Editor’s note: If you or a loved one is facing a mental health problem or substance use disorder, call the Substance Abuse and Mental Health Services Administration National Helpline at 1-800-662-4357 or Visit SAMHSA’s website For treatment referral and information services.
In the spring of 2019, Democratic Senator Tina Smith of Minnesota was busy putting the finishing touches on a bill that would expand access to mental health care for school children.
But she couldn’t shake the feeling that she wasn’t being honest enough about how personal her mental health issues were to her.
Smith is on the verge of an election. She’s under no obligation to speak out about her depression, which she says happened twice — once in college and once as a young mum. But in May 2019, Smith gave a speech on mental health before the U.S. Senate and admitted, “Another reason I want to focus on mental health while I’m here is that I’m one of them.”
“I remember being nervous,” Smith recalled of the speech. “I was worried that people would think I was trying to make it about myself, but once I got past that, I realized I had power in telling the story — especially as a U.S. senator, I It’s said that everything has been together all the time, and then it started to feel interesting, and I could see the value in it right away.”
The National Alliance on Mental Illness estimates that one in five adults in the United States — nearly 53 million Americans — suffers from a mental illness each year. The Centers for Disease Control and Prevention reports that more than 50 percent of Americans will experience a mental illness in their lifetime. But it remains a relatively rare acknowledgment for politicians — who are often far away from home, subject to intense stress and pressure, as well as all the risk factors for mental illness like depression and anxiety — to talk about their own mental health.
That’s why when Pennsylvania Sen. John Fetterman announced in February that he was seeking hospitalization for clinical depression, lawmakers from both parties celebrated not only his decision but his transparency.
“Politics is tough, there’s a lot of scrutiny, and you’re obviously in the public eye a lot. There are consequences to what you say and talk about, but I think in a situation like this, it helps the conversation,” Senate Republican Whip John Thun said. “It helps people recognize and understand the impact of this disease on people across the country.”
Years after telling her story, Smith says she has no regrets. In light of Fetterman’s news, she feels the need to share even more.
“I think every time someone like John or me opens up about their own experiences with mental illness, or you know, mental health challenges, it just breaks down that wall where people say, ‘Oh, it’s possible to be open and honest, don’t Let the whole world crush you,” Smith said.
Smith has been suffering from depression for decades, but she said she still remembers that time.
“I thought I just left,” Smith said. “There was something wrong with me. I disagreed. I wasn’t doing well enough, and then you start beating yourself up a little bit, and I was kind of in that cycle,” Smith said.
It was her college roommate who first suggested she talk to someone. Reluctantly, Smith turned to Student Health Services and began talking with a counselor. She said she started feeling better and eventually noticed a decrease in her depression.
But as Smith says, mental health is a continuum, and about a decade later, as a young mother of two, she found herself experiencing depression again. At the time, she said she was completely caught off guard.
“That’s what makes depression particularly dangerous. You think there’s something wrong with you,” Smith said. “I’ll never forget my therapist telling me, she said ‘You have clinical depression. That’s my diagnosis. I think you’d benefit from medication to help you.'”
Smith said she was initially resistant. However, after continuing the conversation, she agreed to start medication as part of her treatment. She remembers that it took time to work, but eventually she noticed major improvements.
Smith was in her early 30s when she emerged from depression. She said she has had no bouts of depression since then, but she does take a lot of care of her mental health now.
There were 535 members of Congress, only a handful of whom shared personal stories related to mental illness. Most of the people who have spoken publicly about their experiences are Democrats. Most of those who shared their stories spoke of them in the context of their military service. At some point, there is a risk that lawmakers get too personal. Over the past few decades, the history of reactions to politicians coming out about their mental illness has been checkered.
“People still remember Tom Eagleton,” Smith told CNN.
In 1972, Eagleton was newly selected as the running mate of Democratic presidential candidate George McGovern. He admitted being treated for clinical depression and receiving electroshock therapy. Days later, he withdrew from the ballot despite continuing to serve in the Senate for years.
