Panel Discusses Treatments for Depression

Aired April 21, 2005 - 22:00   ET

LARRY KING, HOST: It can make you kill yourself. Millions suffer from it. Many don't even know it. Tonight, battling depression, with Margot Kidder, "Superman's" Lois Lane on the big screen. Off screen, she's battled a bipolar disorder for years, and her last manic depressive episode made national headlines nine years ago. Country legend Tanya Tucker. Behind all her knock-down, drag- out tabloid headlines, she, too, has fought depression. Actress Linda Dano. Her husband and mother died within days of each other. She, too, suffered depression, and is now helping others beat it. Chad Allen, the actor and television star, was so depressed he thought about suicide. And Dr. Karen Swartz of the Johns Hopkins Mood Disorders Department.
This is an hour that could save your life, and we'll include your calls. And it's next on LARRY KING LIVE.

We'll start with definitions. We'll begin with Dr. Karen Swartz, co-director of the Mood Disorder Program at Johns Hopkins School of Medicine, the famous school in Baltimore.

What is depression?

DR. KAREN SWARTZ, MD, CO-DIRECTOR, JOHNS HOPKINS MOOD DISORDERS PROGRAM: Well, depression is a medical illness, and it can be defined by the combination of low mood, a change in physical symptoms, like your sleep, your energy and your appetite, but then also how you feel about yourself. Losing your self-confidence and losing your ability to feel positive about yourself.

KING: How does it differ from, I'm in a bad mood today?

SWARTZ: That's a great question. Because I think we have to see the difference between normal sadness, something we all have, and the kind of depression that's a medical illness. So it's the length of symptoms, it's the severity, but it's also the idea that these symptoms come together and stay for an extended period of time.

KING: How more easily treatable with the advent of anti- psychiatric -- of these drugs like Prozac and the like?

SWARTZ: Oh, antidepressants have made an enormous difference. We have so many options, that if we have one choice and it's not successful for someone, we have many options to try. And so it means that most people, thankfully, can be very successfully treated for their depression now.

KING: Do we know the cause?

SWARTZ: We don't know the exact cause. We have some hints that come from neuroimaging, like PET scans or MRIs, and from genetic studies. But now we're still trying to learn those things.

KING: Do we pretty much agree that it's some sort of chemical imbalance?

SWARTZ: Absolutely. Neurochemicals like serotonin and norepinephrine, are very important for the understanding and are important to the biology of depression. Btu their exact role in exactly how the medications work, we're still learning about those things.

KING: We'll talk with each of our guests. We'll be including the doctor throughout, we'll be including phone calls.

Margot Kidder, it's called bipolar. First, before we talk to Margot, what is bipolar, doctor?

SWARTZ: Bipolar disorder is different than depression in that you have two poles, and say, you can have both manic episodes, where you're very energetic, and you have tons of energy, no need for sleep, going a mile a minute. Those are the manic episodes. And then you also have depressive episodes, as I described before, with a low mood, no energy, feeling terrible about yourself, and sometimes having suicidal thoughts.

KING: Margot, when did this all begin? Can you place it?

MARGOT KIDDER, SUFFERED DEPRESSION FOR SOME 40 YEARS: I don't know. I suppose I was always quite moody. And I had my first suicide attempt at 14. I don't know how serious it was, but when you're 14 and you really want to die, something is definitely wrong. So the mood swings continued for me most of my adult life until, actually, about eight or nine years ago, when I had that last big public flip- out. And then I was able to get better.

KING: Refresh us. What happened that day and night?

KIDDER: Well, it was a combination of things starting to speed up way before the flip-out. And I didn't know enough in those days to check that speeding up. I didn't know enough to get the signs that, oops, I've stopped sleeping, this is really bad, I better do something about it. I've stopped eating, and I was actually quite enjoying the lack of need for sleep and food and was knocking back more caffeine. And eventually, you spiral out of control, and the sleep deprivation and the nutritional deprivation plays a great part. And pretty soon, you're psychotic. You can make pretty much anyone psychotic by removing sleep and food and adding a lot of caffeine and who knows what to their systems.

