May 2000 • Volume 6 • Number 5
Wayne Blount, M.D., left, listens as Kathy Cronkite answers an audience question following their presentations on depression at AAFP's CME course on women's health. BY SHARON DICKINSON DENT
Scottsdale, Ariz.A patient's perspective
Since early adolescence, Kathy Cronkite has experienced extended episodes of overwhelming emotional pain. She found daily problems insurmountable, experimented with drugs to numb the agony and toyed with the idea of suicide, all while struggling to maintain a facade of normalcy.
Cronkite, a member of a National Institute of Mental Health advisory council and daughter of journalist Walter Cronkite, was the keynote speaker at AAFP's Primary Care in Women's Health CME course April 5-8, where she offered a patient's perspective on the battle with depression.
"My parents didn't know, my teachers didn't know, I didn't know that the problems that were disrupting my education and destroying my personal relationships had a name," said Cronkite.
That's typical, she said, noting that many people suffering from depression don't seek help because they don't realize "that the misery they're living in is a treatable illness."
The symptoms of depression -- low energy and fatigue, apathy, cognitive disturbances, lack of motivation, self-blame and hopelessness -- also stand in the way of getting treatment, she said.
Kathy Cronkite
"My parents didn't know, my teachers didn't know, I didn't know that the problems that were disrupting my education and destroying my personal relationships had a name."Cronkite said she saw almost a dozen therapists before her depression was diagnosed by a pastoral care counselor during marital therapy. She denied it at first, thinking she couldn't have depression because she wasn't sad all the time. The therapist said, "I see an ongoing sense of hopelessness," and Cronkite knew he was right. "It was the first time in my life that someone had put into words what I was feeling," she said.
A psychiatrist confirmed the diagnosis and worked with her to choose a course of treatment that included medication and talk therapy, but Cronkite grappled with the stigma surrounding medication for mental illness. "I come from a family of Midwest stoics for whom taking an aspirin when you have a headache is a sign of weakness," she said. "The idea of taking medication, particularly something that alters your mind, was scary."
She did fill the prescription and soon felt the ebb of depression's excruciating symptoms. But she still felt ashamed about her condition. She hid her diagnosis from others, concerned that friends and professional peers wouldn't understand. She kept it a secret from her extended family for about six months, coming forward only when she realized the genetic predisposition to depression could affect other family members.
In 1990, U.S. News & World Report published a story about journalist Mike Wallace -- a longtime family friend of the Cronkites -- and his struggle with depression. "In that instant, my sense of shame lifted," Cronkite said. "I thought, if he -- who has so much more to lose than I do -- can talk about it in public, what am I afraid of?"
She chronicled her struggles and those of many celebrities with depression in her book, On the Edge of Darkness. She also became an advocate and educator on the topic of depression, serving on the NIMH's National Advisory Mental Health Council Behavioral Science Workgroup to help develop its new report, Translating Behavioral Science Into Action. You can download the report at http://www.nimh.nih.gov/tbsia/tbsiatoc.cfm. Or call (301) 443-4513 for a printed copy of the report, available in June.
Cronkite encouraged FPs to dispel four key myths about depression:
"You have to be depressed about something." Cronkite pointed out that even when everything seemed to be wonderful in her life, she couldn't find the joy in it when she was suffering from depression.
"Childhood is a happy-go-lucky time." Studies have shown that young children and even infants can experience the symptoms of depression, she said.
"All teens are a mess; it's those hormones." Cronkite said parents and doctors should be concerned if a teen-ager is moody, irritable, angry and antisocial.
"Of course the elderly are depressed. Look how much they have to be depressed about." The issues of aging may make older people feel sad at times, but that's different from depression, Cronkite emphasized. Elderly patients with depression can live happy, fulfilling lives if their illness is appropriately diagnosed and treated, she said.
The ability to enjoy the small things in life -- warm sunshine, blooming flowers, a baby's smile -- is like a gift each day, Cronkite said. But she expressed frustration that so many people afflicted with depression go untreated. "There is no longer any reason to separate mental and physical illnesses," she said. "There's one kind of chemical change in the brain, and we say they have Parkinson's, and we offer treatment and support for the family. There's another kind of chemical change in the brain, and we call them crazy, and we tell them to pull themselves up by their bootstraps."
FP Report is published by the AAFP News Department.
Copyright © 2000 by American Academy of Family Physicians.
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