May 6, 2010
A joint meeting of The Empire Club of Canada and The Canadian Club of Toronto
Margaret Trudeau
Valerie Pringle
Broadcaster
Children’s Mental Health Week
Chairman: Helen Burstyn, President, The Canadian Club of Toronto
Head Table Guests
Jo-Ann McArthur: Principal, fisheye, and President, The Empire Club of Canada
Nahla Hanna: Managing Director, Marsh
The Hon. Debra Matthews: Minister of Children and Youth Services, and Minister Responsible for Women’s Issues
Howard Brown: President, Brown & Cohen Communications & Public Affairs, Inc., and Director, The Canadian Club of Toronto
Verity Craig: Managing Director, CV Management, and Director, The Empire Club of Canada
Tony Diniz: Executive Director, Child Development Institute
Glen Newby: President, Children’s Mental Health, Ontario.
Introduction by Helen Burstyn
In 1971, at age 22, Margaret Trudeau became the youngest First Lady in the world when she married Canadian Prime Minister Pierre Trudeau. She was immediately thrust into the limelight, becoming one of the most watched and talked-about women in the country. She led a rich and interesting life, travelling the nation and the world extensively, and raising three sons.
But life in the public eye was not entirely satisfying, or entirely her own. When asked about her role as the wife of the most prominent man in the country, Margaret Trudeau famously said, “I want to be more than a rose in my husband’s lapel.”
After leaving the marriage in 1977, Margaret went on to lead an even more interesting life as she became a photographer, an actress, a television host and an author of two books—“Beyond Reason” and “Consequences.”
She remarried and raised two more children. More recently, she became a grandmother—and a very proud one, by all reports.
Though she has led a very public life, Margaret Trudeau has also had a very private life and, for many years, a hidden one. She has suffered from the debilitating effects of bipolar disorder for all her adult life. Now, after receiving medical treatment that has given her life balance and happiness, she is a strong and effective advocate for mental health issues, helping people overcome the stigma of mental illness and promoting appropriate treatment.
She is working with the Royal Ottawa Hospital to raise funds for their new hospital and raise public awareness of mental health issues. And she sits on the Executive Advisory Board of the UBC Mental Health Institute.
She is active in other causes as well. Margaret is the Honorary President of WaterCan, a charitable Canadian non-governmental agency dedicated to helping the poorest communities in developing countries build sustainable water supply and sanitation services.
Our other guest is also a pretty amazing woman.
Valerie Pringle is one of Canada’s best-known and respected media professionals.
She started her career at age 19 as a student reporter with CFRB Radio in Toronto after graduating from Radio and Television Arts at Ryerson in 1974.
Since then, she has moved from one success to another. For many years, she was the face and voice of the CBC TV news and current affairs program, MIDDAY. She went on to co-host CTV’s Canada-AM and then W-5.
Valerie has co-produced and hosted a number of documentaries for Discovery Channel, for CTV Travel and for Vision-TV. She was appointed a Member of the Order of Canada for her contributions to the communications field.
She is also very involved in a number of not-for-profit organizations. She chairs the Board of the Trans Canada Trail and is on the foundation boards of the Centre for Addiction and Mental Health, Women’s College Hospital and the Canadian Broadcast Museum Foundation.
But it’s not because she’s an award-winning journalist or outstanding volunteer that Valerie Pringle joins us today. She is here as a mother and as a family member whose experience with mental illness is very close to home. Her daughter Catherine, now 28, has suffered from severe panic and anxiety attacks, and Valerie has been very public about their family’s experience in seeking help and finding support.
Valerie and Margaret, I invite you both to please come up on stage and share with us your experiences in dealing with mental health issues.
Valerie Pringle
It is a great honour and a pleasure to be here speaking about this topic, which, as you’ve just heard, is very important to both Margaret and me. Margaret and I will be delighted to answer your questions.
