from their fellows long before they start drinking, and the drinking often is a way of balancing the bipolar disorder. And often it isn't until they get sober that they find that there was something perhaps underneath it.

Many of the 12-step programs -- and the reason I'm talking about this is I want so much for people to be there, watching television, say, not separating themselves from this, but saying, oh my gosh, maybe this is me, you know, maybe I'm doing this to cover something up.

Certainly both my parents were alcoholics, and mentally ill at the same time. So when you're an adult child of two alcoholics who are mentally ill, you're defending against their defense, against mental illness. And many of us in this country are like that.

And in the 12-step programs, often there is a tremendous prejudice about medication. And I think what they're promoting is a terrible, terrible thing, and I fight that all the time.

COSTAS: Dr. Jamison...

JAMISON: You've made a huge difference in that, and I think that a lot of the 12-step programs are more aware now than they ever have been about the overlap between, say, alcoholism and depression. I mean, we know for example that 60 percent of people who have bipolar have a significant history of alcohol and/or drug abuse. So it's a huge problem, and I think the fact that people have come out -- I know that Dick Cavett and Mariette and Jane Pauley, having been out there so public with their stories, and people like Mike Wallace and Arty Buchwald and so forth, Bill Styron. I mean, it really does make a difference that people hear that here's somebody who's done all right with their lives, to say the least, out there and you know, have been severely depressed and have gotten well.

COSTAS: Dr. Jamison, briefly, before we have to take another break, how prevalent is it? Roughly how many Americans suffer from depression, clinical depression, at some time or another in their lives, and what percentage of the population does that translate to?

JAMISON: Well, it depends on what study you read and believe, but probably the best estimate is one person in five will have an episode, at least one episode of major depression, and one person in 100 will have the severe classic form of bipolar illness, and another maybe 1 to 3 percent will have the milder form of bipolar illness. So what we know is that these are really, really common illnesses. They are among the most common illnesses that we know.

COSTAS: We'll take a break once more. The conversation continues, from New York and various other parts of the U.S.A. right after this.


COSTAS: And we're back, continuing our discussion of depression on LARRY KING LIVE. Larry, by the way, will be back tomorrow night, and his guest will be Mary Tyler Moore.

Continuing with Dr. Kay Jamison from Johns Hopkins University, you were saying that about one in five Americans will suffer at least one episode of severe depression; maybe one in 100, it will go to a true extreme.

There was a recent survey sponsored by the National Institute of Mental Health that said more than half of Americans will develop a mental illness at some point in their lives. Now, Dr. Paul McHugh, who is a colleague of yours at Johns Hopkins, said this: "Pretty soon, we'll have a syndrome for short, fat, Irish guys with a Boston accent, and then I'll" -- meaning Dr. McHugh-- "I'll be mentally ill."

Now, no one wants to make light of a serious problem, but there is some feeling that we're being overdiagnosed, and there is a syndrome for everything, and we may be mislabeling things in some cases.

JAMISON: Yes, I think, you know, I actually agree with Dr. McHugh on that point. I think that, it's not to take away from the study; it's an enormously important study, and I think the most important thing out of that study is what many people have shown actually over the years, is these are very common illnesses, and they are just widespread in our society.

The issue of, you know, how broadly you should define mental illness is something else, again. We have much more information, I think, about depression and mania and the mood disorders in general, about how prevalent they are. I think perhaps we need to start stretching the borders of what you mean by very mild depressive states, what you mean by a whole series of other disorders that are listed in the "Diagnostic and Statistical Manual." Then it gets a lot more controversial.

I think the study, as I said, is an important one, and it points out that it's very common. I think that within the field, there is a lot of controversy about, you know, how much do you really want to say something is mental illness as opposed to just differences in temperament or differences in the way people go through life.

COSTAS: When we see prescription medications designed to help people deal with anxiety or sadness, commonly advertised now on television, are we perhaps in some cases losing the distinction between sadness or the blues, or normal changes in one's emotions based on external events, and actual clinical depression?

