The Doctor Is In is an occasional series where JHU Press authors discuss the latest developments and news in health and medicine.
Guest post by Susan Noonan, M.D., M.P.H.
On August 11, 2014, the world learned that we had lost a dearly beloved, charismatic human being to the devastating illness and consequences of depression. To most of us, the actor Robin Williams was the dynamic, clever man who made us laugh in hundreds of ways. He had the uncanny ability to take us out of our doldrums and bring a moment of joy to our lives through his many creative performances, from Mork & Mindy to Good Morning, Vietnam, Mrs. Doubtfire, and many others. His talents extended to the dramatic as well when he won an Academy Award for Good Will Hunting.
We watched, but did not know that underneath, Williams was in emotional pain, suffering so much that, despite having access to healthcare, he was unable to bear the burden of his demons. According to the popular press, he was known to have the risk factors of depression, anxiety, and subsequent self-treatment with substances of abuse. After his death, Williams’ wife, Susan Schneider, made a public statement that he had recently been diagnosed with the early stages of Parkinson’s disease, adding another major stressor to his life. Parkinson’s is a neurologic condition that affects one’s ability to control the muscles of the body. It is also thought to be associated with major depression. This August, Mr. Williams finally succumbed to his depression and was drawn to take his own life. He took a step that indicated he could no longer go on and thought the world was better off without him. It is tragic that he felt he had no choice, when we know that the impulse to suicide is transient and that depression is a treatable, biologically-based illness. Depression affects approximately 30 million adults in the United States, as well as 18% of adolescents by the age of 18 years.
We did not know of Williams’ sleepless nights, sad empty moods, feelings of worthlessness and hopelessness, fatigue, irritability, or disorganized thinking. Nor did we know of his overwhelming distorted negative thoughts about himself and his world, the thoughts which drove his actions. We knew nothing of his self-doubt and despair. These are all characteristic of depression and, if and when he experienced them, he kept them well-hidden from the general public. On the surface, his appearance was one of a man with a successful life, a loving wife, and three children. In the midst of depression he most likely engaged in a type of thought distortion that caused him to dismiss those successes in his life, one that made him unable to acknowledge or see past them. But as we know, families and financial security are not protective if one is determined to take the path of suicide.
This tells us that, despite the exterior façade of the seeming ability to function in society or at a job, a person may be seriously suffering deep down and be in need of professional help. Look around you right now: do you see anyone like this? Are you in a position to speak with this person about receiving care? We lose approximately 38,000 people per year to suicide, and 90% of these deaths are due to mental illness. Did Mr. Williams seek out help? Were there barriers to his receiving treatment, or did ego or the stigma of depression get in his way? We will never know. We will only suffer the sadness and loss of a brilliant man who brought others great pleasure in his work and life.
Susan J. Noonan, M.D., M.P.H., is a board certified physician who currently works as a consultant to Massachusetts General Hospital and CliGnosis, Inc. Managing Your Depression: What You Can Do to Feel Better is available from JHU Press.