Depression - The Inner Storm

CEBU, Philippines - The eternally funny and cheerful Robin Williams had committed suicide. He was found dead at his home from "asphyxia due to hanging," officials said. The 63-year-old actor was beloved by fans, successful in his career, famous, and wealthy. How could a person like that

decide to end his life?

Says Linda Carroll in an article on nbcnews.com, "Depression can strike anyone, at any time - but for many it comes as a surprise when someone who seemingly has it all and makes the world laugh is quietly suffering."

"Every time someone commits suicide, it is a surprise, a sad surprise," according to Dr. David Kupfer, a professor of psychiatry at the University of Pittsburgh School of Medicine and chair of the task force that developed the latest version psychiatric diagnostic manual, the DSM-5.

When it's someone as prominent as Williams, we say, “Oh my God, why would somebody like that commit suicide, when he's so successful, so productive and has so much to look forward to in life," Kupfer says. "But there are times when an individual can become so depressed and so concerned about how they feel that they believe there is no other way out other than to attempt suicide."

Although Williams never publicly acknowledged suffering from any kind of mood disorder, the comedian had reportedly been "battling severe depression." In a 2006 interview he denied having manic-depression, and explained that talks that he had it came after posing for the cover of Newsweek for a 1998 story headlined, "Are We All A Little Crazy?" He, however, described his comic style as "manic." His most recent TV foray was called "The Crazy Ones."

One early study found that comedians often felt misunderstood, angry, anxious and depressed. Just this year a study by the group of Gordon Claridge at Oxford University found that comedians  tended to have a "conflicted" profile: "a combination of introverted, depressive traits, on the one hand, and on the other, the complete opposite: extroverted, impulsive, manic traits." 

Claridge explained that their finding "gives substance to the idea of the sad clown," adding that for some comedians, performance can be a "front" or a form of self-medication for an underlying depression, shyness or insecurity. "Sadly Robin Williams was a prime example of that conclusion: a man with underlying insecurity and depression who covered it with comedy," he said.

Psychologist Kay Redfield Jamison, a professor of psychiatry at the Johns Hopkins School of Medicine and author of two books on depression, said, "The rate of suicide in patients with bipolar disorder and also in severe depression is high, and it's one of the many reasons for getting treatment." She admitted having nearly killed herself in a suicide attempt after going off her medication for bipolar disorder, and cited that some 75 to 80 percent of people who kill themselves have suffered from a mood disorder.

Forensic psychiatrist Dr. Liza Gold, also clinical professor of psychiatry at Georgetown University, says that the risk of falling victim to depression rises with age. "As we get older we [become] less resilient," she adds. "That which does not kill us makes us stronger? That's not true."

Unmistakable signs of depression are observed in people going through a so-called "mid-life crisis." Although, recently here in the Philippines the ailment has claimed the life of a ten-year-old girl. Filipinos have various other names for it, the reason why "depression" has not really been a big issue in the country.

Dr. J. John Mann, a professor of psychiatry at Columbia University and director of the molecular imaging and neuropathology division at the New York State Psychiatric Institute, said that Williams' recent return to rehab "is probably highly relevant."

"What happens in someone like Robin Williams is that alcohol can change the whole equation. When they drink they are different. They are altered. Their decision making process is changed. Their probability of acting on emotions increases," he said. "The lesson for anybody suffering from a mood disorder is that alcohol is a tremendous risk factor for suicide."

Dr. Gold advises having family and friends around the suffering person; removing possible means of suicide, such as pills or a gun or a rope; and getting appropriate treatment. Families of someone who may be struggling should be on the lookout for signs of trouble like sleeping all day or missing work, and "not be persuaded there is nothing wrong when their hearts tell them otherwise," said Lloyd Sederer, Medical Director of the New York State Office of Mental Health.

If you see someone suffering, Sederer suggests gathering the family together and giving support, and insisting that the suffering loved one gets proper professional attention and care. It can be really hard; the person may not see his illness, or feel too ashamed to admit it, or hopeless, or guilty. But life is always worth the effort.

  (Main Reference: nbcnews.com)