I will start by saying we have personal stories, but we do want to get a message across and stick to the topic—children and youth mental health. We will try not to stray off topic too much. By starting, I might say it’s interesting that in the introduction we heard about your bipolar disorder being with you all your adult life. But you say Margaret, as you look back now, it started earlier. Eighty per cent of psychiatric illnesses do.
Margaret Trudeau
I would suspect so. We thought the onset of my bipolar condition after the birth of my second son was post-partum depression. Then it was called baby blues. There really wasn’t very effective treatment. I remember the psychiatrist wanted to get me back to being a good prime minister’s wife. I sort of felt like a broken car that needed something fixed, but it wasn’t the right approach.
Looking back because I am working on a book on mental health, I was probably always bipolar. The words that come to mind that my family remembers about me are vivacious, capricious, life of the party, moody, quiet, prone to tears. Bipolar is an exaggeration of emotions for those who don’t understand what bipolar is. It’s a chemical imbalance in the brain. There is not enough serotonin and that drives you into a deep depression. There’s too much dopamine and that fires you up into the highest euphoria and for me madness. I’ve been there a couple of times and I never want to go back up there again. I have had to learn how to live with my bipolar condition because it is a lifelong condition.
I was raised in the fifties. I was very lucky to be born in North Vancouver to a fine father and a really good mum and I was raised well. I had four sisters. Remember in the fifties we didn’t have any of the television and the toys that we have now. We were sent out to play. I played a lot. I had to eat a very strict diet of my mother’s food. That was that. But she also gave us every morning (from daylight savings until the next April) a cod liver oil tablet. That’s one of the things that is in my vitamin regime for my mental health. That is one of my supplements—a mega fish oil. It is very important. So I was given fish oil. I was given a balanced diet. We certainly didn’t have junk food. There was no McDonald’s around the corner and I had to play a lot. I was well educated of course being a Canadian girl. The schools were great. I had a good life. I think the balance of my childhood, the way that I was raised, having to do chores, having to work, having to take care of my own world in my family (we had a community in our family, a clan my father called it) helped balance me.
I do remember when I was over-emotional my mother would say, “Margaret, just go to your room. You can come out when you have a better attitude.” Well I ask now what was in my little girlie room that could have helped me deal with these huge emotions that were flooding me all the time—these wild thoughts, these big, big dreams, these small worries. I was always flooded and when you get manic you are racing as well.
My sister called my mum when I first had post-partum depression and said, “Mum, one of us should go to Ottawa. Marg is in trouble. I think she needs some help.” And my mum said, “You mean a psychiatrist? No, no, no. They just blame the mother.” Sorry Mum. My psychiatrist does blame you because while you raised me well and you gave me a wonderful education and my IQ from my genes was very high, you forgot about my EQ, my emotional intelligence, my learning how to deal with these huge emotions that my sisters didn’t seem to have and I had. I was always trying to suppress them. One of my psychiatrists told me that he felt that depression is really suppressed anger that you are not getting out. You just get deeper and deeper into feeling hopeless and unable to fight and anger actually is very good. I was never allowed to be angry. I was always told to be a pleasing little girl.
Valerie Pringle
I remember I was stunned when you told your story and came out publicly in the newspaper about your diagnosis. I was stunned that in this day and age it had taken so long. How did it take so long for you to get the proper help and treatment?
Margaret Trudeau
The head of the Liberal Party in Ontario at the time was also a psychiatrist and he wrote a very kind letter to Pierre after one of my manic kind of totally irresponsible and inappropriate and bad behaviours.
Valerie Pringle
Did it involve singing?
Margaret Trudeau
Maybe with the Rolling Stones, whatever. A lot of singing and dancing. He said that maybe Margaret might be suffering from manic depression. That was followed up with a nice meeting in a garden in Ottawa with a psychiatrist and of course he found a perfectly delightful and lovely mummy and little babies and someone who seemed to be doing just fine. I was very good at masking what was really going on, because I had been raised to be a pleasing person and to not show emotion and to not rock the boat so to speak. When I do rock the boat it is a big rock because it’s not usual. I had that early diagnosis. I was even put in hospital. Pierre put me in hospital when I was his wife. I wasn’t put into a psychiatric ward. It was about the time that “One Flew Over the Cuckoo’s Nest” was released, and I said, “If you think I’m crazy then put me in a psychiatric ward, not this executive suite for men executives with prostate and urinary tract problems.”
