YoIn 1956, my uncle John F. Kennedy, then a United States senator, wrote a book that is probably more famous for its great title than its content. Was called Profiles in Courage. And JFK considered that it was eight US senators who had made particularly brave contributions to American history.
For some time now I have been thinking about what courage means to me. Growing up with my father, Ted Kennedy, in the Senate, and then serving in the House of Representatives for many years, I saw quite a bit of bravery in politics. But the truth is that the bravest people I know don’t qualify by what they do in public but by what they are able to endure and overcome in private. This is especially true for people who struggle every day with mental illness, addiction, or both, or who help loved ones or family members in their struggles.
The details and daily dramas of these struggles often remain private, hidden. And even when people discuss them publicly, it is often briefly or very cautiously: enough to admit that they have a diagnosis or problem, or “issues,” to support advocacy, but rarely enough to inform to an audience that wants and needs.needs to understand what it is like to live with these diseases every day. When I was younger, and I was the first to receive substance use disorder treatment in the tabloids from someone I was in rehab with, I thought this was all harder for people who were in the public eye. But since then I have learned better: we all live with the same stigma and pay the same price for our silence.
We often cite the statistic that at any given time, at least a quarter of all Americans struggle with mental illness, substance use disorders, or both. And although they are sometimes still considered two separate diseases, because two different worlds were developed to address them, I can tell you, as someone who suffers from both, that they are best understood and treated together as a continuum of diseases of the brain and mind. .
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Unfortunately, the percentage of people affected by these diseases is probably well over 25%. And the percentage of those who do not feel comfortable and supported enough to be open about their experiences is high, a lot higher, as is the percentage of those unable to access or afford evidence-based care and support.
This is an old problem. You just have to look at the historical figures JFK wrote about in Profiles in Courage to see. At least half of them were known, since the early days of post-Revolutionary America, to have struggled with mental illness or addiction, or the struggle for mental well-being had deeply affected their families.
John Quincy Adams, whose story first inspired JFK and his co-author, Ted Sorenson, to write Profiles in Courage—he was nine years old when his father signed the Declaration of Independence, 29 when his father became president, and 35 when he himself became a United States senator. John Quincy lost both of his younger brothers to alcoholism, beginning with Charles at age 30. His father also suffered from depression, especially after the trauma of losing Charles and losing the presidential election to his friend Thomas Jefferson, all during the same week in the late 1800s. John Quincy’s eldest son, George Washington Adams, suffered from depression and he took his own life at the age of 28, just two months after his father’s presidency ended in 1829. Shortly after learning of his son’s death, John Quincy vowed to use his “remaining days” for good works. They contribute to the well-being of others” and soon became the first former president to rejoin the government as a congressman. But he continued to experience the tragedy of mental illness. In 1832, his remaining brother, Thomas, died from complications of alcoholism at the age of 59. And two years later, his own son John died of the same thing at the age of 31.
Among the seven other JFK profiles, Massachusetts lawyer and politician Daniel Webster suffered from alcoholism and died of cirrhosis of the liver in 1852.
Sam Houston, a key figure in Texas independence (and the state’s first president before becoming a senator), had a well-known battle with alcoholism and depression/bipolar disorder. It may qualify as the first case of political mental health stigma in the country. His nickname among the Cherokee, with whom he had been close since childhood, was Oo-tse-tee Ar-dee-tah-skee, or “Big Drunkard,” and his drinking was an open and caustic topic in his public life. His third wife, whom he married when she was twenty-one and he was forty-seven, set out to help him stay sober, but his political opponents continued to publicly shame him.
Lucius Lamar, a U.S. senator from Mississippi, was only nine years old when his namesake father, a prominent Georgia judge, took his own life, just days before his 37th birthday in 1834. He reportedly “entered his house, wrote a “A brief farewell note to his family, he went out into the garden and shot himself in the head with his pistol.”
And these are only the ones we know and can begin to document.
Every time a new statistic is released on the state of mental illness diagnoses, drug or alcohol addictions, overdoses, suicide attempts, and completed suicides, it is followed by a call for a “new appreciation.” of these diseases, a “paradigm change”. .” But part of the paradigm that we must change is the idea that these are new problems. If there is something truly new about them, it is how much they increase worse have received because we have not done enough as a society to address them. We also haven’t made sure that the treatments we already have, which are not perfect but can still save lives, reach the majority of people who need them. Those treatments, which work but have been shown to work better together, are medical therapies, talking therapies, and healing relationships (from support and recovery groups to religious groups). Even those who receive some type of treatment may not be receiving the most comprehensive or evidence-based treatment, and there is often a big difference between what is “approved” or “legal” and what is ideal.
None of this should be surprising. But in some ways it still is. Our nation is experiencing perhaps the most pronounced mental illness and substance use disorder crisis in history; Already high rates of depression and anxiety increased by another 25% worldwide after the first year of the COVID-19 pandemic. However, many of us still do not understand what the experience of having or treating these diseases is like.
In our society, you don’t have to have cancer, heart disease, or diabetes to understand the basic dynamics and challenges of living with these diseases. Their treatment has become part of our culture, openly discussed and encouraged. But when it comes to diseases that affect the brain (cognition, mood, thinking, impulsivity, self-destructiveness) we are surprised again and again, or ignored in a way that is not only unsupportive but can be downright dangerous.
If you or someone you know may be experiencing a mental health crisis or thinking about suicide, call or text 988. In emergencies, call 911 or seek care at a local hospital or mental health provider.
Reprinted from PROFILES IN COURAGE IN MENTAL HEALTH by Patrick J Kennedy, to be published 04/30/2024 by Dutton, an imprint of Penguin Publishing Group, a division of Penguin Random House, LLC. Copyright (c) 2024 by Patrick J. Kennedy.