A Presidential Candidate Openly Taking Meds? Don't Bet On It

Political mudslinging is rarely in short supply during a presidential primary, but this election cycle's Republican field has included such a collection of characters that people keep grasping for new ways to declare one or another of them to be off his rocker. One method that's been getting a lot of traction -- perhaps because it's a bit more modern-sounding than declaring someone "off his rocker" -- is to accuse one candidate or another of being "off his meds."

One of the main targets of the slur has been Newt Gingrich, whose egotism, penchant for hyperbole and wacky futurism have gotten him called all sorts of names. This particular insult surfaced as early as 2003, when the deputy secretary of state denounced Gingrich's criticisms of the State Department by sniffing that Gingrich was "off his meds and out of therapy."

The "off his meds" insult has reappeared in the current campaign, referencing subjects as diverse as Gingrich's immigration plan and his bashing of Mitt Romney's involvement in corporate restructuring and job-cutting while at Bain Capital.

For Gingrich, the put-down likely hits close to home, since his mother, now deceased, took medication for many years to manage bipolar disorder; indeed, at a recent campaign stop in Iowa, he started crying while discussing her illness. As a political putdown, though, the phrase, has not only applied to Gingrich, but also to other presidential hopefuls, including Ron Paul and Herman Cain, before the latter dropped out of the race.

In our contemporary, pill-saturated culture, "off his meds" is often a mere figure of speech. I have to wonder, though, how voters would react to a candidate who wasn't "off his meds" but who was, like millions of Americans, taking them as prescribed for a psychiatric condition. Would that connote triumph over adversity, a favorite campaign trope? A propensity for self-monitoring and self-improvement, certainly a desired quality in a leader? Perhaps a sense of humility that puts the needs of the country before one's own pride or one's aversion to a pharmaceutical solution?

I'm pretty sure that the answer to all three of these scenarios would be "no": A presidential candidate who acknowledged taking psychiatric meds of almost any sort for most any psychological condition would be unelectable.

When it emerged that Michelle Bachmann suffered from migraines, the media erupted with stories questioning whether the disabling headaches would prevent her from fulfilling her presidential duties should she be elected. Assurances from her brother, a psychiatrist, that she took medications that effectively stopped the headaches in their tracks did little to stifle the speculation.

The Bachmann issue did touch on some potentially relevant concerns regarding not just the condition itself, which is famously debilitating, but the medications used to treat it. As a fellow migraine sufferer, I know, for example, that that the drugs one takes to stop a headache are often ineffective if they're not taken early enough. They can also make you tired and fuzzy-headed so that even with them, you're still not functioning anywhere near full capacity.

Psychotropic drugs are a bit of a different beast -- as I detail in my forthcoming book, they are not a cure-all and have plenty of little-discussed complications. But unlike drugs for migraines, they carry additional connotations in our culture, seeming to say something about the character of the person who takes them.

Psychiatric treatment, of course, has long been a major hazard to the fortunes of presidential and vice-presidential candidates. During the 1964 campaign, psychiatrists attacked Senator Barry Goldwater en masse as unstable, based on nervous breakdowns he'd allegedly had decades earlier. Senator George McGovern's 1972 vice presidential candidate, Senator Thomas Eagleton, was forced to drop out of the race when it was revealed he had twice had electroshock therapy for depression.

Yet, our perhaps most exalted president, Abraham Lincoln, was an unmedicated depressive his entire life and talked of committing suicide as a young man. As the author of a book on Lincoln's depression put it in The Atlantic, "if he were alive today, his condition would be treated as a 'character issue' -- that is, as a political liability." Yet, as the author, Joshua Wolf Shenk, argues, it was Lincoln's tortured melancholia that made him such an empathic, far-sighted president. (The psychiatrist and researcher Nassir Ghaemi makes a similar argument about the role of mental illness in shaping great leaders in his recent book, A First-Rate Madness.)

When it comes specifically to psychiatric medications, it's commonly argued that such drugs, especially antidepressants, are overmarketed and overprescribed as chemical crutches for people undergoing the ordinary stresses of everyday life. But in our toxic political environment, a candidate taking such medications would likely draw a different kind of criticism. The charge wouldn't be that he didn't need the drugs. In fact, it would probably be quite the opposite -- that the medication was evidence of the candidate's unfitness for the country's highest office.

Last fall, one of the many baseless rumors going around the conservative blogsphere about President Obama alleged that he was taking antidepressants. A former high-level White House staffer anonymously made the allegations, and Gawker reported that The New York Times was investigating whether the president might be depressed owing to his low approval ratings, pushback from recalcitrant Republicans in Congress and a stalled economic recovery.

Lower on the political power scale, several members of Congress, including former Rep. Patrick Kennedy of Rhode Island, have disclosed that they have mental illnesses, which they manage successfully with medication, without apparent major political repercussions.

Presidential candidates are different, though. The campaign mudslinging and opposition research is more hard-charging, and every gaffe, embarrassing affiliation and skeleton-in-the-closet has the potential to bury a candidate.

But any flap over a presidential candidate taking psychiatric medication would ignore the fact that in order to be a viable choice for office, the person would almost certainly have to have his mental illness under control. Such a candidate wouldn't be "cured" of his "problem," but, as with a person who took insulin for diabetes or blood pressure medication for hypertension, the condition would be managed, thanks, at least in part, to meds.

More than one in ten Americans over age 12 takes an antidepressant, and many others take other kinds of psychiatric medications. They are our doctors, lawyers, professors, computer programmers, business executives and, yes, politicians. George McGovern later regretted forcing Thomas Eagleton off the presidential ticket, saying, according to The Times, "I didn't know anything about mental illness. Nobody did."

Forty years later, we know a lot more about mental illness. But, given the grueling and brutal demands of modern campaigning, and our unreasonable expectations that presidential candidates be flawless and free of personal demons, we would be extremely unlikely to embrace a presidential candidate who acknowledged taking drugs for a psychiatric condition.

I would be very happy to be proved wrong.