The tears of a clown — and a lot of other people you know

Date Published: 
August 15, 2014

Monday evening, the Internet was abuzz with the news that legendary comedian and comic actor Robin Williams was dead, at 63. Beyond that simple astonishing fact was an undercurrent of surprise that Williams had reportedly taken his own life.

A man who was known for being a live wire, a clown, an irresistible spirit of childlike fun, had chosen to prematurely end a life that might have seemed perfect to many — full of interesting people, travel, professional and financial success and public admiration.

It was no secret that Williams had battled personal demons during his life, with a well-known battle with alcohol and drug addiction that had sent him back to rehab just last month for what his representative told the media was a “tune up” to help maintain his long-term sobriety. Williams had reportedly been sober for 20 years before falling off the wagon in 2006 but had apparently been successfully dealing with the problem since then.

And perhaps there would have been less surprise about his death if the initial cause reported had been a suspected heart attack, as Williams also had a history of heart disease, which had resulted in open-heart surgery in 2009.

But when the funny-man is revealed as having himself been living through terrible pain, it’s a discontinuity that begs consideration and discussion. And, as a positive amidst the tragedy, it has spurred a public conversation that needs to be had, about the disease of depression.

For that is what Williams’ representative said he’d been battling recently — not alcoholism or drug addiction, but a life-altering medical condition that can be an even more insidious and silent killer than heart disease.

Something that was once described colloquially as “melancholy” or “the blues” is well established now as a physical disease that not only has physical, biochemical causes but produces physical symptoms that can include headaches, muscle and joint pain, chest pain, digestive problems, fatigue and sleeping problems, and change in appetite or weight.

Add such symptoms to depression’s hallmark feelings of hopelessness, worthlessness, loss of interest in activities, and difficulty concentrating and making decisions, and it’s no wonder that people with depression are said to be “suffering” from the illness. Nor is it any wonder that such suffering can drive someone to put an end to the pain in whatever way they can. But depression is treatable, and finding a way out of the pain can come in positive, life-improving ways.

First, though, people have to realize they’re depressed and seek help. That first part requires educating the general public so that people — and their loved ones — can recognize the symptoms and acknowledge what is happening to them. Armed with a checklist of symptoms including the ones already mentioned here, that really becomes the easy part.

The hard part is accepting the potential diagnosis and asking for help, especially with the stigma that still continues to come with even the notion that one might be suffering from depression.

Too many people still associate depression with moral or emotional weakness and think the recipe for recovery is simply to pull oneself up by one’s bootstraps or to “think positive.” While depression is a mental illness, no amount of mental fortitude can negate a physical illness that has more to do with brain chemistry than the stiffness of one’s upper lip.

Living with depression can require either or both “talk therapy” to deal with emotional and behavioral issues and antidepressant medications to regulate the brain chemistry that causes them in the first place. Understanding and accepting that — and having friends, family and co-workers understand and accept it, too, without stigma or pity — is key to finding a place of peace and strength from which to live daily life.

The great thing about the public perception of depression in recent years has been the beginning of wide understanding of the reality of the disease, with people who have and are dealing with it coming forward to give the public an idea of what life with depression is really like and how they might best deal with it in themselves or in their loved-ones.

One of my favorite writers on the subject is actor and geek-guru Wil Wheaton, whom many of you may remember from his work as a child/teen actor “Star Trek: The Next Generation,” as well as “Stand By Me,” or, more recently, from his many appearances as a fictionalized version of himself on “The Big Bang Theory,” or, as of this summer, from his eponymous geek-culture show.

In “Depression Lies” (http://wilwheaton.net/2012/09/
depression-lies/) — which is a title I love, because it’s just so true — Wil not only reveals his own struggles with depression and anxiety but talks about the life that is possible when depression is properly treated:

“I remember the first week after I started meds, [his wife] Anne and I were out for a walk. I felt her hand in mine, and realized that I didn’t have any lingering tension or unhappiness just buzzing around in my skull. I was just enjoying a walk with my wife, and holding her hand.

“And I began to cry, because I was so happy.

“‘It’s like I was in a loud room for so long, I didn’t know how loud it was,’ I said, ‘and all I have now is the ringing in my ears.’

