From the Editor

Psychiatry seesaws with stars’ ups and downs

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Jane Pauley is well-known for hosting NBC television’s Today Show but also for developing manic symptoms from corticosteroid therapy. Dr. Michael Cerullo (page 43) mentions her case in his excellent discussion of how to treat steroid-induced mania or mixed bipolar symptoms and reduce the risk in patients who require sustained corticosteroids.

Jane (we are on a first-name basis, aren’t we?) revealed in her autobiography1 that she developed mania after taking corticosteroids for urticaria. In this case, a widely admired broadcaster’s revelation probably helped reduce the stigma of psychiatric illness.

But last year Hollywood celebs Tom Cruise and Brooke Shields debated the merits of antidepressant therapy for postpartum depression. That highly publicized exchange—he on the “con” side, she on the “pro”—certainly raised public awareness of depression in new mothers, but its effects on psychiatry’s image might have been more negative than positive.

And what do we make of actress Lorraine Bracco, who plays a psychiatrist on the HBO TV series, The Sopranos? Her character, Dr. Jennifer Melfi, treats mobster Tony Soprano’s panic attacks but not his, well, antisocial traits. Speaking at last year’s American Psychiatric Association meeting, Bracco stated that “in real life, I’m actually someone who has suffered from depression and had to seek the help of a psychiatrist.”

So we have a real patient portraying a psychiatrist treating an imaginary patient and then lecturing to real psychiatrists. That seems ironic, but I think The Sopranos’ popularity and Bracco’s acknowledgment that she sought treatment for depression make psychiatry look pretty good.


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