Depression Doesn’t Have to Be a Life (or Death) Sentence

man with his head in his handsTo say the loss of Robin Williams to suicide is tragic is a gross understatement. Many of us grew up with Mork & Mindy on television and, over the decades, witnessed the incredibly talented actor and comedian reach new heights in films ranging from Good Morning, Vietnam to Good Will Hunting. For many, there exists a sense of knowing Mr. Williams, almost on a personal level, as if his persona was woven into the very fabric of our entertainment world across the span of more than 35 years.

It feels very personal, this loss. It has been revealed that Williams was undergoing treatment for severe depression at the time of his death, and while his wife said after his death that he was sober at the time of his passing, he had struggled with addiction for much of his life. It was also revealed after his death that he was in the early stages of Parkinson’s disease.

No one knows, exactly, how much of a factor depression was in Williams’ decision to end his life. It’s fair to assume it played a role, though, as it often does when suicide occurs. Although it affects different people in different ways, depression is a treatable condition. With competent, compassionate mental health care, an individual who is motivated to recover likely will. Likewise, an individual who struggles with addiction can stay sober with much work and determination.

These challenges are thought to be partially biologically based due to genetics (and, for many women, reproductive hormonal life events can result in depression/anxiety) and may also be influenced by environmental factors (for example, unresolved or continuous stress, trauma, or grief/loss). The confluence of biology and environment can trigger a crashing of serotonin, the neurotransmitter that regulates mood. Each individual has his or her own line of vulnerability.

It is so very sad that Williams was so low he couldn’t emerge from the abyss he was mired in. And yet it is understandable. For many, depression is so insidious that it creeps up on them, and before any family members know what hit their loved one, the individual has hit a wall. For some individuals, depression can be likened to being stuck behind a Plexiglas barrier while watching the world move about in slow motion. I suspect this was the case with our beloved Robin. Factor in any substance use to numb the pain of depression and you have the recipe for not only dropping serotonin levels, but tragedy as well.

What can you do if you or someone you love appears to be slogging through depression?

  • Seek help immediately. If you or someone you love threatens suicide, call 911 or go to the nearest emergency room. Call the National Suicide Prevention Hotline at 1-800-273-8255.
  • Receive psychotherapy with a skilled, compassionate therapist.
  • Be open to the possibility of medication management to restore serotonin levels in circumstances where suicidal ideation is present.
  • Consider integrative interventions, including increasing exercise, good nutrition, good sleep hygiene, yoga, meditation, and journaling.
  • Rule out an underlying medical condition (thyroid issues, substance use, etc.). Get medical attention, if needed.
  • Increase social supports; do not isolate.

I want to say it again: depression is treatable. Depression may resolve with competent, informed care (psychotherapy, social supports, improved self-care, and in some cases medication). It need not be a life sentence. It is never too late to reach out. Get help. Let go of the stigma.

© Copyright 2014 GoodTherapy.org. All rights reserved. Permission to publish granted by Andrea Schneider, LCSW, therapist in Benicia, California

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Liz

    Liz

    August 15th, 2014 at 9:40 AM

    No it does not have to be this way but so often in life we find that for countless thousands it does seem like the only way out of this tunnel of depression is to end their lives.’
    It is a very sad thing to think about the number of things in my own life that make me happy and joyous and to think that there are so many others who never have this feeling of excitement and jubilation that I have.
    All I know is that to ensure that the numbers do not continue to increase there has to be a conversation about this, there has to be more help out there and we all need to commit to listening and actually seeing when there is a friend who is in trouble.

  • craig

    craig

    August 15th, 2014 at 10:45 AM

    Why do you think that it is that more people don’t ask for help when they so obviously need help from others to make it through this? You have to know that they know that there is something wrong with them, and that they did not always feel like this. So do you think that it is about shame or embarassment? maybe they don’t know who to ask for help? Or that they simply get to the point of not caring anymore? It all confuses me so much because I know that when I am sick one of the first things that I would probably do would be to call my doctor. Why isn’t this the case more often with those who are depressed or anxious or even suicidal?

  • bugs

    bugs

    August 15th, 2014 at 11:00 AM

    good reminders Andrea

  • Andrea Schneider, LCSW

    Andrea Schneider, LCSW

    August 15th, 2014 at 11:42 AM

    @ Liz — thank you for your comments…yes, stigma needs to be reduced…depression is nothing to be ashamed of…and anyone who is motivated to get better, resolves their depression…depression is treatable. Get help with a licensed therapist.
    @Craig– complicated questions and answers…folks are ashamed and there is great stigma…many barriers to getting help can also include lack of social supports, depression being very much an internal state that may not be obvious to the outside world, lack of coverage of mental health care, geographical distance from competent help…bottom line is that help is available…also now through telehealth…and that with help, people get better and recover. Some folks wait too long and depression can become more pronounced and severe without treatment…very insidious — getting help right away is key…Andrea

  • Kim

    Kim

    August 15th, 2014 at 7:00 PM

    When someone is severely depressed motivation is nowhere to be found. That is one of the many reasons we refer to depression as baffling.