JAMISON: Probably. But again, that doesn't take away from the fact that these illnesses are very severe illnesses. They have a very high death rate in the form of not only suicide, which is staggeringly high, the rate of suicide in both depression and bipolar illness, but also in terms of connection with heart disease. We know that depression makes a lot of things worse medically, so these are very, very serious illnesses that cause a great deal of pain and a lack of productivity in society. So they shouldn't be minimized.

Advertising to the public and trivializing these illnesses I think for a lot of us, is very unfortunate.


COSTAS: Go ahead, Mariette. Mariette, go ahead.

CAVETT: Go ahead, Mariette.

HARTLEY: I really love you, Kay. Not only should they not be minimized, but they should not be shoved down people's throats. I think the thing that just occurred with Mr. Cruise and Ms. Shields is probably one of the most devastating things, particularly because Mr. Cruise is an extraordinarily influential man. And to literally push this young woman's malady on some level down her throat in a very non- empathetic way...

COSTAS: Mariette, to clarify, as I recall -- correct me if I'm wrong...

HARTLEY: Go ahead, you do it, Bob.

COSTAS: Brooke Shields said that she suffered serious postpartum depression...

HARTLEY: Yes, which is not uncommon in this country or all over the world.

COSTAS: ... and Tom Cruise -- Tom Cruise was skeptical about that, and thought -- and I don't want to misquote him, but thought that she could have toughed it out somehow. Is that a fair characterization?


HARTLEY: Yeah, I think you're minimizing it, yes, because I think, I mean, the feeling to me was almost as if she was now a drug addict, and I understand where he comes from to a degree, but I also would wish that someone like that, with, again, that kind of influence, particularly on women in this country, would have some kind of empathy of other choices that people have to make.

Again, there is no shame with this, and if we can go away with anything in this episode of -- by the way, you're doing a wonderful job, Bob, I got to tell you.

COSTAS: It's a juggling act here.

HARTLEY: Not that you care...

COSTAS: One or two, but three or four? And sometimes Larry has seven or eight, you know?

HARTLEY: And we all interrupt him, we all say -- no, he's great.

COSTAS: With impunity.

Dr. Jamison, women are more prone to depression, not that millions of men don't suffer from it, but women generally are more prone to depression than men, true?

JAMISON: Yes, it's true, about twice as frequently as men, although that's not true for bipolar illness. Bipolar illness is equally common in men and women.

CAVETT: Kay, isn't it harder for men to turn themselves in than it is for women? And also...

JAMISON: It is very...

CAVETT: ... isn't it harder for artists, so to speak -- I know of a suicide of a guy who was wonderful and talented, and they said afterwards, he didn't want having his head shrunk to ruin his talent.

JAMISON: Right, well, I think that's, you know, I mean, a couple of things. Certainly, it's more difficult for men, and men typically turn to drink more, and, you know, may engage in riskier activities and just not go to a doctor. So that's been a real problem, and actually the National Institute for Mental Health has had a terrific campaign to try and get men into treatment for depression.

The issue of artists is more complicated. I mean, I'm a great believer that, you know, I think that artists have a lot of choices now, and no artist I've ever known, no writer I know has ever been able to write well when severely depressed, you know. And most writers come in when they are depressed. And nobody is creative when they're six feet under, for sure, and nobody is creative when they're in four-part restraints or in the seclusion room. So it's important to recognize and take account of, you know, you want to be very sensitive to the side effects of these medications, and to deal with that and to really listen to patients. But you also don't want to romanticize very bad diseases.

COSTAS: In our remaining moments, we'll continue with the conversation. In just a moment, we'll actually try and work in a few phone calls. For years of watching Larry, I've wanted to do this. Fred in Tuscaloosa, hello! Larry, I love your show. I don't need that, what's your question? We'll try our hand at it when we come back right after this.

CAVETT: Thank you for taking my call.

COSTAS: Oh, you're more than welcome.


COSTAS: And now the moment some of you have been waiting for. To the phones we go.

Mooresville, Indiana, hello.

CALLER: Hello to everyone on the panel.



CALLER: I am -- I have a question. I am 52, and have probably suffered from depression from the age of late 20s on. I have a 29- year-old son, as a young child was diagnosed with ADHD, who has recently, within the past two years, been diagnosed with bipolar disorder. My question is, is this inherited or hereditary?

