Tuesday, August 12, 2014
A person I admire, who suffers from chronic depression, wrote after Robin Williams suicided: "What hope is there for the rest of us if Robin Williams, with his millions of dollars, couldn't make it?"
If Robin Williams death means anything, it must be just how tricky it is when you combine substance abuse/addiction with mental health problems. Put these two separate problems together and you have one gigantic mess to deal with. And as much as I can tease out of the situation, Robin Williams was in a depressive episode after relapsing from whatever chemical, or chemicals, which drove him to spend some time at Hazelden in Minnesota
I've known several therapists who, as a condition of seeing a client, would treat you only if you chose to refrain from using alcohol or other recreational substances. Thirty years ago, I thought this was extreme; I don't think so anymore.
I'm not privy to any information on Robin Williams, although being a psych RN who worked close to where Robin had a house, I did hear rumors about him which I will not repeat. So, my guess, without any first hand knowledge, is that Robin Williams, more than likely, was Bipolar. I don't think anyone would be surprised by such an assertion. I imagine he spent part of his life in a hypomanic state. His comedy certainly was brilliantly hypomanic---hypomania being just on the fringe of full blown mania. Many Bipolar people are just amazingly smart: it is the mental illness of brilliance. What people don't understand is that most Bipolars spend a majority of their lives in a depressive state. Or dysthymic (which is just a smidge better than being clinically depressed).
More than likely, Robin Williams would have his relapse on drugs while in the buoyant manic phase and then he'd settle back into the depressed state saddled with the guilt that only a hypomanic phase ---combined with lots of drugs--could instill. It is hard not to misbehave when you have all the energy in the world, all the money in the world and a psychiatric disorder that inclines you to indulge in binges.
The photos I've seen of him during the last two months of his life tell the story. He looks gaunt. Weak. Tired. Worn out. Binges take a toll.
In the end he hung himself with a belt. There were hesitation marks (superficial cuts) to one of his wrists. His wife didn't check on him before she left the house for the day; he was found by his "personal assistant" who, hopefully, will resist any urge to write a tell all book about this unfortunate occurrence.
Substance abuse kills. It kills geniuses. It took Hunter Thompson, Ed Abbey, Jack London, F. Scott Fitzgerald, Ernest Hemingway and a multitude more.
Combine substance abuse with a long term chronic depression, well, that isn't good. Depression can be very difficult to treat in a small minority of cases. And the treatment of last resort, ECT, is not palatable to maybe someone like Robin Williams. Although I've seen it work on other very depressed intelligent successful men. But after awhile, we lose the will to live. We can lose our fight, our pluck and give in to the dark thoughts. Depression can be a lethal illness.