--- description: Find out how Princess Diana of Wales changed lives by speaking openly about her struggles with bulimia and mental health. title: How Princess Diana Changed Lives by Discussing Her Mental Health image: https://static.time.com/v3/assets/bltea6093859af6183b/blt4ac6083d7556ac47/6988dbd297cdff0d0a6b23f6/princess-diana-bulimia.jpg?branch=production&width=3840&quality=75&auto=webp&crop=16:9 ---  * [motto](/tag/motto/) ## motto Update your preferences in [Account Settings](/account/preferences/) Close # How Princess Diana Changed Lives by Discussing Her Mental Health by [Jane Mendle](/author/jane-mendle/) ## Jane Mendle Update your preferences in [Account Settings](/account/preferences/) Close Aug 30, 2017 3:25 PM CUT  Diana, Princess of Wales, at the Royal Brompton Hospital where she visited Cystic Fibrosis patients. 31/8/97 The Princess was killed in a car crash in Paris along with her friend, Dodi Al Fayed, and the driver of their car. (Photo by Neil Munns - PA Images/PA Images via Getty Images) Diana, Princess of Wales, at the Royal Brompton Hospital where she visited Cystic Fibrosis patients. 31/8/97 The Princess was killed in a car crash in Paris along with her friend, Dodi Al Fayed, and the driver of their car. (Photo by Neil Munns - PA Images/PA Images via Getty Images)Neil Munns - PA Images—PA Images via Getty Images by [Jane Mendle](/author/jane-mendle/) ## Jane Mendle Update your preferences in [Account Settings](/account/preferences/) Close Aug 30, 2017 3:25 PM CUT A very specific image of [Princess Diana ](http://time.com/4914377/princess-diana-humanitarian-work/ "undefined")comes to mind as we recognize the[ 20th anniversary of her death. ](http://time.com/4879138/diana-princess-remembered/?iid=sr-link1 "undefined")We remember her as the “[people’s princess](http://time.com/4913709/how-diana-became-britains-queen-of-the-heart/ "undefined")” — from her [jewel-studded wedding](http://people.com/royals/prince-charles-and-princess-diana-wedding-photos/diana-in-procession-after-wedding "undefined") to her petrified [final minutes](http://content.time.com/time/covers/0,16641,19970908,00.html "undefined") in a Parisian tunnel. She walked through fields of [landmines](http://time.com/4726237/prince-harry-princess-diana-kensington-palace-landmines/ "undefined"), [embraced](http://people.com/royals/how-princess-diana-used-the-power-of-touch-to-smash-stigmas-she-wasnt-a-gloves-person/ "undefined") an AIDS patient, introduced us to the [vicious tenacity](http://time.com/4871176/prince-william-hbo-documentary-paparazzi/ "undefined") of the [tabloid press](http://www.pbs.org/wgbh/pages/frontline/shows/royals/readings/tabloids.html "undefined") and embodied the most [glorious aspects of 1980s fashion](https://www.usatoday.com/story/life/people/2017/08/28/20-years-later-princess-diana-still-communicating-through-fashion/544523001/ "undefined"). But what is often forgotten is that Diana was also a paradox: under the magnificently poised image she presented to the world, she struggled with [bulimia](http://people.com/royals/princess-diana-recorded-bulimia-struggles-prince-charles-called-her-chubby/ "undefined"), self-injury and lingering feelings of worthlessness. In the early 1990s, toward the [end of her marriage](http://www.history.com/this-day-in-history/charles-and-diana-divorce "undefined"), Diana gave a series of interviews to promising to share [“her true story.”](https://www.amazon.com/Diana-Andrew-Morton/dp/1476752818/?tag=mottocom-20 "undefined") In 1992, Andrew Morton [published ](http://www.pbs.org/wgbh/pages/frontline/shows/royals/etc/morton.html "undefined")_Diana: Her True Story_ (based on secret recordings Diana had an intermediary [make for the author](https://www.washingtonpost.com/entertainment/celebrities/dianas-common-touch-changed-the-monarchy-forever/2017/08/28/42ed47f4-8bbf-11e7-9c53-6a169beb0953%5Fstory.html?utm%5Fterm=.154c7802deed "undefined")),which revealed that the princess was living with the eating disorder.In an [1995 interview](http://www.bbc.co.uk/news/special/politics97/diana/panorama.html "undefined") with BBC, she described bulimia as a “symptom of what was going on in my marriage.” Diana’s candid self-disclosures in these interviews may be her most powerful and unrecognized legacy. Her honesty helped chip away at the stigma surrounding [mental health](http://motto.time.com/4376324/read-prince-williams-touching-message-about-mental-health/ "undefined") and [encouraged others to get help](http://www.express.co.uk/news/royal/793923/Prince-Harry-Diana-Britain-speaking-out-mental-health-LONDON-MARATHON "undefined"). It is not an exaggeration to say that thousands of people changed their lives because Diana talked about hers. Today, nearly [one in six adults](http://content.digital.nhs.uk/catalogue/PUB21748/apms-2014-full-rpt.pdf "undefined") in the U.K. and [one in five adults](https://www.nami.org/Learn-More/Mental-Health-By-the-Numbers "undefined") in the U.S. live with a [mental illness](http://motto.time.com/4401509/mental-illness-adhd-depression-anxiety/ "undefined"). Millions in the [U.K. ](http://www.priorygroup.com/eating-disorders/statistics "undefined")and [the U.S. ](https://www.state.sc.us/dmh/anorexia/statistics.htm "undefined")currently have an eating disorder, which is often accompanied by [depression](https://adaa.org/understanding-anxiety/related-illnesses/eating-disorders "undefined") or [an anxiety disorder](https://adaa.org/understanding-anxiety/related-illnesses/eating-disorders "undefined"). But only a relatively [small percentage of people](http://www.who.int/whr/2001/media%5Fcentre/press%5Frelease/en/ "undefined") will actually seek treatment. One of the biggest barriers is not access to help, but rather [fear, shame and embarrassment](https://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-10-113 "undefined"). While a number of celebrities, including [Demi Lovato ](http://motto.time.com/4423146/demi-lovato-hillary-clinton/ "undefined")and [Catherine Zeta-Jones](http://abcnews.go.com/Health/BipolarDisorder/catherine-zeta-jones-sheds-light-bipolar-disorder/story?id=13373202 "undefined"), have spoken out about living with mental illness in recent years, such frank disclosures were far less typical when Diana first opened up about her life experiences. Even more unexpected was the [clarity, honesty and depth with which Diana described her bulimia.](http://www.bbc.co.uk/news/special/politics97/diana/panorama.html "undefined") “That’s like a secret disease,” she told the BBC in that 1995 interview. “You inflict it upon yourself because your self-esteem is at a low ebb, and you don’t think you’re worthy or valuable. You fill your stomach up four or five times a day — some do it more — and it gives you a feeling of comfort.” “It’s like having a pair of arms around you,” she added, “but it’s temporarily, temporary.” She said that she often came home from her official engagements “feeling pretty empty” and that she felt immense pressure to keep her marriage together [despite the couple’s well-documented problems. ](http://time.com/4881423/princess-diana-celebrity/?iid=sr-link1 "undefined")“I was crying out for help, but giving the wrong signals, and people were using my bulimia as a coat on a hanger: they decided that was the problem — Diana was unstable,” she said. For people who don’t understand why someone would feel compelled to binge and purge, Diana’s shockingly vulnerable explanations provided a simple answer. Binging, she said, functioned as a release valve for pressures and problems that seemed otherwise insurmountable. The [stigma surrounding mental health](http://time.com/4342089/mental-health-awareness/ "undefined") can often be exacerbated by a lack of knowledge, and Diana’s candid interview allowed others to empathize and understand what it’s like to live with bulimia. Diana’s disclosure had even more value for people with first-hand experience with bulimia. During the second half of the 20th century, [rates of bulimia](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1892232/pdf/nihms19542.pdf "undefined") in Western, industrialized nations [rose dramatically](http://my.ilstu.edu/~dfgrayb/Personal/EatingDisordersCultural.pdf "undefined"). Yet many women viewed [bulimia](http://motto.time.com/4324775/american-idol-lauren-alaina-bulimia/ "undefined") as a private and deeply humiliating experience [that should be kept hidden](https://www.psychologytoday.com/blog/matter-trust/201402/the-silent-suffering-eating-disorders "undefined"). Remarkably, in the years during which Diana spoke publicly about her bulimia, [rates of women](http://www.brown.uk.com/eatingdisorders/currin.pdf "undefined") seeking treatment for bulimia in Great Britain[ more than doubled.](http://bjp.rcpsych.org/content/186/2/132.full "undefined") The press dubbed this [phenomenon the “Diana effect.”](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1113296/ "undefined") Mental health practitioners [credited](https://books.google.com/books?id=3Zy1w5ufLHsC&pg=PA238&lpg=PA238&dq=%22the+diana+effect%22+bulimia&source=bl&ots=zL1e5zo8VE&sig=mgPqyDujwOruS6rU0KTHoOasduc&hl=en&sa=X&ved=0ahUKEwjOpbDkjvrVAhWGJCYKHSchAdI4ChDoAQgnMAA#v=onepage&q=%22the%20diana%20effect%22%20bulimia&f=false "undefined") this shift to greater public awareness and dialogue about bulimia, as well as women identifying with Diana. If a _princess_ could be bulimic, so could they. If she could explain why she hurt herself, they could recognize that side of themselves too. If she could [overcome](http://www.bbc.co.uk/news/special/politics97/diana/panorama.html "undefined") her eating disorder, they could too. Self-disclosures, particularly of people in positions of power or visibility, can change how other people approach their own psychological health. Researchers [have found](https://store.samhsa.gov/shin/content/SMA08-4337/SMA08-4337.pdf "undefined") that knowing someone else with a mental illness can encourage others to get help. “It is notable that the Princess’s death in 1997 coincided with the beginning of the decline in bulimia incidence,” researchers [wrote](http://www.brown.uk.com/eatingdisorders/currin.pdf "undefined") in a 2005 study published in the _British Journal of Psychiatry_ on time trends in eating disorder incidences. “Identification with a public figure’s struggle with bulimia might have temporarily decreased the shame associated with the illness, and encouraged women to seek help for the first time.” Unfortunately, after Diana’s death in 1997, those [rates slowly returned](http://bjp.rcpsych.org/content/186/2/132.full "undefined") to baseline. By 2000, the “Diana effect” had vanished. Currently, in the United States, we are in the throes of a new [mental health](http://time.com/4473575/college-mental-health-guidebook/ "undefined") crisis. A study published in _Pediatrics_ last year found that between 2005 and 2014, there was a 37% increase in the number of individuals aged 12-20 [reporting a major depressive episode](http://time.com/4572593/increase-depression-teens-teenage-mental-health/ "undefined"). But there hasn’t been a corresponding rise in treatment rates. Hopefully, the 20th anniversary of Diana’s death will reignite conversations about why it’s so important to speak openly about mental health and encourage others to seek help. Her sons have already [taken up that task](http://time.com/4899497/princess-diana-prince-william-harry-legacy/ "undefined"). Earlier this year, Prince Harry [spoke frankly](https://www.nytimes.com/2017/04/17/world/europe/uk-prince-harry-death-princess-diana.html?mcubz=0 "undefined") about seeking counseling to address his grief over his mother’s death. Meanwhile, Prince William [appeared](http://people.com/royals/prince-william-princess-diana-bulimia/ "undefined") in a documentary about [anorexia](http://motto.time.com/4656791/anorexia-survivor-weight-gain-happiness/ "undefined"), where he discussed his mother’s experience with bulimia. “We need to normalize the conversation about mental health,” Prince William said in the documentary. “We need to be matter-of-fact about it, and not hide it in the dark where it festers.” Diana did not set out to be a mental health advocate. She simply told her truth and her narrative resonated. These days, we could use more truth-tellers like her. [_Jane Mendle_](http://www.human.cornell.edu/bio.cfm?netid=jem482 "undefined") _is a clinical psychologist and associate professor at Cornell University. She is a Public Voices Fellow with_ [_the OpEd Project_](https://www.theopedproject.org/ "undefined")_._ _Motto hosts provocative voices and influencers from various spheres. We welcome outside contributions. Opinions expressed do not necessarily reflect the views of our editors._ ```json [{"@context":"https://schema.org","@type":"NewsArticle","@id":"https://time.com/4918729/princess-diana-mental-health-legacy/","mainEntityOfPage":{"@type":"WebPage","@id":"https://time.com/4918729/princess-diana-mental-health-legacy/"},"headline":"How Princess Diana Changed Lives by Discussing Her Mental Health","datePublished":"2017-08-30T15:25:27.000Z","dateModified":"2026-04-13T09:05:51.576Z","description":"'If she could overcome her eating disorder, they could too'","url":"https://time.com/4918729/princess-diana-mental-health-legacy/","keywords":["motto","health","Wellness","Opinion"],"thumbnailUrl":"https://static.time.com/v3/assets/bltea6093859af6183b/blt4ac6083d7556ac47/6988dbd297cdff0d0a6b23f6/princess-diana-bulimia.jpg?branch=production&width=1200&quality=75&auto=webp&crop=1200:675&height=675","author":[{"@type":"Person","name":"Jane Mendle","jobTitle":null,"url":"https://time.com/author/jane-mendle/"}],"articleSection":"","image":[{"@type":"ImageObject","url":"https://static.time.com/v3/assets/bltea6093859af6183b/blt4ac6083d7556ac47/6988dbd297cdff0d0a6b23f6/princess-diana-bulimia.jpg?branch=production&width=1200&quality=75&auto=webp&crop=1200:675&height=675","width":1200,"height":675,"headline":"DIANA Portrait Royal Brompton","caption":"DIANA Portrait Royal Brompton","creditText":"Neil Munns - PA Images—PA Images via Getty Images","representativeOfPage":true}],"publisher":{"@type":"Organization","name":"Time","url":"https://time.com/","logo":{"@type":"ImageObject","url":"https://time.com/images/logo.png","width":528,"height":156},"foundingDate":"March 3, 1923","sameAs":["https://www.facebook.com/time","https://www.instagram.com/time/?hl=en","https://twitter.com/time","https://www.pinterest.com/timemagazine"]}},{"@context":"https://schema.org","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"item":{"@id":"/tag/motto/","name":"motto"}},{"@type":"ListItem","position":2,"item":{"@id":"https://time.com/4918729/princess-diana-mental-health-legacy/","name":"How Princess Diana Changed Lives by Discussing Her Mental Health"}}]}] ```