Demi Lovato leaned into the microphone. “I tried to talk to my piano,” she sang softly, stopping as she broke into tears.
It was her first performance since she suffered a drug overdose in 2018. The audience — gathered in Los Angeles’s Staples Center last month for the Grammy Awards — applauded as Lovato took a deep breath and restarted “Anyone,” the intensely personal ballad she wrote just days before the overdose nearly took her life. Lovato’s tears returned when she finished the song.
There was no need for Lovato to explain the emotions behind that moment — the singer has talked for years about her battles with bipolar disorder, substance abuse and eating disorders. That honesty made Lovato a “pioneer” when it comes to celebrities opening up about mental health, said Katrina Gay, director of strategic partnerships for the National Alliance of Mental Illness.
It’s a space that largely didn’t exist in 2012 when Lovato first shared, in an MTV documentary, that she had struggled for years with self-harm, anorexia, bulimia and drug and alcohol abuse, even as she courted increasing fame as one of the Disney Channel’s marquee talents.
Nearly one in five U.S. adults live with a mental illness, according to a 2017 survey by the Substance Abuse and Mental Health Services Administration. Experts say talking openly about mental health can help break down stigmas that persist around depression, addiction, eating disorders and other issues.
“Research has told us that the best way to change someone’s beliefs around mental illness is to have a direct contact with someone who has a mental illness that you relate to,” Gay said. Because social media has lessened the degrees of separation, celebrities — with highly visible platforms and fans who look up to them — can be particularly influential when they share their stories. But opening up about these serious, sometimes deadly, illnesses can come with its own set of challenges.
Lovato, 27, has repeatedly emphasized that her recovery is ongoing. In an interview released Tuesday on model Ashley Graham’s podcast, she said she continues to educate herself on how to talk about the issues that affect her. “When I make mistakes, it’s important that I own up to them right away and am vulnerable with it and say ‘hey, I don’t know about certain things’ or ‘you’re right, I should have been more educated on this topic,’ ” Lovato said. “But it’s just about being real. And if I’m wrong, I’ll admit it.”
Taylor Swift recently opened up about her history with disordered eating as part of her uncharacteristically candid Netflix documentary, “Miss Americana,” released last month.
“I’ve learned over the years that it’s not good for me to see pictures of myself every day,” Swift says, noting that in the past, pictures she perceived as unflattering would sometimes lead her to “just stop eating.”
“I thought I was supposed to feel like I was going to pass out after a show — or in the middle of it,” Swift says as the film flashes to images of her during the world tour for “1989” — an unspoken emphasis on a frame she now says was never meant to be that thin. The juxtaposition between footage of Swift now and photos of her from several years ago made the singer’s story “so much more visceral and more emotional,” director Lana Wilson told Glamour.
But those scenes veer into territory that can raise concerns for those who treat eating disorders. Experts caution against sharing images — particularly those that perpetuate the stereotype that eating disorders only affect emaciated white women. “The more that we put forward that particular image, the more people that actually end up getting undetected and go without treatment that they could really benefit from,” said psychologist Christine Peat, an assistant professor of psychiatry at the University of North Carolina at Chapel Hill.
Sharing specific numbers — as Swift does with her past and present dress size — or detailing diet or exercise regimens is also discouraged. “With eating disorders there’s so much comparison that even if your intent is a good one — to show your story and how dangerous some of this was — inadvertently people may take that as a benchmark … to measure themselves against,” said Peat, who spoke generally because she had not seen the documentary.
Swift has acknowledged her own shortcomings in discussing that part of her life. “I’m not as articulate as I should be about this topic because there are so many people who could talk about it in a better way,” the singer told Variety following the film’s premiere at the Sundance Film Festival. “But all I know is my own experience.”
Swift’s ability to share that experience reflects changing cultural attitudes. Less than two decades ago, Gay had trouble booking a celebrity for a NAMI event. She eventually landed Patty Duke, the Oscar-winning actress who became an outspoken mental health advocate following her 1987 diagnosis with bipolar disorder. At the time, Duke told Gay that many of her colleagues were reluctant to discuss their experiences with mental illness because they feared professional fallout — including being denied roles — should they speak publicly about their mental health.
Gay cites the 2014 suicide of beloved actor-comedian Robin Williams as a major turning point, in part because “so many different people related to him across demographics and age groups.” The cultural shift has been so profound that even newcomers like goth-pop sensation Billie Eilish, who has said her rapid rise to superstardom led to severe depression, can be frank about their mental health.
The 18-year-old said in a recent interview with Gayle King that at her lowest point she contemplated jumping out of the window of her hotel room. Like eating disorders, discussion of suicide can be triggering for some. But Gay said Eilish’s take on her experience — which also mentioned therapy and support from her close-knit family — struck the right tone overall because it was honest and unique to the singer. “For her to have been more vague about it wouldn’t have been authentic for who she is,” said Gay.
Over the past few years, a diverse group of stars — including Bruce Springsteen, Brad Pitt, Ben Affleck, Chrissy Teigen, Justin Bieber, Dwayne Johnson, Big Sean and more — have also spoken openly about their experiences with issues ranging from substance abuse to anxiety and depression.
Although it’s easier now for public figures to talk about mental illness, celebrities who regularly advocate for awareness often take on more direct responsibilities. NAMI takes a custom approach with its celeb supporters, advising them on the best way to share their stories. The organization also primes them on things for which they might need to prepare, such as vulnerable fans approaching them at a meet-and-greet. The goal, Gay said, is to ensure the stars can be helpful — directing people to proper medical resources when necessary — while staying true to their personal brands and taking care of their own well-being.
Mental health advocacy has arguably become part of Lovato’s brand, as her victories and setbacks have been a recurring theme in her music (and her ever-growing collection of tattoos). “Saturday Night Live” comedian Pete Davidson has similarly incorporated his battle with mental illness into his persona on the NBC sketch comedy series, where he once began a bit by riffing, “I think I speak for all crazy people when I say ‘Aaaah!’ “
Renee Solomon, a clinical psychologist who runs Forward Recovery, a Los Angeles-based rehabilitation center for mental health and substance abuse issues, has mixed feelings about Davidson’s comedic approach, because his self-reported diagnosis of borderline personality disorder is a serious illness that is not widely understood outside of the mental health community.
But, she said, Davidson’s candor and discussion of treatment, however humorous, can be helpful to vulnerable viewers. “If you think you’re depressed, see a doctor and talk to them about a medication and also be healthy,” Davidson said in the same appearance, before quipping: “If you’re in the cast of a late-night comedy show, it might help if they, you know, do more of your sketches.” Ahead of “SNL’s” winter hiatus last year, Davidson joked that his vacation would be the kind “where insurance pays for some of it, and they take your phones and shoelaces.”
Solomon added that seeing Davidson on air — even amid public setbacks including his whirlwind 2018 engagement and breakup with Ariana Grande — can be an inspiration for viewers struggling with mental health. Lovato’s Grammy’s moment was triumphant for the same reason: “It gives people hope that they can get through their own issues and come out on the other side stronger.”