Depression, Parkinson’s and the loss of Robin Williams

The recent news of Robin Williams’ suicide has saddened many, but it has also served to open a discussion about what the effect of depression and Parkinson’s can be in a person’s.

For someone as complex as Robin Williams it isn’t easy to point at one thing and say it was the cause of his decision to commit suicide – as in life, he is a shining example of the multi-faceted nature of life.

Robin Williams was a success by just about everyone’s standards; he was respected, had a solid family life and yet also suffered from major depression, addiction and was recently diagnosed with Parkinson’s.

The tendency in media and culture is to write off a suicide as either the ultimate act of selfishness, or an act only made possible by mental illness.

For many, the decision comes from many different feelings and thoughts; some that can be based in mental illness, some that may be caused by the effects of a chronic and degenerative condition such as Parkinson’s and some that are aided by the disinhibiting effects of addiction.

What we cannot say for certain

There is no person on Earth who is capable of saying why Robin Williams took his life except for the man himself. He may have talked about his reasons with others in his life, but that will most likely remain a private matter.

For the public, coming to terms with his death requires a willingness to look at the impact of chronic conditions and chronic pain – emotional, mental and physical.

By looking at the impact of chronic illness and pain on a person’s life, we can then find better ways to support them so that suicide does not appear as their only option.

How could he be so depressed if things were going so well?

If someone is suffering from depression, the events around them aren’t going to change how they feel inside. A diagnosis of major depression recognizes that there is a chemical imbalance in the body that prevents the hormones and chemicals that are necessary for emotional resiliency to be delivered.

Different types of anti-depressants work to inhibit or enable certain neurotransmitters in an attempt to allow the brain to return to normal functionality.

People with depression can’t just “talk it out” or “fake it till they make it;” the root of depression lies in the inability of the brain to properly transmit messages that allow for someone to let go of ideas or emotional states.

There are many different causes for depression from the chemical imbalance occurring naturally, as a result of food allergy, as a result of prolonged addiction to brain altering substances, and as a result of overwhelming trauma – physical, emotional or mental.

It is also thought that your environment can cause depression. If you are not living in a life where there is opportunity and validation, your emotional and mental state will cause a prolonged release of associated hormones and chemicals that will cause your brain chemistry to change.

So addiction may have been the cause of his depression?

Addiction is a very complicated issue. While, in America, we look at it as a disease, most of the rest of the world doesn’t. Addiction is generally viewed as a response to a lack of coping skills that then may be complicated by triggering a physical addiction to a substance because it allows the body to release hormones to relax, or feel better.

If you already have an imbalance in which you are not getting enough (or too much) serotonin – the main neurotransmitter required for all emotional and mental processing – finding out that taking a substance can boost that level and make you feel good is all you really need to know if you don’t know of any other options.

Disease or not, addiction is rooted in the learned behavior of seeking a negative reward. Negative rewards are actions that cause an expected result even if the action is not beneficial to the person.

Getting drunk to escape stress and relax is a negative reward because it is also damaging to the body and can cause social and functional problems.

Having a glass of wine to relax is considered a positive reward for most people as the actual physical process of the false prompting of relaxation is controlled and doesn’t harm the body.

What most addiction specialists believe is that addiction starts as an attempt to create relief from a chronic pain that can be mental, physical or emotional.

Substance abuse is considered to be a symptom of an underlying issue. That issue may be a lack of coping skills, a lack of adequate pain management, or an attempt to self-medicate to control symptoms of a disorder that may not be otherwise treated.

If you take a look at Robin Williams’ life, and the things he said about the type of pressure, sadness and loneliness that being an actor and comedian brings – you can begin to see that his addictions may have been a wrong-minded coping skill that got out of control.

Who was Robin Williams?

It is an oversimplification to say that Robin Williams was a great actor and comedian who also happened to struggle with addiction, depression and was recently diagnosed with Parkinson’s.

You need to have an understanding of the path of his success in order to see how the triad of addiction, depression and Parkinson’s may have come together to result in his ultimate act.

