Leading article: A new state of mind


It feels like a turning point. Quite suddenly, the stigma attached to the most common form of mental illness - manic depression or bipolar disorder - is lifting. We welcome Alastair Campbell's willingness to be open about his experience of the condition. Whatever anyone thinks of his political career and his practice of media management as the Prime Minister's press secretary, his personal story strikes a human chord. In advance of Mental Health Day on Tuesday, he joins a growing band of public figures who have used their fame to raise awareness. In our special report today, we have tried to give some idea of the range of prominent people who have taken what is still the courageous step of speaking about their illness. Stephen Fry's recent television programme reached millions with its simple message about the reality of the condition for sufferers - and it was honest enough to modify the idea of "suffering" with the benefits that it can sometimes capriciously bring.

Of course, there is bound to be some spluttering. There always is when social attitudes undergo a significant change. The floodgates of the confessional have opened, according to the stiff upper lip tendency, for whom talking in public about one's unhappiness is a slip on the slope towards American-style emotional incontinence. We do not agree, although it is as well to be aware of the complexities, and of the danger of going too far.

Dr Rufus May's perspective, on page 12, is a useful corrective and a reminder of the complexities of mental health. He is right to argue that not all depression should be seen as predestined by genetics, to be medicalised and treated by drugs. He is right to say that medical terminology is imprecise and evolving - as in the current shift from depression to bipolar disorder. And he is right to point out that sometimes people are sad for a reason and that neither antidepressants nor even "positive thinking" therapies might be called for. Sometimes what is needed is to understand one's sadness and to learn not to fear it, he says. It is possible that David Blunkett's confessional interviews yesterday illustrated this point: there were clearly good reasons why he might have been unhappy. His relationship with the mother of his child had come to an end and his political career was in ruins.

That said, there is clearly a genetic component to bipolar disorder for many people, and for some sufferers drugs are absolutely the right choice. Others would benefit from therapy and others still from a combination of the two. There is no one treatment that suits everyone. One of the benefits of a greater understanding of the condition, for which this newspaper has campaigned for years, is that government policy is starting to shift towards therapy and away from the presumption in favour of drugs.

There is, however, much farther to go. The Independent on Sunday's campaign for better understanding of mental illness, and better provision of services for sufferers, is a long way from reaching its goals. In a way, manic depression may be the easy part, because of its association with gifted creativity. But there are many other conditions that are imperfectly understood by the medical profession and terribly misunderstood by the general public. Popular attitudes to the mentally ill are still characterised too much by fear, and by unjustified associations between mental illness and violence.

That fear inhibits open discussion and blocks understanding. As Mr Campbell puts it in his interview with this newspaper today: "There is a tone of bereavement when people talk about mental illness - 'Isn't it terrible' - and for a lot of people it is, but I think we have to get to a position where it's talked about in the same way that you talk about someone who has broken their leg."

Mental health is an issue for our times, after the great liberalisations in attitudes towards women's rights, racial discrimination and homosexuality. We congratulate Mr Campbell for making his contribution to moving popular opinion in that direction, and hope that the change in social attitudes continues to gather momentum.

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