  • Lynn

    Lynn

    August 15th, 2014 at 11:26 PM

    What about those with chronic issues? Sometimes it isn’t treatable. Sometimes it just doesn’t go away. Who are we to say that’s not what Robin Williams was dealing with for the past x number of years? Why is everyone minimizing it to his “recent depression” and diagnosis? Of course, I can’t know that it wasn’t just recent events yet with his previous problems it sure seems to point to a more chronic process.

    It’s great to tell everyone who is depressed – see a doctor, they can help. Unfortunately, it can’t always be treated effectively. The whole idea of this article is disturbing because for some people it IS a life sentence. It’s like telling a cancer patient that if they just get chemo and eat a balanced diet and think happy thoughts they will be cured. Nice try, but let’s be realistic about it.

  • Lorna

    Lorna

    August 16th, 2014 at 10:44 AM

    There is too much blame that is going around about this topic when clearly there is no one to blame when this happens. It just happens, and many times the depression leaves one who suffers feeling totally out of control of those feelings and in a purely helpless state where they need help, but don’t know what to do about it. Let’s all be more considerate of that.

  • Andrea Schneider, LCSW

    Andrea Schneider, LCSW

    August 16th, 2014 at 2:03 PM

    @Lynn–of course, depression doesn’t just go away without treatment.I speak not only as a therapist but as a survivor of depression myself, so I know what I speak of. How is this article minimizing Robin William’s issues? On the contrary, it is a tribute to his struggle to battle depression. When someone has depression for a chronic period of time, without treatment, it intensifies and worsens, reaching dangerous levels…as shown in Robin Williams’ situation. Depression IS treatable…there are studies and evidence to indicate so…the person needs to want to get better, and the interventions need to occur as soon as possible in the course of the illness. I think you misunderstand completely the message of the article. Nice try back at ya. ;)

    @Lorna– agreed…reduction in stigma is so very necessary. And depression can be paralyzing once intensified and severe.
    @Kim– yep, motivation is typically not there in severe depression…but those in mild or moderate states connect with their motivation and drive to get better, and do so, if they get help.

  • Lynn

    Lynn

    August 17th, 2014 at 1:50 AM

    I believe you misunderstood what I was getting at. Sometimes, even with treatment – medications and therapy and shocks and everything else proposed to treat depression, it’s not treatable. Why do mental health professionals feel they have the right to promise hope of a cure when there may not be one? If a person struggles with suicidal depression for years on end and has tried the available “treatments” maybe the answer IS suicide. Of course none of us know the entire picture for Robin Williams, but based on what we know it sure seems he may have been justified in ending his life sentence.

  • Andrea Schneider, LCSW

    Andrea Schneider, LCSW

    August 17th, 2014 at 10:17 AM

    @Lynn…with all due respect, I disagree. Depression is a treatable condition…no respectable mental health professional promises the hope of a cure…they know that their client needs to find that light within, with the help of psychotherapy, to connect with change. Unfortunately for some who have battled chronic depression for years, their condition can intensify and become what feels hopeless and rock bottom, so some choose suicide. I understand the pain Robin Williams went through, and I believe, that with treatment earlier on and consistently, he might have considered other options besides taking his own life. There are numerous evidence-based, scientific articles that back up the fact that depression is treatable…The role of the therapist is a guide to help the client to the “water”…however, the client is tasked with doing the work to do the actual recovery work (i.e. the analogy of leading a horse to water, but the horse actually has to be the one that drinks it). It is up to the client to connect with the motivation and light within to do that work,…or not…

  • Andrea Schneider

    Andrea Schneider

    August 17th, 2014 at 11:18 AM

    @Lynn–no matter how badly a person is depressed, that person should know that suicide is never ever the only option — there are so many interventions available if that person wants to get better and resolve their depression. Suicide shouldn’t be an option for someone with depression. Best wishes, Lynn. Peace out.

  • Becki

    Becki

    August 18th, 2014 at 5:07 AM

    There are so many different treatments available, but the key is having the patient not give up hope while they are searching for the one thing or combination of things that will work the ebst for them. And they need to be told that what may work for right now might not be the end all and be all. This could be something for which you will have to change and modify for the rest of your life. But that alone should not be a reason for giving up hope, for not trying anymore. That should make you want to try harder to find that one sweet spot where everythign can feel good and right again.

