The loss of Robin Williams hit me harder than I could have imagined. Maybe it was because I read that he suffered from depression and that the reports were stating
suicide. Maybe it was because he
reminded me of my brother and the impossible loss of him that leaves a haunting
remnant which may never quite disappear.
Maybe it was because as a little girl my first all time favorite
television show was Mork and Mindy. Our
two Siamese cats were named after that show.
And of course Robin Williams is simply a legend who has been a constant companion
for us on screen over decades. His roles
in Dead Poets Society and Good Will Hunting will forever move me. A young teen who is waging their own battle
against depression spoke about Mr. Williams and said simply to me, “If only he
could have held on for 5 more minutes and made another choice, things might
have changed by tomorrow”.
I realize no one gets out of this life alive, and I realize that
the loss of any life by any means can feel so utterly tragic. Yet upon hearing this today, I feel the need
to speak out to the tragedy of depression and suicide. This is about more than the loss of a
celebrity. In my profession, I watch
people wage a brave battle against mental illness everyday... old, young, rich,
poor, known, unknown. It is very real
and still very stigmatized. According to the World Health Organization, “depression
is the leading cause of disability and the 4th leading contributor
to the global burden of disease in 2000.
By the year 2020, depression is projected to reach 2nd place
in the ranking of DALY’s (disability adjusted life years, which are measures of
overall disease burden, defined as the years lost due to ill health, disability
or early death)”. Approximately 16% of
the population is estimated to be affected by major depression, and an
additional 1% is affected by bipolar disorder.
And those who suffer from depression live in a darkness that few who
have not been there can possibly understand.
Symptoms of depression can
include feelings of worthlessness and guilt, hopelessness, long periods of
sadness, feelings of emptiness, irritability, changes in sleep or appetite,
loss of energy, loss of interest in pleasurable activities, thoughts of suicide,
difficulty concentrating, problems with memory, and unexplained physical
problems such as back pain or head aches.
Depression symptoms have a major impact on life functioning and can also
manifest on many different spectrums. Certain
specifiers for types of depression include: anxious distress, mixed features
(simultaneous depression and mania), melancholic features, atypical features,
psychotic features, catatonia, peripartum onset (related to pregnancy), and
seasonal patterns. Symptoms may also
manifest differently in children and teens and in the geriatric population, and
differently in men and women. Depression
can also co-occur with other mental health conditions. And no matter what your background, your
race, your SES, depression does not discriminate
In my work as a therapist and in my collaboration with To
Write Love on Her Arms – a nonprofit movement dedicated to presenting hope and
finding help for people struggling with depression, addiction, self-injury and
suicide, we are dedicated to removing the stigma of mental illness and addiction. I was recently revisiting a radio show I did
in 2011. The host questioned how people could
lay in bed for 2 weeks, why can’t they just get up? He was questioning the governance of our own
lives and how we have become so resigned to handing our lives over to
therapists and medications?
Well, imagine this. The
feeling of weights on your chest, ropes around your limbs, restricted breath,
heavy air, a bowling ball in your stomach, pain in your body and heart and
breath, all smothering you to the point of an endless exhaustion. Imagine walking out into the brightness of
day and feeling blinded and blank and dead, unable to connect to the aliveness
in the communities we share, feeling plastic and disconnected. Your mind tells you to get up, to get happy,
to get help, to get better. But nothing
in your body or mind can connect to it or activate. Sometimes it is numbness. Sometimes it is a pervasive feeling of dread
and debilitating anxiety. Sometimes it
is an endless ocean of tears. And
sometimes all of the above. You are not supposed to just get over it, and
you are not supposed to travel this road alone.
You are not crazy. It is ok to
need help, and there is great courage in asking for help.
The helplessness and hopelessness that often accompany major
depressive episodes are symptoms, and sometimes they are contributing factors
in the case where someone may have experienced trauma or/and abuse in their
lives to the point where they have internalized a sense of worthlessness or
helplessness, as their experience likely dictated to them. Sometimes these environmental experiences
trigger genetic vulnerabilities.
Sometimes genetic vulnerabilities are expressed with no environmental
trigger. There are also extensive
neurobiological explanations as to the etiology of depression that point to
disruptions in the neurotransmitters serotonin, norepinephrine and
dopamine.