Valerie Pringle
Or alcoholism. They were probably tucked in there as well.
Margaret Trudeau
I tried treatment, but really the breakthrough came for people suffering from bipolar around 1985, when the first anti-depressants, serotonin-uptake drugs, were put on the market. They provided the one thing that was missing in me when I would get so depressed. I didn’t even know what serotonin was, none of us did, and I didn’t know why I couldn’t get back on my feet when I got knocked down. I just got deeper and deeper into depression as depressed people do, pushing everybody away, blaming everybody else because of my problems. Pierre’s fault. The nanny’s fault. Someone else’s fault. Not mine. Running away trying to escape it. Self-medicating with marijuana. Then alcohol.
Valerie Pringle
You’ve said that marijuana was probably a really huge mistake in terms of really harming you.
Margaret Trudeau
Oh yes. The two times I was seriously hospitalized followed quite a lot of self-medication with the magic herb. I thought I could lift myself out of the sadness, out of the depression, because it is a euphoric drug and has been our drug of choice since the sixties. It was always there.
Valerie Pringle
But it probably made things much worse for you.
Margaret Trudeau
It triggers you into mania. It has a propensity to do so. It is not a direct cause but they do say, and this study didn’t come out until maybe 10 years ago, that there really is a link between cannabis and mania. Obviously there is a link between cocaine and mania because any stimulants will push you up, but we thought that marijuana was a sort of benign happy choice instead of alcohol. It is not a happy choice at all.
Valerie Pringle
Can you take marijuana or alcohol or anything now?
Margaret Trudeau
Oh yes. All of it.
Valerie Pringle
That’s really good news.
Margaret Trudeau
I’m human. Everything in moderation. Alcohol is no problem because I have never had an alcohol problem. The problem is not the alcohol. The problem is not the drugs. Finally they got it right and started putting mental health and addiction together in one place instead of saying, “Your problem is that you are an alcoholic,” not “Your problem is that you have a mental issue that you are not treating and you haven’t faced and you are trying to self-medicate and drown your problems with alcohol or escape it. It’s just your way out.” Some people use food. Some people will get so overweight. They eat until they can’t stop eating. They can never stop eating or taking drugs or alcohol. This is the symptom of the problem, not the problem.
Valerie Pringle
I was listening to you talk about your mum. The person, who has become a poster child for mental health along with me, if I can call myself that, is my daughter Catherine, who is spectacular. She should be here today but she is very busy working. This is a cause that she is championing too. Through her life she would get overwrought for a skating test, for any test. She had a mild eating disorder. At one point she was concerned enough about her mood swings that she said she thought that she needed to see someone. I remember taking her to the wonderful Diane Zak. She had a conversation with her and decided this was a teenage thing.
Margaret Trudeau
But you are advocating for her. You are doing everything right.
Valerie Pringle
Well that was good but it did get to a point that it got worse—the crying through university and exams. I would get her on the phone and start the bromide. I have never really experienced that at all. I can say I have never had a panic attack. Everyone has been nervous but this was just off the charts. Her friends were very good at helping her through it, but when she finally started her first real job, she was living at home then, she fell apart. She was just a quivering crying ball on a bed. I used to say, “You will get better, look at your record, look how good you are, look at how fabulous you are,” but these words were pretty useless. It was like your mum telling you to go and get a good attitude or whatever. So what was interesting is that finally I guess we realized that she had to get some help. She went to a GP. She got anti-depressants. She is on Efexor. This was not great news for her and I suppose it isn’t for anybody. “Great. Crazy pills for me. What is wrong with me?” Some therapy was advised. It was more like counselling that had a lot of questions about mothers. Anyway I did call David Goldbloom at the Centre for Addiction and Mental Health (CAMH) whom I knew and he saw Catherine. He talked about cognitive behaviour therapy that has been really helpful with panic and anxiety.
