# Robin Williams



## forgetmenot (Aug 11, 2014)

Fought with depression a long time and battled with his addictions
he lost that battle  
I hope his family his children have supports in place  to help them


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## David Baxter PhD (Aug 11, 2014)

Not just depression. Bipolar Disorder plus long history of struggles with addictions plus heart surgery not that long ago.


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## making_art (Aug 12, 2014)

So sad. He will be greatly missed by the world! If only he had called for help.....


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## H011yHawkJ311yBean (Aug 12, 2014)

It blows my mind.  Have to process.

Makes me so sad. 

It makes me sad when any person takes their own life.  ♥


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## MHealthJo (Aug 12, 2014)

Oh my gosh.... 

Thinking of this gorgeous man and his family....


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## forgetmenot (Aug 12, 2014)

My first thoughts were he could not wear his mask any longer
    I am sure his humor was his way of surviving  he gave so much of himself to others so others would not feel sadness.

   It is just so sad  he was alone  he was all alone.


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## desiderata (Aug 12, 2014)

My biggest concern is the possible epidemic rise in suicides due to this. The thinking being, "If Robin Williams, the funniest man in the world can do this why can't I?"


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## forgetmenot (Aug 12, 2014)

My thoughts were if he could not beat the sadness then who can
 Who knows why really he chose to leave what pushed him to finally give in 
 Depression does not need a reason to take you away but one wonders now  how can one beat this illness  how.
why was the connection to his children his family  why was it not strong enough to hold him here  
what was it that finally made him decide to leave
sorry just thought now  
I am just so sorry now for his family  the pain they must endure now


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## Retired (Aug 12, 2014)

desiderata said:


> My biggest concern is the possible epidemic rise in suicides due to this. The thinking being, "If Robin Williams, the funniest man in the world can do this why can't I?"



I'd like to think that most people have a built in brake that protects us from suicide and self harm despite the feelings of hopelessness that drive suicidal thinking; however none of us can be sure of how we might react to suicidal thoughts which is why it's so important to tell someone we are in distress and to reach out for help to one's doctor, a local ER or crisis line.

It's a medical emergency and should be seen as such.


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## desiderata (Aug 12, 2014)

It comes down to people who are on the edge. Whether it be copycat shooting sprees or those who act out on themselves only. They are not thinking rationally and no one knows what their triggers are. The images seen in the media, actions of the famous, sports role models and on, have an impact on many. I hope all of us have a built-in brake but reality shows us that we don't. Those whose brakes are worn can be at risk.


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## Jesse910 (Aug 12, 2014)

As I think back upon the characters that Robin Williams portrayed, in between the laughter, there was a sobering understanding that the man understood loss, pain, sadness, and loneliness. We can only speculate upon his life the past few months.  And, we can play the "what-if" saga repeatedly.  It grieves me that a man whom I considered a hero is gone.  He appeared to have found a way in which to rise upon his woes and fight against bipolar and his dark depression.  It begs the question, where was his support?  Who could he confide in without shame or fear? In the end, he unfortunately turned inward because like the person standing in the mirror, he saw what he could not resolve -- his raw self.  Let those of us who fight each day for survival continue to find the strength to reach outside of ourselves and ask for help when we feel as though we are going under.


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## Retired (Aug 18, 2014)

Williams' Tragic Death a Reminder Suicide Risk Is Pervasive
Medscape Psychiatry & Medical News
August 14, 2014

The death of actor/comedian Robin Williams at age 63 is a tragic reminder that the risk for suicide is pervasive, particularly among white, middle-aged men, experts say.

"There are good data available that show that baby boomers ? particularly white males between the ages of 55 and 64 ? have the highest rates of suicide of any demographic in this country," Prakash Masand, MD, president, Global Medical Education, New York City, told Medscape Medical News.

According to the Centers for Disease Control and Prevention (CDC), in 2011, there were more than 28,000 completed suicides among white males vs 7600 among white females and fewer than 2000 among black males.

"If you tried to create a profile of someone at high risk of committing suicide, one likely example would look like this: A middle-aged or older white male toward the end of a successful career who suffers from a serious medical problem as well as chronic depression and substance abuse, who recently completed treatment for either or both of those psychological conditions and who is going through a difficult period, personally or professionally," write Lenny Bernstein and Lena Sun in the Washington Post (August 12, 2014).

*Deadly Diagnosis*
Robin Williams fit that profile perfectly. Reportedly a heavy cocaine user at least up until the death of friend and fellow actor John Belushi and a relapsing alcoholic, according to Mark Breslin, cofounder of the Yuk Yuk's chain of comedy clubs who knew the former comedian well, Williams was also apparently bipolar, according to a number of news reports.

