I heard the news while driving: Robin Williams was dead. The apparent cause of death was suicide. The next day it was confirmed that Mr. Williams had killed himself.
Since the first announcement on August 11, we were reminded that Mr. Williams struggled with depression and had recently been hospitalized for rehabilitation. Many of us struggle to imagine how someone who seemed so full of life and who could create humor out of any situation would be depressed. In this short time, I’ve heard and seen various media commentaries on humor and depression. Some commentators have asked if comedians have a higher incidence of depression than the general population. Others have used the metaphor of “the sad clown” to describe comics with depression. I’ve wondered how many of these commentators have bothered to learn about the mental illness commonly called depression.
In the United States, the term depression is not a diagnostic term. Instead, there’s a group of what are called mood disorders. Under the category of mood disorders are found several depressive disorders. Major depressive disorder (also called clinical depression) is most common. But there’s also melancholic depression, psychotic major depression, catatonic depression, postpartum depression, seasonal affect disorder, dysthymia, and a few others. The other category of mood disorders is comprised of the the various forms of bi-polar disorder, which also have episodes of depression.
Approximately 9% of Americans experience some form of depression. While anxiety disorders are the most common mental health diagnosis in the United States, the depressive disorders come in as second. Among more than 2/3 of those who commit suicide, depression is somehow involved. Depression is much more common than most people realize.
Depression isn’t about feeling blue or sad. Most people who are depressed report feeling not much of anything. They are tired, disengaged, have no motivation, and can’t find a way to become engaged. Activities they’d normally enjoy aren’t interesting; things that would normally draw their interest seem meaningless; everything that they do seems hollow or empty. For many, the most basic feeling is something like, “Why bother. It really doesn’t matter anyway. It’s just too much effort.”
The most successful treatment is a combination of approaches. The first approach is typically medication to help stabilize the production of neurotransmitter levels in a person’s brain to help the person actually feel again. Too often, people think that medication alone is the solution. Typically, it helps relieve the symptoms but doesn’t change the overall problem. The second step is the right kind of therapy. There are a few well researched counseling approaches that have been proved to be effective. This is one area in which psychology has a great deal of evidence. Specific cognitive approaches that teach a person to think differently about life along with proper medication lead to significant improvement in depressive related disorders in over 2/3 of people. The last has to do with life changes: diet, exercise, and practices like meditation. Diet, exercise, and meditation are “brain healthy” activities that reduce the chance of relapsing into depressive symptoms.
In this mix of treatments, the spiritual dimension of life is often helpful in resolving depression. When someone, with the help of spiritual practice, is able to affirm the goodness of life in the midst of struggle or find hope for the future, there is movement away from depressive symptoms. While people with depression can be encouraged and supported toward positive outlooks, ultimately it’s something that each person needs to embrace for self. But that’s really not different from when one attempts to integrate spirituality with any other life experience. Yet, discovering that life can be meaningful or purposeful is essentially the anti-thesis of depression. Meaning, purpose, and hope for the future are all hallmarks of the spiritual journey.
I don’t know what Robin Williams did to treat his depression. I don’t know what was working or not working or anything about his situation. I expect that the media will portray a variety of sensationalized facts that are out of context. What I am sure of is that Robin Williams was not “a sad clown.” Instead, he was someone who struggled with an illness. In the end, he died because of complications related to an illness, just as someone else may die due to complications related to cancer or heart disease. Perhaps if we, as a society, were better educated about illnesses like depressive disorders or anxiety disorders (including PTSD), people wouldn’t be ashamed to seek treatment. Perhaps if there was most social support in society, then people wouldn’t attempt to treat depression and anxiety themselves with alcohol or other drugs, which commonly occurs. Perhaps if mental illness were no less stigmatizing than a broken leg or a bout with the flu, people would have a greater chance of recovering.
While I’ll miss Robin Williams and his humor a great deal, I can only hope that his death will cause us to consider more seriously what mental disorders are all about. After all, if we don’t experience a mental disorder ourselves, we know many others who do. We probably just don’t realize it.
© 2014, emerging by Lou Kavar, Ph.D.. All rights reserved.