“How Are You?” Fair Game in Politics?

Is ‘How Are You?’ An Unfair Question in Politics?

The question has gone viral: Should questions about the mental health of an office holder – or candidate for office – be fair game? Through the magic of hindsight and in the hope of learning from history, the following is a true story depicting the situation as it has become in the political world.

• Scene: An Accountant’s office Characters: The Client, The Accountant
• Client: These figures for my income tax are higher than I estimated they’d be. Can it be because you haven’t taken that large medical deduction?
• Accountant: The one showing how much you paid a psychiatrist? Take my advice. Forget the deduction. Don’t let those expenses show on your records. You’re a smart, ambitious young fellow. Someday, you might want to run for political office.

Fear of mental-health-deficient government leaders first became rampant in the days of “finger-on-the-button” mentality. According to the Political Dictionary, the expression was “used to evoke the possibility of nuclear war and to imply that the president of the U.S.–or his counterpart in other nuclear-powered states–has the power to set off an atomic war at any moment.” The anxiety caused by an itchy trigger finger was exacerbated by motion pictures and novels. Then, a hydrogen bomb was added to the stockpile… So, with fears of mental health incompetency pointing the way to the end of the world, whom did Americans elect? Looking back in the rearview mirror, let us examine a few presidents of the United States of America:

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Lyndon B. Johnson

The 1963 photo of Lyndon B. Johnson taking the presidential oath in Air Force One–right after the assassination of John F. Kennedy in Dallas–is a study in shock and sorrow. Nevertheless, it set the stage for a term marked by accomplishment. With a vision of The Great Society, President Johnson led the country in making strides in civil rights, improving the environment (along with his wife, Lady Bird Johnson), health care, and education. All of that was accomplished, according to the National Alliance on Mental Illness, “between bouts of mania and depression, what we now believe was actually bouts of bipolar disorder.”

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Richard M. Nixon

As a candidate in 1960, he participated in the first televised presidential candidate debates; unfortunately, his opponent was the young, strikingly handsome, cool, Boston-accented John F. Kennedy. Nixon’s face was sweating, and he was obviously in discomfort. As president (1969-74), Nixon went to China and opened that “Sleeping Giant” to the world. Unfortunately, that is probably the accomplishment he is most famous for (an opera was composed about it). He is primarily remembered for the politically motivated break-in at the Watergate in Washington, D.C., and for having to resign from the presidency. While still in office, he abused prescription drugs and alcohol. Among the pills he was taking regularly were sleeping pills, barbiturates, and anti-anxiety medications. In fairness, let it be said that the highly unpopular war in Vietnam may have played a part in revving up the president’s anxiety.

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Woodrow Wilson

Obesity, among other signs, may reflect inner turmoil. President Wilson, in office 1913-21, was an overeater. This habit was diagnosed due to his suffering from “generalized anxiety disorder.” The excess pounds, in turn, led to obstructive sleep apnea. His term in office, coincidentally, took place during World War l, after which he became a principal architect of the League of Nations (a precursor of today’s United Nations) and, for this, a Nobel Prize for Peace.

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John F. Kennedy

Probably one of the most famous film clips is of “Happy Birthday, Mr. President,” being crooned to JFK by screen sex symbol Marilyn Monroe. His affair with her–and countless others–was kept secret from the public by a code of silence among the Secret Service and the press corps during his tenure (1961-3). In addition to this hypersexuality, President Kennedy displayed high energy. The effect of the two indications together is associated with hyperthymic temperament. In psychiatric terms, this could mean constant mild manic symptoms. Dr. Nassir Ghaemi, who ran a Mood Disorders Program at Tufts University in Boston, made this diagnosis. He studied the former president’s medical records and attributed some of the causes of the behavior to genetics. Dr. Ghaemi’s subsequent book was “A First Rate Madness: Uncovering the Links Between Leadership and Mental Illness.” In it, he argued that “leaders with some mental illnesses, particularly mania or depression, often are better (leaders) in times of crisis.”(NPR Author Interviews, All Things Considered, August 2011).

In giving his opinion on Dr. Ghaemi’s conclusion, a more considered approach was taken by Ben Brafman, co-founder of the Sylvia Brafman Mental Health Clinic in Tamarac, Florida. “Personally,” he began, “I would base a theory on such an important topic on facts less open to varied opinions than medical records. Also, I would choose to verify whatever facts are available in the light of the greater expertise we possess now. Mental health knowledge has made great strides in the intervening years.” “The stakes have risen,” Brafman continued. “The consequences of our leaders’ actions resound much more quickly and are much wider in scope.” If these incumbents–and candidates for office–feel the need for a steadied and steadying hand, I hope they will take advantage of the experience, knowledge, and training of a mental health professional.”