While mostly known for his comedic roles and stand-up comedy routines, he was considered by many to be one of the finest dramatic actors around as well.

A genuinely funny man, who was also very lonely

Born in Chicago Illinois in 1951, Robin Williams described as a quiet and introspective child. He spoke of himself as a child saying that he felt shy and awkward.

The fact that his childhood was marked by the absence of his mother and father who both worked, you can begin to build a picture of a child who was lonely and by self-admission, socially awkward.

By the time he was 12, the family had moved to Detroit and boyhood friends there remember him as being very funny. Later, after the family moved to California, Williams was known as being very bright and full of fun, but by his high school years in Redwood High he distinguished himself by being voted “Most Likely Not to Succeed” as well as “Funniest” for the class of 1969.

The Genius of Juilliard

Even though comedy had become an increasingly important part of his life, Williams didn’t launch into studying acting right out of high school. He enrolled at Claremont College in California with a major in Political Science.

After a bit of studying there, he switched his focus to acting and left Claremont to enroll at the College of Marin. There he studied for three years but did not finish.

He applied to Juilliard in New York, one of the arts and drama schools in the world. He was one of 20 students accepted in 1973. He was also accepted into the special advanced studies there taught by John Houseman.

There was only one other student accepted into the advanced program with him, an actor called Christopher Reeve. After less than 4 years at Juilliard, Williams left.

He was encouraged by Houseman to leave the school as Houseman felt that there was nothing more for him to learn there. Many of his teachers and schoolmates remember him and were struck by the genius that lay behind his craft.

Professional comedy

Robin Williams had started to do professional comedy back when he was still in California. He performed at many different stand-up clubs and even had an HBO special in the years following Juilliard.

He said often in an interview that life as a performer, specifically a comedy performer, wasn’t easy and it got worse when you were travelling on the road. The entertainment culture revolved around drugs, alcohol and being able to get up and “turn it on” when you didn’t feel like it at all.

Drawing from his main influences Jonathan Winters, Richard Pryor and Peter Sellers, Robin Williams developed an act that saw all of life as an opportunity for comedy, and much of his comedy was based in the physical.

He explained his early love for cocaine as being necessary to keep up the energy to onstage the kinetic and crazy funnyman people expected, while alcohol became the drug of choice for coming down from all of that. This started a cycle that followed him through much of his early career.

The rising star

Robin was given small parts on shows like the Laugh-In Revival and The Richard Pryor Show. From there, he was asked to audition for a small but recurring role on the hit sitcom Happy Days, playing an alien named “Mork.”

Almost all of acting he did as Mork on Happy Days was improvised and included a lot of physical comedy as well. The character was so popular that the network spun off a series just for him, Mork and Mindy with Pam Dawber.

He was cast as the lead in the film “Popeye,” and then had a significant part in “The World According to Garp,” as well of several other small films.

Good Morning, Vietnam and the Dramatic Roles

The role that changed everything in Williams’ life was being cast as the lead in “Good Morning, Vietnam.” He caught the attention of the world as the funny, irreverent, and desperate DJ broadcasting for soldiers during the Vietnam War.

He went from someone who people had heard of to a household name almost overnight. His string of successful comedic roles that followed firmly established him as a force to be contended with.

While he was gaining worldwide recognition for his comedic roles and stand-up, Robin Williams was appearing more in dramatic movies that showcased his genius.

These movies didn’t generate the kind of recognition and buzz that his comedy roles did because he “wasn’t doing a Robin Williams,” he was portraying some very complex characters.

His first notes dramatic role was “The Fisher King,” in which he played a homeless man, and then “Moscow on the Hudson.” In these roles, Williams was still playing safe as they allowed for flights of comedy as if the directors wanted to remind the audience who was in the role.

With roles as the psychotherapist in “Good Will Hunting,” the teacher in “Dead Poets Society” and the doctor in “Awakenings” he began to build his dramatic credibility with producers and directors.

