Tuesday, August 12, 2014

Depression affects even the happiest people: Thoughts on the death of Robin Williams

To his many adoring fans, Robin Williams will always be remembered as a funny guy.  He almost always had a smile on his face in public and though he had two rehabs stints (the most recent in 2006), it really seemed like he had his act together.  That's why it's so shocking to many, even those that knew he suffered from depression, that he would commit suicide.  

He had everything going for him, right?  He was famous!  He was wealthy!  He had a great family and many adoring fans!  What could possibly be so wrong in his life that he would choose to end it?  Unfortunately, that's how depression works.  It's a voice in the back of your head telling you that your happiness is a lie, that people don't love you, and your successes don't matter.  Sometimes you can snap yourself out of it or someone will help you snap out of it and sometimes... you can't.  

I tell you this from personal experience.  I suffer from clinical depression and have been on and off medication since I was sixteen.  Looking back on my childhood memories, I think the issues really go back to when I was as young as ten but it was written off as normal puberty/growing up issues.  I wish it was.  I wish I didn't have depression but I do and it is something I have to deal with.  

I think there is a misconception that people with depression just need to get out of their own way, suck it up, and deal with it because life stinks sometimes.  We all have hard times right?  For me, depression didn't just manifest itself as sadness.  I had horrible mood swings and bouts of severe anxiety.  I would burst into tears at the least provocation.  I was awful to be around at times.  I would get mad at myself after the fact, after my ridiculous outbursts and crying jags.  Why was I feeling that way?  Why?  

My original official diagnosis was PMDD (as my episodes were worse around that time of the month) and I was prescribed a form of Prozac.  I did very well with this for several years.  I was doing so well, I slowly went of the medication and I was doing fine.  For a while.  

You know those commercials you see for Cymbalta with their slogan:  "Depressions Hurts- Cymbalta can help?"  Well, depression can manifest with physical symptoms.  In my case, it manifested itself in the way of digestive issues: lack of appetite, reflux, and diarrhea so severe I had to seek care from a gastroenterologist.  My test results (including an endoscopy and colonoscopy) were inconclusive so I stopped going and dealt with it as best I could with over the counter medicines as needed.  When I went back on my anti-depressant, however, my symptoms leveled out, as did my mental and emotional well being.  

I had (and still have) good friends that stuck by me even at my worst.  I knew that logically but depression does screwy things with your brain and makes you think/feel that people don't care about you and don't love you.  It makes you feel like you are worthless.  It feels like you don't have a reason to keep on living.  

I was never suicidal in the sense of actively seeking to end my own life or making a plan but it would cross my mind in the darkest moments.  For the most part, while I had no particular desire to live, I also had no particular desire to die.  I was completely indifferent.  One positive force in my life was my family and friends:  I knew I could never do something like that to them.  The thought of someone I love reading a suicide note or discovering my body was--and still is--horrifying to me.  

No one knew about any of this, however.  I kept it from all my family and friends and pretended everything was okay.  For the most part, people bought it.  The people closest to me always could tell something was up but I don't think they ever realized the extent.  My lowest lows were back in high school, right before I started medication but my relapses/flare ups/whatever you want to call them has been severe enough on their own.  I always had enough get-up-and-go to get out of bed and go through the motions but sometimes I barely managed.  The fall semester of my senior year was the worst for that but I'm not sure that's surprising given that my mother was battling cancer at home while I was trying to be a normal college senior.  My emotional swings didn't make it easy for anyone that I lived with.  Maybe I should have explained it to them and maybe they would've gotten it or maybe they would suffer a lot of the misconceptions of the general public about the real affect of depression on a person's life.  I didn't want to burden them with this information.  Maybe they'll read it now and know that I wasn't just a lunatic.  

I think one of the misconceptions about depression is that being depressed means you are sad all the time and are never happy.  For most people, this just isn't true.  I still felt happiness.  I could still crack a joke.  I could still smile.  But the negative emotions would just become overwhelming.  

I think happy people, like Robin Williams, have some of the worst struggles with depression.  He was funny and successful and he just wasn't supposed to be depressed!  He was supposed to be like the characters he played in so many comedies.  And yet, his depression was severe enough to make him feel like his only option was to end his life.  

Mental illness carries a huge stigma, even the relatively common place forms like mild depression or anxiety.  There is a perception that you just have to suck it up.  Unfortunately, that isn't the case.  The reason it is depression (a clinical diagnosis) and not just sadness (an emotion) is because you can't just get yourself going.  Physiologically, it is a shortage of neurotransmitters in the brain.  To way over simplify, it is a lack of serotonin--which is why SSRIs (Selective Serotonin Re-uptake Inhibitors) are the front line of anti-depressants.  It is, in fact, a physical issue in the brain.  You wouldn't tell someone with diabetes that they need to suck it up and get over it so don't tell someone with depression to suck it up and get over it.  

I hope that the suicide of a high-profile celebrity like Robin Williams opens up people's eyes to the ravaging affect of depression.  Depression takes so many forms and can drive people to do the unthinkable.  I am praying for the family and friends of Robin Williams and the families and friends of the many other people who have also taken their life because of depression.  I hope we are able to open up a dialogue about depression and make it less taboo to talk about depression and other forms of mental illness.  

Robin Williams, rest in peace.  


July 21st, 1951-August 11th, 2014
Image from the movie 'Patch Adams' found HERE

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