Senator Fetterman and Political Leadership
How Senator Fetterman's hospitalization and leadership is changing the way we all think about the mental health challenge our country faces.
Hello,
It’s Tuesday February 21st and I’m Tyler Fisher. This is the first regular edition of Bipolar & Bipartisan, a newsletter designed to serve people with bipolar disorder and other mental health challenges, and those in their support network.
Today, I’m writing about U.S. Senator John Fetterman and political leadership. If you want to skip the messiness of politics, skip to the bottom of this note for one fact about Bipolar Disorder, a recommended read, and a wellness tip.
Senator John Fetterman (D-PA) Hospitalized for Clinical Depression
Over the weekend, news broke that Fetterman, the junior U.S. Senator from Pennsylvania, checked himself into a hospital to be treated for clinical depression. I’m thinking of the Senator, and wishing that he gets the support he needs from his medical team, that the outpouring of love from voters, colleagues, and family gives him energy, and that he gets the time and space he needs to make a very personal recovery.
Patients must come first, even for someone in elected office. While society will undoubtedly benefit from national attention on mental healthy, onlookers should be mindful that all of the commentary may actually make the Senator’s recovery harder, if he feels overwhelmed by the volume of outreach or puts too much pressure on himself to help others before he has recovered himself. People with mental health challenges (including me) cannot help others unless we take care of ourselves. Also, I say “may” because every depression story — just like every bipolar story — is different, and perhaps the Senator will benefit from all of the attention.
We should not assume one way or the other, and follow the lead of his family and closest confidants. For example, his wife tweeted: “After what he’s been through in the past year, there’s probably no one who wanted to talk about his own health less than John.”
We should also all keep in mind that, as Annie Karni reported: perhaps his depression was caused by too quickly returning to the campaign trail after his stroke last year, a demand voters and the mainstream media made of him. More than one third of those who have a stroke go on to have a depression shortly thereafter. From Karni:
“The possibility that [Fetterman] may have missed out on a crucial recovery period [from the stroke] has become a source of pain and frustration for Mr. Fetterman and people close to him, who fear that he may suffer long-term and potentially permanent repercussions. His schedule as a freshman senator has meant that he has continued to push himself in ways that people close to him worry are detrimental.”
Fetterman’s experience is not unique. Plenty of Americans are overworked by their employers, often contributing to mental health challenges. As a result, conversations on “work-life balance” have spiked over the last decade.
Fetterman’s story is a helpful reminder of this fact, including that the way in which American politics works. 24/7 “breaking news,” excruciating public schedules, demanding campaign environments, and more can take a toll on the mental health of the public servants meant to solve public policy problems. When elected officials struggle with mental health, their jobs become harder. Oftentimes the impact is less gets accomplished in Congress, State Legislatures, and City Halls. Maybe if we want more from our political leaders, we should start by demanding less of them.
For readers rightfully worried about the Senator, they should know that doctors have said that he will receive a few weeks of inpatient care (meaning he will be fully hospitalized). Doctors will try to find a medication regime that works well for him, and will likely provide him with other coping mechanisms (including therapy) to re-enter public life. Yahoo! reports that depressive periods after strokes are common, Fetterman has a 70-90% chance of a full recovery, and that it’s positive Fetterman acknowledges he needs inpatient care (rare among those facing depression).
Most importantly the Yahoo! story reports that "Hospitalization is often the thing to do to recover quickly. A hospitalization, rather than ending anyone's career, enables them to regain lost function."
Two Quick Notes on Politics
It’s commendable that Senator Fetterman is using his small-dollar fundraising engine to support those with mental health. Politicians spend years building email and phone lists they can leverage ahead of their next election, often to pay for ads that demonize the other political party.
But, Fetterman is doing something different: he’s demonstrating what real political leadership looks like. Instead of the next templatized political fundraising solicitation, Fetterman is emailing his constituents to ask for donations to the National Alliance on Mental Health and the Pennsylvania Mental Health Consumers’ Association. Here’s an example email his team recently sent:
I’d also be remiss if I did not include writing from my Bipolar and Bipartisan colleague Collier Fernekes. Last year, Collier wrote a blog on “Absent Senators: Pairs, Proxies, and Procedure” that covers how the U.S. Senate will continue to operate without Fetterman, including the implications for a Senate that may operate for a few weeks with 50 Republicans and 49 Democrats, with Vice President Kamala Harris casting tie-breaking votes.
On Speaking Up About Personal Mental Health Challenges
In a TV segment for CNN over the weekend, Michael Smerconish of CNN opined: “We need mental health role models, right now.” I couldn't agree more. A major challenge facing individuals and our society is the way in which mental health has been stigmatized and talking about it has been marginalized.