Individuals suffering with significant depression or mood
disorders that can lead to suicidality are not crazy. They are often all too sane and are resorting
to the consideration of suicide in a desperate, last ditch effort to seek
relief in order to deal with their immeasurable pain. They need help. They need understanding. They need to know suicide is a permanent
solution to a temporary problem and that there is hope and there are other
solutions. They need to know that if
they can hold on just a beat longer, something can change. Many
of these individuals will benefit significantly from seeking out therapy and a
medication consult with a psychiatrist.
In some cases medications may not be needed, but in many cases they are
life saving in conjunction with talk therapy.
Along with this treatment, many life changes are recommended along a
biological-psychological-social-spiritual-nutritional-fitness continuum. And for many, this is a lifelong
battle. Even with therapy and medication
or/and other holistic methods of mood management, depressive episodes can
manifest periodically throughout one’s life.
The goal of therapy is often to assist the individual in mindfully
observing themselves and being able to identify changes in their life and mood. This then helps them to reach out for support and make the changes they need to get in front of and manage a
depressive episode, and to know that it is temporary and that it does not define
them. Cognitive, behavioral and
narrative coping methods are also often taught throughout the individual’s
therapy, as well as assisting them in healing from any childhood trauma they
may have experienced.
In closing, here are some quotes that paint a powerful
picture from individuals who have suffered from this debilitating illness. (Names held for anonymity).
“I was a stripped electrical wire and my life was a raging
ocean. I think I died. I think I am a shell of my old self. I feel like a refugee. I feel like a battlefield survivor that just
doesn’t know how to make it in this society, in the everyday flow and hum and
buzz. The flow drowns me, the buzz
floods me, the hum agitates me. I am
separate. I am an observer. I am broken.
I am meant to be more.” – Anonymous
“I’ve seen
the line between sanity and madness, and it’s not a thin line. It’s an invisible fault line. I’ve seen it in others, and within myself. I know the madness within me is only one or
two choices away, for many of us. My
depression can try to take me to depths of darkness where the world feels like
one of Sylvia Plath’s final poems.
Mechanical, emotional, raw, shameful, crude, distorted. It drives me
down to the recesses of hell. The pain
is in my body; my head throbs, my heart aches, I want to scream, I want to cry,
I shake. But it’s just another day. The sun is out, yet today it blinds me, my
eyes never adjusting. The air is heavy on my skin, the oxygen thick, the air
never cold enough, sleep never long or restful enough. But everyone else is
going on with their day. It’s just a day…why have I changed? I have to push through mud, pull the corners
of my lips against gravity into a smile; I have to remind my heart to
beat. These feelings - I have to see
them and name them. And I have to ride
them out. And then I am aware I know so
much, have seen so much, I sometimes feel so sane, that the sanity gets to be
too much. I yearn for the luxury of
brokenness again, of losing myself into the false promise of suicide’s
relief. Then I remember the flip
side. And I remember that relief and
freedom and bliss are in showing up and walking right through the pain and the
fear. I have to keep going. And I do.
I keep going, and I am bigger than the depression, than the
madness. It speaks to me and I choose
whether I listen and how I respond. I
fight to build the muscle of my happiness, and some days are easier than others.”
- Anonymous
To all of you out there struggling with depression or suicidal
thoughts, this is not the end of your story.
There is hope. Your life can be
beautiful. You are needed and you are
loved. In many ways we are all weird, beautiful,
broken, extraordinary human beings, no matter what our path. You are not alone.
Please reach out to a teacher, a pastor, a parent, a friend,
a therapist. Resources can be found in
your area via the following links:
This
link will take you to mental health and substance abuse treatment resources. It
also provides a link to the suicide prevention lifeline. http://findtreatment.samhsa.gov/
You
can also search www.psychologytoday.com
to locate a therapist in your area.
If you are in an immediate life-threatening
crisis, please call 911.
REST IN PEACE ROBIN WILLIAMS
References
World Health Organization (www.who.int)
Mayo Clinic (www.mayoclinic.org)
To Write Love On Her Arms (www.twloha.com)
