What to look for with signs of depression
Ken Duckworth, medical director at National Alliance on Mental Illness.
WASHINGTON -- It's hard to believe that Robin Williams, so many of whose movie roles and standup performances radiated with humor and joy, could take his own life. But that's what evidently happened Monday, as the actor and comedian died at the age of 63.
But Williams struggled with addiction and depression, and Kevin Hill, an addiction psychiatrist at McLean Hospital and assistant professor of psychiatry at Harvard Medical School, says it's important to know that they are diseases, like any others.
"Nobody plans on doing this," Hill said of Williams' troubles on WTOP.
"Alcoholism and depression go hand-in-hand," Hill added.
Depression usually comes first, and can easily lead someone to drinking, Hill says.
"Suddenly," Hill says, "you're battling two very difficult problems."
Williams had had several stints in rehab.
"It seemed like he had treatment at some very reputable facilities ... and he had extensive periods of sobriety," Hill says.
But he adds that addiction is a "chronic relapsing/remitting condition." In plain English: "These are medical illnesses; they are not character flaws. They must be treated, often very seriously," sometimes with medication.
Dr. Drew Pinsky, TV personality and WTOP commentator, said brain disorders should not be demonized.
"Brain disorders need to be managed like any other medical condition," Pinsky says.
"These are brain conditions that do sweep over us, but they are no different than a disorder of any other organ and unfortunately, frequently fatal," Pinsky adds.
The fact that Williams went to rehab several times points out the seriousness of his problems, Hill says.
"The majority of people who have either alcohol problems or depression don't end up getting treatment. And so the people who do end up in treatment are often have the most serious depressions and the most serious addictions. And … [they] can be very difficult to treat. A lot of times, people can do well for a while, and they may relapse. … It's an ongoing battle," Hill says.
If you think you may have a problem with addiction or depression, Hill says the most important thing is the simplest: Talk to someone.
"We just want to encourage them to go in and talk to somebody who knows about addiction," he says.
Often, your primary-care physician's office is the best place to start -- your doctor has knowledge and access to resources. If you need to stop drinking, it's even more important to get help.
"If you're drinking daily, and you stop on your own abruptly, you can have a seizure," Hill says. "Alcohol withdrawal can be fatal."
But just getting out of detox is "just the tip of the iceberg," Hill says. "These people are dealing with a problem that they're going to try to be managing for the rest of their lives."
Some patients can be treated on an outpatient basis; some need a residential program for a few days at a time, or long-term.
"These addictions don't go away; they need to be continually managed. People can do very well if they get the right treatment and they're motivated, just as someone might respond to a chronic medical illness like diabetes or high blood pressure," Hill says.
If you know someone with similar problems, Hill's recommendation is similar.
"Never worry alone. Talk to someone who can help you," he says.
The important thing is to start the process, Hill says.
"There are many people out there who want to help; it's just unfortunate when people don't get the help that they need."
Pinsky offers some suggestions for dealing with addiction and depression as well:
- Stay on top of treatment for chronic disorders of addiction and depression, because they can be recurring.
- Don't allow people with addiction or depression to isolate themselves.
Pinksy says isolation could be what led to Williams' death.
"He was allowed to drift into isolation, and unfortunately, that is what took his life."
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