These are the sentences that stood out to me most:
“Schools, workplaces, healthcare plans and American society in general still do not treat those with a mental illness, the same as those with a physical affliction.
Think about it: God forbid someone in your orbit gets cancer. People rush to raise GoFundMe Money, bake cakes, and help take care of their children. But if the affliction is anxiety or depression, many will shun even those they know, and that’s if the illness is made public at all.”
Individuals with mental health problems are frequently told to not talk about their experience publicly, for fear of the impact on their careers, their friendships, and their livelihoods. A doom loop then occurs, whereby very few notable people (who follow this advice) stand up to say they need help. The rest of us are left feeling lonely and that we are unique in the challenges we face. The impact is that often people do not get the help they need, and the impact on individual lives is devastating.
Consider Smerconish’s analysis of a recently released study from the Center for Disease Control (CDC). Smerconish reports that “More than one in five American teens have seriously considered contemplated suicide. And among girls the number is 30%.” He goes on to say those numbers are nearly double what they were a decade ago, and tend to be higher among marginalized communities, like LGBTQ+ populations. The way our country is talking about mental health, or not talking about it at all, is destroying lives — often leading to suicide.
The news that Fetterman voluntarily hospitalized himself and shared the news publicly struck a deep personal chord. Four weeks ago I was hospitalized, but — unlike Fetterman — not on my own terms. Instead, I was put on a medical “hold” by a mental health evaluator who determined I presented a risk to myself and the public, requiring me to be hospitalized. I did not agree with the decision, as I thought the healthy habits I had prioritized the weeks prior had me on a path to recovery. Alas, the evaluator disagreed and I quickly got in line, going willingly in an ambulance to a hospital 75 minutes away.
When I got there, I experienced something that Senator Fetterman probably will not, but many Americans do. The white board said “Nazi” and “KKK.” There were patients running and screaming. There was only one old pay phone for 15 people to share. I only saw a psychiatrist for 15 minutes over a seven day stay. I was tackled by eight staff and had a shot injected in me. I had to share a room with loud roommates. There was no hot water in the shower. The nurses could not get me my medications on a regular schedule. I did a puzzle, but other patients frequently messed up the pieces. I was verbally assaulted and physically intimidated by other patients. I was yelled at by my caregivers (and yelled at them in return, despite me believing they should be paid more money for the tough job they have).
I reflected more on my experience on Facebook (you can read here), including why my experience has inspired me to start writing this newsletter. I received appalling treatment that I wish was not the norm in America, but it is.
And despite it all, I faced criticism from those close to me that I should move slower in sharing my story. I understand thier intent in protecting me, and making sure I take care of myself first, which I know I need to do. At the same time, I am watching our mental health system fail every day, and it’s hard to remain silent. I’m grateful for the outpouring of support from friends and family, and eager to return the favor by sharing my story for the good of others.
Just One Story
This New York Times’ headline is huge. It demonstrates that one of the leading papers in our country may actually desire to be a part of the solution to the mental health “crisis” we find ourselves in. The reporting begins to normalize announcements that famous people are struggling with mental health problems in the way that a famous person who received a cancer or Alzheimer’s diagnosis may be covered. It’s a stark reversal from the role many institutions that make up the Fourth Estate have actually contributed to the crisis we find ourselves in (a topic for a separate newsletter).
Like a lot of commentary the last few days, the New York Times article:
Clarifies basic facts like symptoms of depression and the severity of the Senator’s “clinical depression” diagnosis, which is also known as “major depression”
Identifies a sad trend: despite better treatment solutions than ever before and even more public acceptance of mental health problems, depression is actually on the rise in America.
Connects the dot between physical and mental health: Fetterman had a stroke last year, and a quoted psychiatrist notes how adjusting to a major life event can impact one’s mental health.
Sidenote: if you’re struggling with your mental health, consider a focus on your physical health: go see a doctor; get some exercise; eat better food, and do all the things our parents taught us to take care of our bodies.
But, for me, what stands out most is the opening line of the article:
“Lynn Rivers, a Democrat from Michigan, opened up about her diagnosis with bipolar disorder during a radio call-in show when she first ran for Congress. Her opponents had been hinting she had mental health problems. She decided, spur of the moment, to let it out.”
The year this happened? 1994. I commend Rivers’ actions from more than a quarter of a century ago. At the same time I wonder why more elected officials have not stood up since then to say they are bipolar. There’s a number of reasons why our political leaders may not be comfortable opening up. Here are just three that come to mind:
Politicians may fear they will lose their next election. Politicians worry about their job security, and voters get to decide their fate. Opening up that they struggle with mental health could impact whether voters think they’re qualified to represent them.
