What we can learn from Carrie Fisher

The stigma surrounding mental illness is one reason why those in the public media usually refrain from discussing their mental illness or becoming spokespersons for that cause. Not so for Carrie Fisher.

Fame came at the age of 19 when she played Princess Leia, twin sister of Luke Skywalker and daughter of Darth Vader in the first “Star Wars” movie. Later, she told us how she struggled with bipolar disorder and substance abuse. She elaborated on this and more in her autobiographical memoirs and novels, including "Postcards From the Edge," "Surrender the Pink," "Wishful Drinking," "The Best Awful There Is," and, just recently, in 2016, "The Princess Diarist." She apparently died in the midst of a tour to promote the new book, as she was a renowned public speaker. She even spoke at a convention of the American Psychiatric Assn. and taught us much we needed to know.

Here are some of the lessons she taught us.

1. You can survive and thrive even if you come from a very dysfunctional family

She was a child of two Hollywood celebrities, Debbie Reynolds and Eddie Fisher. If that wouldn't have been difficult enough, they divorced when she was only two years old when her father married her mother's best friend and another Hollywood star, Elizabeth Taylor. The following year her mother then remarried and her new husband apparently secretly spent Reynolds' life savings.

Carrie Fisher's self-help during childhood and adolescence seemed to be immersing herself in literature. As we now know, bibliotherapy and journaling are generally safe self-help strategies.

2. Beware of self-medicating bipolar disorder

Medicating one's mood swings with street drugs is not a safe self-help strategy. She said she did so because they made her feel more normal, though she was unsure what normal meant. She was reportedly diagnosed with bipolar disorder at age 14. Eventually, with more infrequent substance abuse relapses, she came to realize the dark side of self-medicating.

3. ECT can be life saving

Perhaps due to its early side effects and brutal depiction in the movie "One Flies Over the Cuckoo's Nest," electroconvulsive therapy (ECT) has been even more stigmatized than the mental illness it was designed to treat! That outdated conception has led to its limited availability. With new technology, side effects are minimal and the effectiveness higher than other treatments, especially for treatment-resistant depression, which not infrequently leads to suicide. For some time, she received ECT every six weeks. Though medication was often helpful at times, too, she told us psychiatrists that she thought ECT saved her life.

4. Come out of the closet of mental illness

Most with mental illness don't talk about it with anybody other than family or profession caregivers. Fisher talked and talked about hers to our nation. She said:

"People related to aspects of my stories and that's nice for me because I'm not at all alone with it. Also, I do believe you're only as sick as your secrets."

Also she told us:

"I now get awards all the time for being mentally ill. I'm evidentially very good at it . . . It's better than being bad at being insane, right?"

Yes, you are right, Carrie Fisher. I'm sure she would be honored if we used her life history to help destigmatize mental illness and learn how to care for it better. So, if there is a new year opportunity to do so, resolve to publicly eulogize Fisher in your setting, for your staff and for your patients. Though her living force ended on December 27, her life force will remain with so many, especially for mental health. May the force be with her and you.