COSTAS: Dr. Jamison? JAMISON: Well, bipolar illness is certainly hereditary. It's genetics, as also ADHD is genetic. We've known for hundreds and hundreds and hundreds of years that it is genetic, and there is a lot of actually very exciting research going on now.

COSTAS: Dick, on a slightly different subject, what was it that Marlon Brando said to you many years ago about how to continue in the public eye even when everything is turmoil inside of you?

CAVETT: Well, he said, what was your problem? And I said, I was doing a show with Laurence Olivier and his wife, Joan Plowright. And all during it, I thought, I'm not even interested in this, I don't care if it's Olivier, my head is getting heavier. Surely he's too smart to see that either I'm nuts and they're going to take me away and say, it's all right, Dick, we'll finish the show somehow -- and I could never watch that show. And Brando said, "do me a favor. Look at it." I did. And I was fine. It was -- he said, "automatic pilot. I use it all the time."

COSTAS: And I imagine you've used it, Jane, and you, Mariette, and you, Dr. Jamison. You don't just study this situation, but have suffered from it.

HARTLEY: Yes, I think there is a danger in that. Yes, absolutely. I mean, I got through a lot of my life that way. The morning program, most of it was automatic pilot, because I was so tired.

But one of the things that I wanted to address is the whole artist way. I have just finished a one-woman show where I play 14 people, one of which is my father, and I tried to get inside his brain before he committed suicide, and then I as him bring me into the room.

I could never have done that had I -- had my disease, my familial disease not been attended to. So the idea that medication will flatten us out to such a degree is really a myth.

COSTAS: Jane, in the time we have remaining, in a world where everyone seems to court people's attention by inviting them in, almost to be voyeurs about their lives, your reserve, I always thought, was an attractive quality. It's clear to me after reading your book why you felt that that reserve had to be put aside and you had to address this issue, but I imagine it was more difficult for you than it would have been for some, because that's not your natural stance.

PAULEY: It was -- couldn't have been easier.

COSTAS: Really?

PAULEY: The reason I was very private as a person, as a mother was because there was value to privacy -- raising children, for instance. I didn't want to cultivate celebrity. I wanted to stay a real person.

(CROSSTALK) PAULEY: Yeah, so -- but the real value in telling this story, or Mariette, or Dick is that you -- you can do something to redeem a lousy situation. I have plenty of capital. I had a good reputation. I could spend down some of that capital if necessary on behalf of someone else who because of their job, can't tell anybody that they're suffering. So...

HARTLEY: And you can also save lives.

PAULEY: ... it was the easiest thing I ever did. And you can save lives.

HARTLEY: Save lives.

COSTAS: All right, we have less than a minute here. By way of wrapping up, Jane Pauley's memoir, "Skywriting: A Life Out of the Blue" is available now in paperback.

Dick Cavett, what are you up to? Real quick?

CAVETT: I'm working on DVDs for all the people who stopped me on the street and said, when can we see some of those shows? And I want to let people know that...

COSTAS: DVDs of the old Cavett show?


COSTAS: Which was a tremendous show.

PAULEY: Oh, wonderful.


CAVETT: I've only been depressed twice. Do you think the less of me for that?

COSTAS: They were for long stretches, right?

CAVETT: But I got my money's worth.

COSTAS: I guess we can laugh about it, huh?

Dr. Kay Jamison, thank you very much for being with us as well.

JAMISON: Thank you.

COSTAS: Her upcoming book is "Exuberance: The Passion for Life."

JAMISON: It's already out, actually.

COSTAS: Oh, it is? It says here to be published in the fall, but you've got the jump on us.



HARTLEY: And my book you can get on Amazon.

CAVETT: Quick, write another one.

COSTAS: And Mariette Hartley...

HARTLEY: You can get mine on

COSTAS: There you go.

And we made it with about eight seconds to spare. More news upcoming on CNN. Larry King is back tomorrow night with Mary Tyler Moore. Thank you for being with us. I'm Bob Costas from New York. Good night.


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