Margaret Trudeau
There isn’t a magic pill. There is a pill that will get you on firm ground like everybody else. At least you can think clearly, or maybe not that clearly depending on what the pill is, but at least you are on firm ground. But then you have got to start therapy. You have got to start talking. You have to get rid of all of the self-loathing that came from the mistakes you made. You have to get rid of your fear of ever being able to contribute. You have to get rid of your jealousy of other people who seem to have such a nice life and you have to get rid of your anger. Why me with a mental illness?
Valerie Pringle
I know and it’s forever.
Margaret Trudeau
Why do I have to take drugs forever? One psychiatrist at a question-and-answer period after I had given my speech said, “Margaret I think that you think you have recovered from your bipolar condition. Don’t you know that there is no recovery?” I said, “Well I guess I’m cured from the fear of my bipolar condition because I know what it is. I self monitor. I know how to deal with my emotions finally. Maybe I’m just finally a grown-up.” That is the problem with our youth and our teenagers. For them to have the maturity to accept the hard choices and take medication and be compliant is a hard one. Most of the medications have side effects that teenagers will be particularly unhappy about, such as decreased libido and fat.
Valerie Pringle
It is something to deal with.
Margaret Trudeau
You have to be so strong. The anti-depressants don’t have to be forever. What is the anti-depressant doing? It is raising your serotonin level and keeping it up. How do we get serotonin? We get serotonin from exercise. We get serotonin from laughing at a joke. We get serotonin from sex. We get serotonin from eating good food, from sleeping well, from being healthy. Most of the people in this room, a third of you, won’t have good serotonin, because a third of Canadians are depressed. Only a third of the third of you will ever admit it and get help. That’s your problem because you can be so much better so quickly if you only reach out and get help.
Valerie Pringle
To finish about Cath, one of the things that I was going to tell you is that her dad and I are so proud of her. After that particularly bad episode, and she could not work during that time, a friend of hers, Heather Armstrong, (we will never forget her kindness), phoned her and said, “Get in the shower, get dressed and call me. Get in your car, call me. I will meet you outside the office.” She met her and walked her into the office. Catherine was wondering what they would say. Everybody was going to look at her. It was so embarrassing to have missed work because of this. She had said to her dad the night before, “What do I say?” And he said, “Tell the truth.” And so she went in and everybody asked her where she had been and what was up. And she said, “Well I have been having panic and anxiety issues.” Then she went to her boss and said, “That’s the issue.” Everybody was referring to people with the same problem. It was gone and it was known. There was no shame in it and that was something we were hugely proud of.
I became more involved with CAMH on the foundation board, and then the campaign cabinet. Mike Wilson, who I think is such a hero, spoke out about his son’s suicide, and that was very brave. James Bartleman, Ron Ellis are really brave, wonderful people and they said to me, “Would you do a public awareness campaign?” I thought, “Lord, in my family—alcoholics and drug abusers, who doesn’t?” This is everybody’s family. It is everywhere. It is everywhere and you don’t hide it. You don’t not talk about it. It is everywhere and it is time we shed some light on it.
I said, ‘Well probably Catherine would agree to be talked about in this ad, but it is sort of lame. Panic and anxiety disorder is sort of low in psychiatrics. There are schizophrenia, other things that are way more serious. Who is not on anti-depressants? Who doesn’t know about this?” I said I would do it if it helped and they put up these bus shelter ads and radio ads and I found I was so wrong. There wasn’t a day that went by that people weren’t coming up to me and saying, “I have never spoken about this. I’m far too ashamed. I can’t admit it.” It is still a personality failing. It is their flaw and kids are afraid to have that label and they don’t want to name it.
