Last week, Senator John Fetterman disclosed that he checked into Walter Reed National Military Medical Center to be treated for clinical depression.

In the Atlantic, Jennifer Senior writes, “As a national figure, Fetterman was continuously, relentlessly obligated to perform a certain role—that of a competent, confident politician. More than that, possibly: an accessible, obliging politician.”

Fetterman’s persona as a larger than life man of the people with a great sense of humor was first tested by the stroke he suffered while campaigning for the Senate in 2022. Imagine feeling the pressure to show up as that person while recovering from a stroke that nearly claimed your life? Being a politician means you are open for business 24-7.

Senior writes, “But depression, almost by definition, is a backstage emotion: lonely, prickly, uncomely. When you’re in the throes of it—something I know a thing or two about—it positively defies salable shtick. What this means is that every high-functioning depressed person has a self they try very hard to conceal. It is work performing your wellness—for some people, it’s more exhausting than their actual day job.”

When you’re depressed, the mere act of brushing your teeth can feel too hard. Working in a demanding job is a constant trial of forcing yourself to perform tasks you never even had to think about when you weren’t depressed. 

As a national figure, Fetterman can’t just be depressed. He can’t just focus on trying to brush his teeth. He has to manage the reputation and impact of his mental illness. He becomes a symbol for this question: can you be a freshman Senator and have mental illness? 

It is difficult to be open about mental health challenges when you’re in the climbing phase of life. 

In my search for guests on The Anxious Achiever I find that people who have achieved what they wanted to will share their struggles. But there's a big gap: people who are in the prime of their achieving years don't want to talk about their mental health challenges because it’s seen as a liability. And I have no idea how to change that. John Fetterman is a guinea pig for the conversation, which feels completely unfair.

This week The Anxious Achiever features two powerful men who experienced severe mental health challenges. Darshan Patel’s Bipolar disorder led him to betray his family and create big financial debts even while he climbed as an executive.  Lenny Mendonca was a Partner at McKinsey for many years. When he left McKinsey, he became active in public service, and agreed to join California Governor Gavin Newsom as his Chief Economic and Business Advisor. But, as he wrote on a popular California politics blog:

“On Friday, April 10 (2020), at 5 p.m., Californians learned I had resigned as Chief Economic and Business Advisor to Gov. Gavin Newsom and chair of the California High Speed Rail Authority. 

The press release stated I was leaving “to focus on family and personal business.” In corporate speak, this usually means someone got fired. I was not fired, and I approved this press release, even though I hate 5 p.m. Friday press releases. 

I am sharing additional information because I faced a challenge one of every three people in America has: depression and anxiety. 

Three weeks before my resignation, I had an emergency overnight stay at the hospital. After a battery of tests, I received a diagnosis of severe depression and anxiety. Against medical advice, I dove right back into coronavirus response. This was late March. The crisis was all-consuming and my local businesses and family also needed attention. 

At the time, I told myself and my team that we all have to operate at 120%. For me, this meant 80-hour work weeks and barely sleeping. I realize now that not only did I put my own health at risk, but also I was a bad role model for my team.” 

When Mendonca spoke publicly about his depression, the response was overwhelming. But I asked him: If he were still at McKinsey, would he be so public?

“The honest answer is, I don't know. I'm privileged enough to be at a point in my life where I don't really care. It's easier for me to talk about it when there's not as much actual or perceived downside to it. And so, if anything, the experience of talking about it has convinced me even more that we need to talk about it.”

Every week, millions of people “perform wellness” so they don’t lose everything they’ve worked so hard to build. We push through the signs of mental illness- not eating, not sleeping, sleeping a lot, working too much, feeling unable to work or concentrate- because our image of our successful selves is at odds with the reality that we are ill, and we need help. I have done this myself. 

Research shows it's more difficult for men to ask for help. Men have to perform success in our culture differently than women do. 

Addressing your depression before it’s a crisis can really help. I’m attaching some of my favorite episodes featuring men who’ve met their mental illness head-on:

NBA’s Kevin Love: Trying to Achieve His Way Out of Depression

Mark Goldstein: Compassion for Your High Achieving Self

Paul Greenberg: Battling Depression from the C-Suite

Jason Miller: How the Mental Affects The Physical

PS: Check out an excerpt of my book in the March-April issue of The Harvard Business Review, featuring two men who are open about their mental health challenges