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Carrie Fisher was a powerful force for lifting the stigma against mental illness. The beloved "Star Wars" actress, who died Tuesday after suffering a heart attack, was courageously open about her lifelong troubles with bipolar disorder, depression and addiction.
In her last "Ask Carrie Fisher" advice column published Nov. 30 in The Guardian, Fisher responded to a question about bipolar disorder, also known as manic depressive illness, from someone named Alex, who asked: "Have you found a way to feel at peace when even your brain seesaws constantly? I can’t see very far down the line from here and I hope that you can give me some insight."
Fisher's response was compassionate, kind and characteristically self-deprecating:
"We have been given a challenging illness, and there is no other option than to meet those challenges. Think of it as an opportunity to be heroic — not 'I survived living in Mosul during an attack' heroic, but an emotional survival. An opportunity to be a good example to others who might share our disorder. That’s why it’s important to find a community — however small — of other bipolar people to share experiences and find comfort in the similarities."
Her honesty about her mental illness gave many people hope, said Natasha Tracy, a mental health blogger and author of “Lost Marbles: Insights into My Life with Depression and Bipolar.”
“Carrie Fisher coming out and saying she had bipolar disorder was almost like a bright light for people, showing them that they could achieve their goals even with a mental illness like bipolar disorder," Tracy told TODAY.
"There’s a feeling that all you are is the disorder. You can feel like a freak, like you’re the craziest person in the whole world and then someone comes out and dramatically talks about having bipolar disorder. You can start seeing your own experiences echoed in someone you really identify with.”
Fisher said in interviews that she was told she had a form of bipolar disorder at age 24, but didn't "accept" the diagnosis until her late 20s, after she had survived a drug overdose and alcohol addiction.
She chronicled her mental health struggles in several books, including her best-seller "Postcards from the Edge." She was unsuccessfully treated with numerous drugs, including Lithium, until she underwent electroconvulsive therapy for depression.
While promoting her 2011 book, "Shockoholic," Fisher told TODAY, "There was a hopeless quality going on. I wanted to deal with it."
As much as Fisher did as a mental health advocate, many people still didn't realize her battles, Tracy said.
“When I give talks one of the things I generally do is to put up a picture of Carrie Fisher because everyone recognizes her face as Princess Leia,” Tracy told TODAY. “Then I tell them she has bipolar disorder and it’s almost like the crowd gasps when they hear it. They think that no normal or successful person could have such a severe mental illness.”
The causes of bipolar disorder — a combination of genetic and environmental factors — aren't clearly understood. Research indicates that bipolar disorder is associated with an imbalance in the brain chemicals called neurotransmitters. About 2.5 percent of Americans, or 6 million people are diagnosed with bipolar. It can run in familes; Fisher said her father, singer Eddie Fisher, was manic depressive, too.
While Fisher's many friends and other stars throughout Hollywood mourned her passing, some expressed gratitude for her bravery in speaking out about mental illness.
When someone like Carrie Fisher speaks about their experiences with a mental illness, “it demystifies it,” said Dr. Dean MacKinnon, an associate professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine and author of “Still Down: What to Do When Antidepressants Fail.”
“It can make it a lot less frightening to go to see a psychiatrist for the first time,” MacKinnon added. “Having it out there that it’s OK to have a mental illness and that it’s not your fault can make a difference.”
Fisher's closing words in the Guardian column were supportive and hopeful for anyone suffering from mental illness:
"Move through those feelings and meet me on the other side. As your bipolar sister, I’ll be watching. Now get out there and show me and you what you can do."