Many of his “greatest fans” for his comedy were unaware of his very successful turns both killers and thrillers in “One Hour Photo” and “Insomnia.” He also had several very successful runs in off Broadway dramatic plays.

Recovery, illness and depression

Addiction plagued Williams during the early decades of his career, but the death of his friend and peer, John Belushi, led him to go into recovery from drugs and alcohol.

He relapsed during the filming of “Alaska” with alcohol in 2003 and in 2006 sought treatment for alcoholism. Since 2006, his wife reports that he was completely sober.

This has confused many people as it is public knowledge that he sought treatment again for alcoholism in early 2014. It is important to understand that what Williams went into treatment for was to reinforce his recovery, not to treat a relapse. In the between years of addiction and recovery, Williams was diagnosed as suffering from depression.

He worked very hard to treat his depression through the use of medications and fitness routines. While this helped him manage the extremes of his depression, it didn’t rid him of the condition.

His movie and film career began to really take off after his recovery and he became more involved with philanthropy as well. In all of his films, the kinetic, spontaneous and physical presence of Williams was called on.

Whether he was playing a comedic role, or a dramatic one, his presence on screen or stage was based in his ability to control himself and to respond improvisationally to situations.

What being diagnosed with Parkinson’s means

While many people are familiar enough with Parkinson’s disease that they can recognize and name the often very visible tremors that can be a symptom of it, few people really understand how the disease really affects the body.

Parkinson’s is a progress degenerative disease that can eventually lead to a person becoming completely physically disabled. It can also lead to a type of mental deterioration that is similar to dementia.

One of the most common associated conditions of Parkinson’s is Parkinson’s related depression. Scientists do not know if the depression is caused by the neurological degeneration that occurs with Parkinson’s, or if it is a result of the person’s awareness of the prognosis of the disease. While there are very many medications that can slow the progression of Parkinson’s, there is no known cure.

Parkinson’s and depression

One thing that is recognized by the medical community is that over 60% of persons diagnosed with Parkinson’s will also develop major depression.

If you already have a diagnosis of major depression, then you have an 80% chance of having a relapse or worsening of the symptoms. With Parkinson’s related depression there is no known onset phase to gauge a person’s progress by.

Many doctors will automatically prescribe anti-depressants for those diagnosed with Parkinson’s in an attempt to prevent the impact of depression in their lives.

It can be hard to imagine, faced with a progressive deterioration that holds the potential for dementia that a person would not go into at least a grief related state of depression as well.

What may have tipped the cart for Williams?

If you look at his life and career, Robin Williams was shaped by his ability to do improvisational and physical comedy. To do that, while suffering from major depression is a feat of determination.

His early self-medication habit that developed into addiction was addressed through his commitment to recovery. This is shown through his willingness to put himself back into treatment to reinforce his recovery when faced with Parkinson’s.

As Williams had not yet chosen to go public with his diagnosis of Parkinson’s, it isn’t really known how its progression was affecting him.

For someone who’s whole being revolved around their command of their mind and body, the degenerative progress and prognosis of the disease would have been devastating.

If he also developed depression related to Parkinson’s, he very well could have overwhelmed the beneficial effects of any anti-depressant he was on at the time.

It would not be surprising, when the toxicology reports come back; to discover that he had alcohol in his system at the time he took his life.

That doesn’t necessarily mean that he relapsed, but that he may have been desperate to self-medicate the double level of depression away.

It could also mean that with a clear head, he decided that he had gone as far as he could in life. This is a view of suicide that is not popular in America, but many cultures and belief systems recognize the option for “death with merit.”

What we need to learn

Robin Williams showed us how to laugh at ourselves, in his death he can also show us how to care better for those around us and ourselves.

Depression is a disease that requires treatment and that doesn’t magically go away with “good thoughts.” More awareness is needed of the impact of a diagnosis of Parkinson’s, and its potential to develop a related chemical depression in the person as well.

With awareness, we can make living with a chronic and degenerative disease something that doesn’t have to be the end of your life, but a reordering of how you live with quality of life.