KING: And what did you do that night?

KIDDER: So that was a big crash out. And then, well, I was pretty wacky for a good week. I wondered around L.A. thinking the CIA was after me and found myself living among the homeless in downtown L.A., which is actually an experience I treasure, because I learned a lot from it. And then was able to come down, after I faked sanity in the loony bin in L.A., and flew up to Canada and was able to come down with acupuncture, and then was put in touch with an extraordinary man, Dr. Abram Hoffer, who has been curing schizophrenics with nutritional -- rather complicated but nutritional means, something called orthomolecular medicine, where you remove the toxins from the system and you replenish nutrients.

And so between the acupuncture and the orthomolecular medicine, I have not had an episode for nine years, which is a miracle if you're me. So I feel very good.

KING: Now, Dr. Swartz, her description -- that's not, for want of a better term, the kind of normal depression we hear about, right?

SWARTZ: Well, she's describing a manic episode. And...


SWARTZ: ... going up and have tons of energy, going out of control in many ways, as opposed to the depressive phase.

KING: But it is all depression.

SWARTZ: Well, in bipolar disorder, you have two very distinct phases. So it's both -- they're both mood disorders, but a manic episode -- there's very little depressive about a manic episode. Most people feel on top of the world, that they can do anything. They have -- it's the exact opposite of depression, actually.

KING: Chad Allen, the actor -- let me hold it, I'll get back to you, Margot. We will get everybody. Chad Allen is the actor best known for co-starring in the TV series, "Dr. Quinn, Medicine Woman." And he will also appear in "Cold Case" this Sunday night. What happened with you? You attempted -- did you try to kill yourself?

CHAD ALLEN, ACTOR, BECAME DEPRESSED, HAS HAD SUICIDAL THOUGHTS: You know, I never made what would classically be defined as a suicide attempt. My sister -- I have a twin sister -- she made several very real suicide attempts. However, I am familiar with what it feels like to feel suicidal, to want to die, to not be able to wake up in the morning and feel like I can't lift up my head, I can't get out of the house today. What am I going to do?

KING: How long does this go back?

ALLEN: You know, I first started -- since probably 12, 14 years old. I also started drinking alcohol and using drugs right about the same time. So for me, that was my first -- my first sort of coping mechanism I used. And when I finally got sober when I was 24 years old, I finally felt what it was I was hiding from. First, it was anxiety, which is kind of the evil twin sister of depression, and then those feelings of absolute just despair and sorrow, you know, I can't get out of here today, what am I going to do?

KING: You were in the closet, right?

ALLEN: Yeah.

KING: Did being gay, do you think, had anything to do with it?

ALLEN: Absolutely, we started a campaign...

KING: Absolutely yes?

ALLEN: Absolutely, had a lot to do with it. We started a campaign called the talk-about-it campaign, to address the issue of depression in the gay community. The gay community has an almost 18 percent, if not higher, instances of depression than the community at large. You know, people are always asking me, why is that? And I say, you know, I hosted the Tulsa, Oklahoma pride festival last year. I get in my car and I'm all set to go down the street -- Tulsa, Oklahoma is famous for its Christian protesters -- and one man was holding up a sign; the sign said "how come the community that calls itself gay has the highest suicide rate?" With almost no understanding of the irony that maybe it had something to do with him standing there holding that sign, you know.

The fact is, there's a lot of things that we've had to deal with, and coming out and being who I am, that's part of it. But it's been a tough battle.

KING: Dr. Swartz, does depression in the gay person mean they're depressed because they're gay, or they're depressed because of the way they're treated by being gay?

SWARTZ: Well, usually, when you have a stressful thing going on in your life, such as the process of coming out or dealing with the way people are reacting to that, what you're dealing with is the combination of a stressful life event with your underlying biology. And so, certainly not everyone going through that process would necessarily have depression, but it's enough of a stress that if you had that vulnerability that, in you, that it could come out, that the depressive symptom would come out.

ALLEN: In my case, my twin sister is not a homosexual. She had other issues going on.


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