Margaret Trudeau
I say the shame is not having a mental illness. The shame is having one and not seeking treatment and not getting better and not being able to be the whole wonderful person that you are meant to be. You are impaired by something in your brain. Why can’t we look at our brain the same as any of our other organs? Yes, it is more mystifying. It is the last frontier of medical research, but it is still an organ that can have its dysfunctions. Be sympathetic to people as equally as you would when someone gets told that they have diabetes and are going to be taking insulin for the rest of their life. When someone says to you, “I’m bipolar and I’m going to be taking medication for the rest of my life,” don’t mock them. Say, “Yeah, good for you,” because they are taking hold of their life. They are taking hold of their problem. We all have problems. We are not perfect. You asked me at the beginning, “How come it took so long?” It was me. I was in a prison. I would not accept that I had a mental illness. I thought I could get through it all by myself. I had every rationale and reason to blame everybody else and that’s what people who have an untreated illness will do and particularly ones who are still very angry about their condition. They will blame everybody else. Ninety per cent of marriages, where one spouse is bipolar and is untreated, fail. My two marriages failed because of the roller coaster of emotions that I led my poor balanced husbands through.
Valerie Pringle
We talked about one in five people suffering from a mental illness in this country. A larger number of people are living with them and caring for them and dealing with them. Was there a support group for your husbands? What is it like to live with bipolar? People who are caring for schizophrenics need that. It is an enormously difficult situation.
Margaret Trudeau
Bipolar is all a question of balance. All the drugs have side effects. Everybody will say, “But I’m so creative in my manic stage, and you are going to take that away from me.” The drugs do. There is no question they put up a ceiling. They bring you down and stop you from being too high and they bring you up from being too low and put you in a nice place where you can be a whole contributing normal human being. We wouldn’t have had a Van Gogh painting, we wouldn’t have had half of the creative work in the world, if all of these people had taken their Prozac.
Valerie Pringle
Having said that, one of my very favourite interviews was with Leonard Cohen. And I said to him, “You have been suffering from depression your whole life.” And he said, “Yes, I’ve treated it with Prozac, alcohol, Buddhism, sex, whatever.” He saw his art as a victory over suffering, not as a result of the suffering. He also said the best thing he ever wrote was that line from “Anthem,” where he said, “Ring the bells that still can ring, forget your perfect offering, there is a crack, a crack in everything.” And he said, “I think I nailed it.”
Margaret Trudeau
He did nail it because it is in our cracks and in our flaws that we become unique and beautiful and not the same.
Valerie Pringle
How do you communicate that to children though, Margaret?
Margaret Trudeau
This is my concern. I’m working with a doctor Alan Young at UBC in the Department of Psychiatry. He’s working on bipolar in children and I’ve learnt a lot from him. He’s a British psychiatrist, now Canadian. One of the problems is that the Americans are throwing drugs at children. They are now diagnosing bipolar which is good. They used to diagnose bipolar children in their manic phase as having an attention deficit. They gave them Ritalin, which gave them more stimulation, which wasn’t really the solution for those children, and the depression was being ignored. We really need to work at it through diet and exercise and proper play and I mean real play, imaginative play, in the real outdoors. I know we are afraid to let our children outdoors but what a shame. The world is out there for children if they are allowed to be in it and play in nature. This was an important part of my childhood. I did have someone flash me once. Who doesn’t?
Valerie Pringle
I did. It was when I was hitchhiking down Yonge Street when I went to Ryerson on a daily basis.
Margaret Trudeau
There have always been pedophiles, always been flashers, and we should trust that our children can have some play.
Valerie Pringle
Well here is a question. What kind of impact does stigma have?
Margaret Trudeau
I think it comes out of ignorance. Stigma is not being informed and educated and the only way to get rid of it is with education and people becoming aware how wrong it is just to shut off a whole population of people because they have a flaw that you perceive as a character flaw when in fact it is just a physical, mental one.
Valerie Pringle
We’ve seen changes, huge changes, in how we see AIDS and so many things such as cancer. There are changes coming in mental health. There are so many people who have taken leadership roles at CAMH. I’m involved in something called the Canada Post Foundation for Mental Health as well.