“She squeezed my hand and I said, ‘I’m going to remember that ringing in my ears, so I never go back into that room again.’

“That was about four years ago, and I’m happy to say that I’ve stayed out of the room,” he wrote. “I can actually enjoy my friends, my family, and my life. I have bad days from time to time, but I know they’ll pass, and — most important of all — I may have Depression, but Depression doesn’t have me. I know that’s sort of corny, but it’s pretty accurate, too.”

Journalist Annmarie Timmins responded last year to reader skepticism about the statistic published in her paper, the Concord Monitor, on how many New Hampshire residents have a mental illness — 26 percent — with the admission that she herself was one of that 26 percent (http://www.concordmonitor.com/
home/5103177-95/mental-husband-didn-health).

Legendary journalist Mike Wallace, too, shared his struggles with depression, despite the potential reaction from sources, subjects, colleagues and the public, which could certainly have negatively impacted his career, since some people then (and still some now) erroneously consider depression or other mental illnesses as an automatic indicator of unreliability, weakness or inability to cope with daily life.

Don’t get me wrong — dealing with life while depressed can be a challenge. I mean, some of the basic symptoms of the disease are a lack of motivation or difficulty concentrating or making decisions. But being depressed doesn’t automatically make you unreliable, and plenty of steady, go-getter types also suffer from depression.

In the end, the perception that someone with depression is any less able to do an important job is not only inaccurate but unfairly harmful to them and their work. Wil wrote about his success with medication and Timmins wrote about the support structures that have enabled her to continue her work, while Wallace emphasized the value of a good psychiatrist in his long-running career.

Successful people can and do live with depression, just as some live with diabetes or heart disease or physical disabilities. (My current favorite real-life hero is Miles O’Brien, the former CNN anchor who lost most of his left arm after an accident while working overseas early this year. His story is a must-read and can be found at http://nymag.com/health/
bestdoctors/2014/miles-obrien-2014-6/.)

Someday, I’m sure, we’ll all be so well informed that someone admitting they have depression will be about as impactful as them admitting they’re nearsighted. In the meantime, every step made toward removing that stigma is a step in the right direction, if for no other reason than encouraging people to acknowledge their illness and get treated can prevent suicide and help people live successful lives. And that means every person who shares their struggle with the disease is another step toward ending the stigma and saving lives.

So, I’m going to do the brave thing here… I’m going to add myself to the list of people who’ve acknowledged publicly that they suffer from depression. (And, thank you, Affordable Care Act, for eliminating pre-existing conditions…)

Shy, private and passionate even as a kid, I was first diagnosed with clinical depression as a teenager. What might have been stereotypical teenage moodiness in other kids was taken to another level for me. The tiniest little problems reduced me to tears, down on myself and the world. I worked hard to establish my unique identity while at the same time feeling pressured to succeed in the eyes of parents and teachers and to conform to the ideals of my peers.

My parents grew concerned enough to take me to a psychotherapist. I say “take me to” when, in reality, it was pure bribery — if I went, they said, they’d buy me a guitar and pay for lessons. I was a very private person even then, so talking to a stranger about my innermost thoughts wasn’t high on my list of things to do. But I went, grudgingly.

Luckily, they’d found about the coolest therapist they could have — a professional guitarist whose wife worked in a recording studio and who was willing to spend a few minutes each session teaching me some guitar, too. We clicked, and so I kept going.

I can’t say I recall him pointing out any particular issues I needed to deal with, but that’s sometimes the case with clinical depression — treating it can hinge on just having someone to talk to, to give you a perspective not affected by your illness, so you can learn when not to trust that inner sense that says the world is coming to an end because you got a B or someone laughed as you walked past.

Because depression lies.

Boy, did Wil (and blogger Jenny Lawson — http://thebloggess.com/2012/09/today-and-forever/ — whom he borrowed it from) get that right… You see — depression tells you things are more important, more disastrous, than they are. Little failings become tragedies you can’t get past or let go. The fear of failing can keep you from making decisions or taking action, and that fatigue can mean you don’t feel like doing much of anything, even when it’s something you really need to do, like laundry.