Memories of these events can influence how members talk about their mental health, even in recent memory.
“When I was in Congress, I did everything I could not to let everyone find out that I needed help,” former Rep. Patrick Kennedy told CNN.
Kennedy represented Rhode Island in Congress from 1995 to 2011. He suffers from drug addiction and bipolar disorder. While he was there in 2006, his green Mustang convertible crashed into a barrier outside the Capitol early in the morning.After the accident, he pointed to sleeping pills as the culprit and checked I went into the Mayo Clinic for treatment.
“It’s the best kept secret in town for anyone with any of these conditions, and you’re often the last to realize you’re out of shape. People don’t tell you to your face , because you’re a member of Congress, and your staff is walking on eggshells,” Kennedy said.
“When I do go to therapy. I do it after I get caught in trouble, like I’ve been in a car accident.”
But when he returned, Kennedy heard from many of his colleagues about their own struggles with mental health-related issues.
Kennedy predicts that when Fetterman returns to the Senate, the same could happen to him.
“I think he’s going to have his colleagues in the House and Senate come to him and tell him what’s going on with them. He’s the only one they know,” Kennedy said. “While the stigma is disappearing, there is less tolerance for people with mental illness and addiction.”
After January 6, 2021, is another moment when the topic of mental health begins to shift in Hill. Suddenly, members and their employees experience trauma and shared experiences in the workplace.
Rep. Sara Jacobs, D-Calif., was just four days into Congress on Jan. 6 when she and several other members of her party were trapped in an upstairs hallway of the House of Representatives . The experience—the sound of a gas mask unfurling, the frenzy of fleeing, the echo of a gunshot—has left her dumbfounded. Jacobs said she felt capable of seeking help. She already has a therapist. However, she noticed that some of her older colleagues did not have the same tools.
“I remember actually talking to some of my older colleagues here after January 6 and encouraging them to seek therapy and help because it wasn’t customary for them,” she said.
Lawmakers stuck in the gallery also sought treatment together via Zoom and stayed in touch via text link.
For Jacobs, the trauma of Jan. 6 manifested in unexpected ways. Suddenly, fireworks—her favorite thing—began to go off. Shouting or people gathering somewhere makes her nervous. She said a lot of her colleagues also dealt with anger, “a lot of anger at colleagues who went back that night and continued to deny the election.”
When her brother got married in the fall and set off fireworks, she had to find an excuse to go to another room because “it put a lot of strain on my body and my nervous system.”
Rep. Dan Kildee, D-Michigan, also came forward after Jan. 6 to talk about his struggles with PTSD after that day.
It’s not easy.
“There’s still a stigma. People still make their own judgments, which is one of the reasons I decided to talk about it so people see it can happen to anyone. You just get the care you need.”
“When I sought treatment, not everyone accepted it. My ex-opponents scoffed at it,” Kildee said.
For Jacobs, who has been taking medication for anxiety and depression since 2013, stories like Fetterman’s are a sign that the conversation about mental health may be starting to change not only in the Hill but also in other parts of the country.
“I think there’s definitely a generation gap. There’s also a gender gap, which is why I think Fetterman was so brave not only getting the treatment he needed, but talking about it,” Jacobs told CNN. “I think as a young woman, I spend a lot of time talking to my friends and peers about mental health, talking about therapists and what we learn in therapy, but I know that other generations don’t really understand these feelings Very open.”
Ultimately, it’s unclear how Fetterman’s openness about his mental health will affect Hill’s future. It’s unclear how it will resonate with voters in other parts of the country or even at home. But for lawmakers who have already taken steps to share their stories, they hope it will make a big difference.
“It doesn’t take a statistician to tell you that in 100 people in the U.S. Senate, mental health issues are going to affect every one of us in some way,” Smith said. “I think it allows people to talk about it more openly.”