Robin Williams and Depression

I was a fan. But then again, is there anyone in the world that was not? Robin Williams was the real deal. He was not only one of the funniest people alive, from all reports, he was also a Mentch. This was in fact what fellow comedian Steve Martin said about him in reaction to the news of his death at age 63. And it was true. The reports I have heard about him since his death testify to that. He was open and honest about his problems. He had great humility and was very generous with his time for all.

There was rarely a time when I saw him on TV that he didn’t make me belly laugh. He was truly a comic genius whose mind was so quick that he could find humor in just about anything and quickly react with humor in ways that few others could.

The Talmudic sage Rava used to open his lectures with some humor. In this way he got the attention of his students who were then more inclined to learn from him. Chazal tell us that people who make us laugh and thereby cheer us up - get an automatic portion in Olam Haba. I don’t think this is limited to Jews. Chazal also tell us that non Jews can earn their way into the world to come. Perhaps Robin Williams qualified.

It was common knowledge that Robin Williams had a drug and alcohol addiction problem.  For this he had to go to rehab several times in his life. The question arises, why would such a successful man who by all accounts was one of the most thoughtful and ethical people in show business stoop to taking drugs? Does this not show a lapse in his judgment or character? Why does a man like this choose to get high on drugs?

I don’t really know the answer. I’m sure that there are people who do know the answer including the mental health professionals that treated him inside of rehab and out. But I’m going to take a stab at why I think he may have taken these drugs – based on what has been revealed about his mental state prior to his suicide.

I do not believe that Robin Williams abused drugs as some sort of recreational activity. I believe he was probably self medicating. Apparently Robin Williams was one of the many Americans who suffer from a mental disorder known as clinical depression.  Actually I think calling it a mental disorder is a misnomer. In the vast majority of cases, clinical depressions is really a physical disorder.

As a student of psychology back in the late sixties (…my undergraduate degree from Roosevelt University is in psychology) I was taught that all disorders of this nature could be treated with psychotherapy. Abnormal behavior had some underlying psychological cause that existed in the unconscious mind. Once the patient discovered and understood it the abnormal behavior would end.

But as I later discovered, this is usually not the case with clinical depression. That is rarely caused by external factors. In the vast majority of cases, clinical depression is caused by a chemical imbalance in the brain. When this is the case, there is no amount of psychotherapy that will help. The only thing that will is the right medication. Without out it, life can be so unbearable that suicide looks like a better alternative than living.

I’m not sure I can accurately describe what it’s like for a clinically depressed personality. But I will give it a try. Clinical depression knows no socio-economic, ethnic, or religious backgrounds. It is usually an inherited trait. The symptoms include constant states of anxiety, frequent panic attacks, loss of appetite, (or in some cases an increased appetite), inability to sleep at night, and disinterest in work or any part of your daily routine. Depressed people cannot function well in their jobs and even if they somehow do force themselves to go to work, will just go through the motions.

Depressed personalities find it excruciatingly painful to go through the day doing even menial tasks that most people do by rote. Nothing interests them. Emotions are shut down. They don’t feel the natural love they might otherwise feel for a loved one (spouse, children, parents, etc). You basically feel numb. And very quickly after just a few days of this kind of living you begin to feel  hopeless about your situation. Day after day of waking up in a panic and living in a constant state of anxiety feeling no other emotions will take its toll very quickly. And thoughts of suicide become a very attractive out. Ending one’s life ends the pain.

This was apparently what Robin Williams suffered throughout much of his life. Many depressed personalities hide it from their friends. They seem quite normal to them. But it is an act. The depression is there and constant, only to be let out when no one is around (except for the one or two people you may have confided in). Talking about it doesn’t help. Only the right medication will. Unlike other physical disorders many of which have medication that specifically treats the disease, depression has many anti depressants all of which work for some people and not for others. Sometimes a combination of drugs needs to be taken.

This has to be done under the supervision of an psychiatrist, who is an MD - licensed to prescribe medication. Until that ‘magic bullet’ is found, a depressed personality will remain so… adding to the feelings of hopelessness as each day passes. But when it is found, it works. The brain chemistry returns to normal and you are no longer clinically depressed.  

It should be noted that when the right medication is found, it usually needs to be taken permanently. Many patients who start feeling better after a while, get off the drug and the depression inexplicably and without warning returns at some point. And then getting back on the drug or drug combination will no longer be effective. That can really be devastating to the renewed depressed personality. That person will have to start all over trying to find a new drug or combination of drugs that will work.

I don’t know what Robin Williams’ experiences were along these lines. But obviously he was once again suffering from severe depression. And apparently he felt he would never be able to get out of it again. So for him, suicide was the only way out.

According to the National Institute of Mental Health, an estimated 16 million adults over the age of 18 in the US had at least one depressive episode in 2012. That is almost 7% of all American adults. It is one of the most common mental disorders in the country. 

Jews are not any more immune to depression than are non Jews. I personally know many Orthodox Jews who suffer from this terrible disorder. Not only do the individuals themselves suffer, but so do close members of the family living with them. Living with a depressed personality is not easy. More than one person I know got divorced because of it. In one case I know, there was a suicide. In other cases there were unsuccessful suicide attempts.

Even with as many people I know that suffer from clinical depression, I’m sure there are a great deal more that successfully hide it from me and everyone else. It is relatively common for depressed people to fake it... and appear to be just as normal as everyone else.

I think that the Robin Williams’ suicide ought to be a wake-up call for us. If you have any of the above symptoms for any length of time - get help. If you know someone who does, convince them to see a professional with the ability to prescribe anti depressants and who has a good track record. There is no more shame in this disorder than there is in any other physical disorder. Just because there are no physical symptoms does not make it any less of an illness than heart disease or cancer. While effective treatments are trickier, they do exist. 

And by all means avoid metal health practitioners that tell you that all you need is psychotherapy. In most cases that is a sure prescription for failure.  This is a disease that can be licked. But the first step must be taken be getting professional help. Because many of the people I know that suffered from clinical depression did find the right doctors who prescribed the right medication and now lead completely normal lives.