It’s important to point out that experts say it’s rarely one single thing that leads to a suicide attempt. You can speculate that Robin Williams was depressed after his sit-com “The Crazy Ones” wasn’t renewed back in May, after 22 episodes, but the chances are that was just one drop in the bucket of what drove him to take extreme measures to deal with his pain. Maybe it was the final big drop, but without all the others, it’s likely it wouldn’t have resulted in his death.

The other thing most people don’t realize about people who attempt suicide is that they may have been suicidal for a time, in so much emotional pain that life doesn’t seem at all enjoyable, but they’ve felt so unmotivated and/or fatigued that doing anything about it was impossible.

If there’s a simple reason why some people commit suicide after getting help for depression, my suspicion (as a not-a-doctor and not-playing-one-on-TV, and having never gotten to that point myself) is that, for some, they’re now feeling just enough better to do something about it.

It’s a tricky time for people, as they emerge from a helpless depression to feeling more able to take action, and it’s the smallest things that can set or keep them on a tragic path or one that leads to a happier, healthier place.

Maybe it’s the caring call from a loved-one, or the invitation to a movie or a concert, or the singing of a bird or the blooming of a flower, or a hug — sometimes all it takes to bring someone back from the brink is a symbol of hope or support, something that reminds them there’s something to look forward to for tomorrow or next week or next year.

That’s something to remember if someone you know is suffering from depression. And the take-away if it’s you who’s suffering is to remember that it can, and usually does, get better. There is very likely something you’ll miss out on if you don’t stick around that you’d wish you hadn’t missed, and even if it doesn’t feel like it, someone will miss you.

And while getting help can seem hard, it’s all downhill from there, with plenty of people to help you paddle until you’re in peaceful waters again. The trick is reaching out for that help, whether it’s to a friend, family member, therapist or hotline. You deserve the help, and it will be there if you look.

Sometimes that help comes in the form of medication. That’s a hard thing to swallow for some people (pun mostly unintended), because it might seem like taking medication means accepting that you’re going to have to take it forever or like it cements a diagnosis that will define your life. It doesn’t have to be either.

Sometimes, medication can be a way to take some of the weight off your shoulders until you learn to deal with your depression through therapy. Sometimes, you simply need it, but it’s not a statement about who you are — it’s about fixing brain chemistry that isn’t working quite right. Just like a diabetic might need insulin to be healthy, you sometimes have to medicate depression to be healthy. And that’s OK.

I’ve had ups and downs in my life since those teenage years. I haven’t ever stopped suffering from depression. In my case, it isn’t a hard life experience that causes the depression — it is my innate brain chemistry, and while it won’t go away on its own, it can be ameliorated by correcting that imbalance.

Once you find a medication that works for you — and not every medication works well for everyone — it’s like Wil said: That sensation that made things feel like they weren’t quite right, like there was a weight on your shoulders, like things might never get better, goes away, and you get to feel just like yourself, pure healthy you.

During good times, I’ve found that medication alone keeps me feeling like myself. At other times, talk therapy has put me in a good enough place to go off the medication and make it through by just reminding myself that depression lies. In rough times, I’ve struggled, even medicated. Maybe the laundry doesn’t get done that week. But I have a few friends I fall back on and support from other people in my life, and a deep spiritual faith that sustains me and offers solace, and I make it through the rough times, each and every time.

I’ve sometimes been accused of being a pessimist by some who know me. Really, it’s the furthest thing from the truth. I’ll cop to being a pragmatist. I plan for the worst, but I expect the best. That makes it easy to be let down and to feel like things are going badly, and that maybe I deserve that somehow. But when my depression lies and says the world is against me, I know now that that’s all it is — lies.

I trust in my optimism, and even when it feels like things are bad, I know they’ll get better. Sometimes I forget that for an hour or 12, but there’s always a smile or a bit of music or a whiff of sea air or some funny guy on TV who makes the sun shine in my brain for a moment or 12.

When you string those moments together, it makes for a life worth living, even if pain sometimes intrudes.

If you’re dealing with pain that feels like it’s swallowing the joy in your life, please reach out and talk to someone, no matter who that person is. If you or someone you know is thinking of suicide, call 1-800-273-TALK. That’s the Suicide Prevention Lifeline. I like that name. It’s not a “hotline” — it’s a lifeline. And sometimes that’s all you need.