May renewed commitment to help and hope be part of Robin Williams’ legacy

Rosecrance Chief Medical Officer Thomas Wright, M.D., reflected on the death and legacy of actor Robin Williams in a guest column published Sunday, Aug. 17, 2014, in the Rockford Register Star.

Dr. Thomas Wright, Rosecrance Chief Medical Officer
Dr. Thomas Wright, Rosecrance Chief Medical Officer

For some reason, the death of actor Robin Williams by suicide hit harder than similar stories about other super celebrities who die too soon from suicide or other causes. The sad ending for this beloved public man felt more personal, somehow.

Maybe it’s because most of us are so familiar with Williams’ hilarious comedy antics, and we know that genius was one of a kind. Maybe it’s because he infused even his wackiest movie characters with likable humanity, from the wisecracking genie who just wants his freedom in “Aladdin” to the devoted dad who cross-dresses as a housekeeper to be close to his kids in “Mrs. Doubtfire.” The list of beloved characters is long.

Maybe it’s because he was so open about being a flawed human being.  He was candid about his battles with addiction and depression, and his humor about these serious conditions made the public able to listen and, maybe, learn something that could eventually lessen the stigma for others who struggle.

Part of the reason may be because we all know and care about someone who lives with addiction or mental illness, and we hope and pray for outcomes that are less tragic. That Williams couldn’t find treatment to save him makes me sad, and even, a little bit angry.

Depression and addiction are treatable illnesses, and science is making great strides toward medications, psychotherapies and other treatments that can help people live better and suffer less. These conditions affect millions of people on our planet, and we need more general education about both the illnesses and the treatments.

Here are some realities:

  • According to the National Institute for Mental Health, almost 7% of adults have experienced a major depression in the past year. It’s most common in women between 18 and 25, and Native Americans.
  • The prevalence of a mood problem in adolescence is almost twice as high as adults and highest among girls.
  • Depression is what most often leads to suicide, but, it’s not the only cause. People with schizophrenia and bipolar disorder along with substance use disorders are also at very high risk.
  • Depression is treatable.  There is hope.  Common treatments include:
    • Cognitive behavioral therapy.
    • Psychodynamic Therapy or psychoanalysis. Obstacles may include expense and time commitment.
    • Medications. They may be effective, but many patients are resistant due to side effects.  Adolescents may be at increased risk of suicide.
    • Other treatments, including Transcranial Magnetic Stimulation (TMS) and electroconvulsive (ECT — shock therapy) are non-medication options that may be used in severe cases with resistant symptoms.  TMS is more economical and has fewer side effects than ECT with similar effectiveness.
  • Successful suicide is most common among people in the 45-64 age group, among males and among Caucasians and Native Americans.
  • The suicide attempt rate is higher among women, but men are more likely to be successful.
  • Suicide is much more common in the LGBT (lesbian, gay, bisexual and transgender) population than in the general population
  • Suicide is often a very impulsive behavior and is responsive to interventions.

The bottom line is that depression is a common illness among the population, and suicidal thoughts are common in people with depression. Depression and suicide are particularly linked with substance use disorders. Let us shine a light on those realities and, at the same time, broadcast far and wide that depression is treatable and can be individualized to the patient.

There is hope for even resistant depression with newer, less widely available treatments such as Transcranial Magnetic Stimulation (TMS) and with new uses for medications like ketamine.

People who struggle must not lose hope, but instead, reach out for help. Honestly share what you’re feeling with people who really listen and access the network of care that is available. Those of us who come in contact with people who have depression must not avoid the proverbial “elephant in the living room.” We need to ask the hard questions, listen to the answers and guide the person we care about to appropriate help.

Beyond Robin Williams’ amazing body of professional work, beyond the joy and pathos he brought to our lives over the years, may this be part of his legacy.

Thomas Wright, M.D, oversees all medical operations for Rosecrance. He is certified as a child and adolescent psychiatrist by the American Board of Psychiatry and Neurology and in addiction medicine by the American Society of Addiction Medicine. Dr. Wright specializes in the treatment of co-occurring disorders. He joined Rosecrance in 2005.