Harry Croft, MD, a psychiatrist in private practice in San Antonio, Texas, told Medscape Medical News that even if that diagnosis has not been officially verified, "you just had to watch Robin Williams and wonder whether he wasn't bipolar at least sometimes."

And bipolar disorder (BD) can be a deadly diagnosis ? literally. According to an expert interview conducted by Medscape Medical News, on average, 1 suicide occurs for every 30 attempts in the United States.

"In bipolar patients, it's 1 suicide for every 3 attempts...so in patients with bipolar disorder, their attempts are 10 times more lethal," Jan Fawcett, MD, professor of psychiatry, University of New Mexico School of Medicine, Albuquerque, told Medscape Medical News.

"The combination of depression and substance abuse is a particularly lethal one and is associated with a much higher rate of suicide compared to depression alone," said Dr. Masand.

At least one explanation behind the high risk for suicide in middle-aged white men might be the way men in general express depression.

"Men in particular self-medicate, especially with alcohol," said Dr. Masand. Men also deal with depression differently than women. For example, studies have shown that men are more likely to become angry and irritable in response to depression compared with women, who are more likely to feel sad, hopeless, and worthless.

*Treatment Gap*
Recent evidence also suggests that because men do not meet standard diagnostic criteria for major depression, they are likely to go undiagnosed ― and untreated. Even if Williams had been correctly diagnosed with BD, both physicians concurred that bipolar depression is probably one of the most difficult illnesses to treat in psychiatry. "Bipolar patients simply require a lot more 'TLC,' " said Dr. Croft.

This is borne out by the fact that in the United States, there are only 3 Food and Drug Administration (FDA)?approved drugs for the treatment of bipolar depression compared with perhaps 40 or 50 FDA-approved drugs for the treatment of unipolar depression.

"Antidepressants in general do not work in bipolar depression, they only work in unipolar depression," Dr. Masand cautioned.

Despite this, most patients in the United States with bipolar depression are treated with antidepressants, he added. "So there is a huge gap between what's happening in the real world and what evidence says we should be doing," Dr. Masand said.

It is not clear whether Williams was receiving treatment ? appropriate or not ? at the time of his death. But, Dr. Croft noted, news reports about the actor's suicide indicated that Williams was revisiting Hazelden, a highly prestigious addiction treatment center, around the time of his suicide.

"Hazelden is probably the best treatment center in the country," Dr. Croft observed. And although Williams apparently was going there to maintain his sobriety, "I'm not sure what that means," said Dr. Croft, "but part of what's going on in my mind is, maybe he went there because he was depressed or was in bipolar depression."

If Williams was seeking medical care, even if disguised as seeking treatment for addiction, he was again smack dab in the middle of the usual pattern of people who commit suicide.

"After a certain age, a very high percentage of people have seen a medical professional within 1 to 3 months of committing suicide," Dr. Croft said. "And particularly amongst the elderly, this is especially true. Many have seen their primary care physician within a month of killing themselves.

"What this is telling us is that there is an opportunity to do something about it."

*Important Reminder*
Williams may have slipped through the cracks, but his death serves as an important reminder to physicians to be on the lookout for patients who may be suicidal, said Dr. Croft.

"I?ve been in practice for over 30 years, and I learned long ago not to ask about suicide directly, so I don't ask, 'Are you suicidal? Are you thinking about killing yourself?,' because the answer is generally, 'No.' "

"A lot of the elderly assume that if they tell their doctor that they're going to kill themselves, the first thing the doctor will do is put them in the hospital in a locked unit, and they won't want to be in the hospital in a locked unit," he added.

What Dr. Croft now asks is, "Have you ever felt so down or so despondent that you felt that life wasn't worth living anymore?"

If the patient acknowledges that they sometimes they feel that way, the clinician should ask follow-up questions, including the following:

Have you ever actually thought about killing yourself?

Have you made a plan?

Have you done anything to make that plan come to life?

"That way, people start opening up," he said. "And I think that's because they believe you really care. Most people don't really want to kill themselves. They are just tired of the pain, the despondency or the stress, whatever it is, and they want that to end.

"So it is always appropriate to ask about despondency, and if you get an answer that makes you think, 'Wow, this sounds like ideation and a plan,' then I would say, 'I?m really concerned about your feelings and what you?re telling me' and ask them if we can't do something together to help them get past this."


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## H011yHawkJ311yBean (Aug 18, 2014)

I am sure it was another blow that he had recently been diagnosed with Parkinson's.

Just one more thing to add to his already huge load.  Poor fella.  

Robin Williams was in early stages of Parkinson's disease, wife says - Arts & Entertainment - CBC News


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