A Republican, Herschel Walker, who was scorned by Democratic voters and politicians for past actions, including for having multiple girlfriends. Walker has multiple personality disorder, a fact that progressive organizations had no trouble over-looking to attack the Republican in hopes of winning the U.S. Senate last year.
The month before the election, the Georgia Democratic party released a scorning webpage. It’s hard to say what the webpage is actually arguing for or against, but it’s clear that the Democratic Party was actively trying to sow doubt among voters just before the election that Walker should be elected as a result of not fully having his dissociative identity disorder under control and not taking full responsibility by actions that may have been the result of a wicked mental health diagnosis.
Politicians may fear unfair backlash from social media followers, the public, or their colleagues. Public service is a brutal business, and every word a politician mumbles is scrutinized.
A veteran with Post Traumatic Stress Disorder (PTSD), Congressman Seth Moulton (D-MA) recently said “[Social Media Critics] accuse me of being a baby killer in Iraq, and that’s why I have PTSD, because of guilt...People have said that my PTSD is rage-filled, and that I can’t be trusted in government. They have certainly tried to weaponize it.”
Politicians may fear the care they will receive. Our elected officials are frequently briefed on the challenges our country faces, and with the mental health “crisis” top of mind politicians may fear falling victim to a system they are told each day is failing.
Rivers, the bipolar Michigan politician from the early 1990s said she “would prefer to be thought of as alcoholic, because it was more socially acceptable.”
These fears are the same ones that Americans who are bipolar are facing.
People with Bipolar Disorder are frequently told that sharing their diagnosis publicly may impact their career prospects;
Bipolar patients are reluctant to share their story out of fear their friends and family will treat them differently;
Americans with Bipolar Disorder likely know the mental health system in our country is broken, and do not want to get trapped in a system that can make things worse, not better;
If you’re bipolar and/or depressed, and you’re reading along, pause for a second. This is really… freaking…hard. You should not feel pressure to follow Fetterman’s lead in sharing your diagnosis with the world, because the whole world is likely not equipped with the tools to support you.
But, it’s critical to start somewhere. Tell a loved one you are bipolar, visit your primary care doctor who can help you find a specialist, or call the Bipolar Hotline: 866-903-3787.
Bipolar Disorder is protected by the American Disabilities Act (ADA) and your employer and future employers cannot discriminate against you — including in hiring and firing decisions. Even if your friends and family have done things to make your mental health worse, they do love you and do want to help (tell them how they can be helpful!). Finally, as broken as our mental health system is performing, it can make things better, especially by connecting you to mental health providers who can help.
Bipolar Digest
The final section of each of our newsletters will share a few tidbits on Bipolar Disorder, often starting with a fact. We’ll share recommendations for songs, podcasts, documentaries, and movies. We’ll tell you about famous people with bipolar disorder. And occasionally we’ll share a wellness tip that everyone can use, not just those with bipolar disorder. Today, we have a fact, a recommended read, and wellness tip.
A fact: There are two types of Bipolar Disorder: Bipolar I and Bipolar II.
The major difference is those diagnosed with Bipolar ! have had a major manic episode in their lifetimes. Those with Bipolar II have never had a manic episode. I (Tyler) am bipolar I, and have had two serious manic episodes — first in March 2019 and recently in January 2023. The two disorders have very similar symptoms, and the difference is often in how severe patients experience them. Read more on Good Rx. A future newsletter will cover bipolar symptoms.
A recommended read: The CDC Study on Mental Health among American teenagers.
The study released last week and referenced above found:
Nearly 3 in 5 (57%) U.S. teen girls felt persistently sad or hopeless in 2021—double that of boys, representing a nearly 60% increase and the highest level reported over the past decade.
Nearly 1 in 3 (30%) seriously considered attempting suicide—up nearly 60% from a decade ago.
1 in 5 (18%) experienced sexual violence in the past year—up 20% since 2017, when CDC started monitoring this measure.
LGBQ+ teens continue to face extremely high levels of violence and mental health challenges
A wellness tip: Drink more water. To do so, carry a water bottle around.
Speaking of the CDC, they have a webpage on the benefits of drinking water. It starts:
“Getting enough water every day is important for your health. Drinking water can prevent dehydration, a condition that can cause unclear thinking, result in mood change, cause your body to overheat, and lead to constipation and kidney stones.”
This seems like a very basic tip, but it’s very important. As I personally battle hypo-mania I also invest in other drinking habits, like only consuming decaf coffee and non-alcoholic beer. If you’re struggling with mania, or just need a mental health refresh, try a week or two without caffeine and alcohol and see if you feel better.