Margaret Trudeau
Great West Life, the insurance company, has the most remarkable Web site. I can get papers from psychiatrists at the Mayo Clinic through their Web site. It is just an absolutely open beautiful Web site to help people understand mental illness and to get early help. Why is Great West Life, the big insurance company, doing this? It is the bottom line. It’s a huge cost to our economy to have people who stay depressed, who stay in a rut where they can’t function or they are not functioning because of a mental illness that they are too afraid to admit. Don’t call it a mental illness. Call it your brain health.
Valerie Pringle
I was on a panel with Phil Wilkerson a few days ago, talking about mental health and workplace issues. He felt it would be a great leap forward if we stopped saying mental illness. We should start breaking it down. We should say schizophrenia, panic and anxiety disorders.
Margaret Trudeau
Brain health. Even labels are distressing. There are some that are absolutely clear what they are and some that are not so clear. There may be a scattering of different issues. Just talk about having a balanced functioning happy brain that thinks clearly. When you are manic and when you are depressed, you’re not thinking clearly and the worst thing that happens again and again and again, it certainly happened to me, is denial. You just will not get help. You will not accept that you need help. I’m not mentally ill. You are mentally ill if you think I’m mentally ill.
Valerie Pringle
Well this is such a hard thing for parents.
Margaret Trudeau
Well 50 per cent of recovery apparently is in accepting your diagnosis. Then you are on your way. The doctor thought I was so compliant when I had my complete breakdown after Michel and Pierre’s deaths. I totally lost my mind, had complete madness, I was hospitalized and had to start from absolutely the ground up to get well again. The whole essence of it was balance. It was just making hard choices that would lead to a balanced lifestyle. Getting my serotonin out of food and exercise. I’ve got a personal trainer. I hate going to the gym. I have spent so much wasted money. I dieted. I put on so much weight, at different times, up and down. I dieted and diets are distressing in every way to the family, to you, your friends, everyone. No dieting. Just find out how to get your metabolism going, how to get that energy so that you can function at high speed. Well not high speed; high-speed fun.
Valerie Pringle
Speaking just to the stigma issue. I remember my first tour of CAMH down at Queen Street, which they are transforming as you know and we are happily accepting donations. When I went through it I found there was no gift shop. This is a hospital with 600 beds, more than Sick Kids. It is huge. There is no gift shop because there is no economic model. Nobody comes to visit. Nobody buys gifts for all the people in there who are probably feeling worse than most people in any hospital. I was part of a campaign last Christmas called “Gifts of Light” which was a fundraising campaign. Catherine and I did a lot of TV interviews etc. just trying to get money so that everybody in CAMH would get a gift last Christmas—a bathrobe, a blanket, a pair of slippers. I went to the mood and anxiety unit one day. I was delivering some of these. The staff there did an amazing job. We were trying to reduce stigma and also to reach out. Catherine said that it is like a hug. The most important thing, and she would say this too as I’ve learned in trying to get better in dealing with her, is realizing that this is for life and it’s sort of depressing for her to think she would always be like this. I’ll see her face go flat.
Sometimes she gets a little rigid. She is just getting a bit panicky, she’ll say. Or I’ll phone her and she is very weepy. Instead of now just telling her to sing a happy song or whatever, I tell her to come here and see me. We just sit. She just wants to be held. She wants to know people will be there. She doesn’t want to think that they’ll get sick of her. They’ll get tired of this. They’ll get fed up with her behaviour. No one will want to marry her. No one will want to be her friend for the long term because every once in a while she dips down and can’t do anything about it. She doesn’t want to have to feel guilty or ashamed because of that but that’s the fear.
Margaret Trudeau
It isolates you and it marginalizes you as you go deeper and deeper into depression. You know that you’re no fun. You are no fun. You haven’t got the ability to laugh. Nothing is funny. You are not getting enough serotonin. You have no delight. You know that you are a bore and a party pooper so you stop going out and you stop accepting invitations and then you think that you probabl