  • Carolyn R

    Carolyn R

    August 18th, 2014 at 10:16 AM

    After a week of crying continuously, I realized I’d forgotten to take my Cymbalta for those 7 days of hell. As soon as I took the pill at bedtime, I felt better the next morning…no more crying at the least and I mean very least little thing. But, I feel I still need therapy due to declining health issues which have resulted in an extreme change of lifestyle. I also, understand the option of suicide. A year ago I definitely gave it consideration…just because another health issue cropped up and at the moment I felt I couldn’t take anymore. But I finally realized that I can…I just need help in doing so. It’s really scary to think how close I came to taking that step and then changed my mind. This is the first time I’ve publicly announced this profound moment…I guess I feel at ease with the members of this forum.

  • The GoodTherapy.org Team

    The GoodTherapy.org Team

    August 18th, 2014 at 10:27 AM

    Thank you for your comment, Carolyn. We wanted to provide links to some resources that may be relevant to you here. We have more information about what to do in a crisis at https://www.goodtherapy.org/in-crisis.html

    Warm regards,
    The GoodTherapy.org Team

  • jennifer

    jennifer

    August 19th, 2014 at 12:22 PM

    I want to know what you all think about pretty much forcing someone to get treatment.
    If they are hell bent against it, then will forcing them to go somewhere do any good or is it only prolonging the inevitabele?
    I hate to think in those terms but at some point the person has to be willing to work and recieve the help that they are being given , and if they can’t do that then how in the world is there to be any healing?

  • Sims

    Sims

    August 20th, 2014 at 10:36 PM

    As someone who has dealt with depression and thoughts of suicide for most of my life, its not as easy as knowing you’re sick, calling the doctor, and getting help. Depression has a way of sneaking its way in a little at a time. I was fine a few months ago and most of the time I’m fine, but every once in a while, I’ll feel like I’m losing my mind, like I just want to give up because nothing that can happen in my life is ever going to make it worth it. Do I know that this is depression talking? Well yeah. Do I know I need help? Probably, but when you wake up in the morning and realize how silly you were thinking that life was so bad, you’re able to convince yourself that you’re ok and happy.. until you’re not again at 2 am and you can’t sleep. It doesn’t help when you mention how you sometimes feel to your spouse or someone you’re close with and they think they need to call the cops because you’ve gone crazy, or you just need to snap out of it. It doesn’t help when you’re dealing with issues and feelings that literally no one in the world could possibly care about you and even if they did, if you just ended it, they’d get over it. They’d move on and everyone would get what they wanted. Maybe Robin was over it, maybe he tried for so long to see what was so worth it about being alive and realized it was never going to come. Not only are all these thoughts just going through your head, you TRULY believe them. You feel broken, worthless, and you just don’t want to have to pretend anymore. I sound like a prime candidate for some shock therapy or something. I’ve been on meds and I’ve been to therapists, but you get to a point where you convince yourself that you’re alll better and everythings fine again. I can honestly say I am at ZERO risk for suicide, sure I think about it, but I could never do it. I more just wish I was given an option to decline being born. I don’t want the dramatics of a suicide, the awful aftermath, I just wish I could’ve opted out in the first place. I just thought I would give a little sample of what goes on in at least my head. Its hard to think of what goes on through someones mind when they decide they’ve had enough, and I’m sure it only gets worse than this. Until you’ve been there and you feel the sheer weight of these thoughts on your chest, you won’t understand. Sometimes having the option to just NOT is pretty appealing. Yes, I know that getting help is easier now then ever, but admitting that you need help just to want to live feels pathetic. Everyone says we need to talk about this, we need to have a conversation about it, but it gets a little too real and a little too uncomfortable when someone actually does. I know I need help, but I keep convincing myself that I’m not THAT bad yet. FYI, this is NOT cry for help or pity.

  • Andrea Schneider, LCSW

    Andrea Schneider, LCSW

    August 21st, 2014 at 8:39 AM

    @Jennifer…you really can’t “force” someone to get treatment. They need to connect with the motivation to get better…depression is a very complicated mix of biology, neurology, environmental stressors, and relationship dynamics…if someone is suicidal, call 911 or drive the individual to the nearest ER where they can receive emergency medical attention — in which case typically that involves a short hospital stay until stabilized…and then the psychotherapy once discharged is an intervention the client will need to connect with their own motivation for long term resolution.

  • Andrea Schneider, LCSW

    Andrea Schneider, LCSW

    August 21st, 2014 at 10:37 AM

    @Sims…thanks for sharing…wishing you well, love, light, and healing.

  • Maryam Abdul W.

    Maryam Abdul W.

    October 19th, 2014 at 1:39 AM

    Hello Andrea,
    I was in Therapy and Medication for 2 years. I was anti-social in school as well as depressed. Attempted suicide twice by overdosing on random pills.I can really say that I’m totally alright. Everyone tells me I’m lovable. I have alot of friends and I like to socialise now. But no matter how hard I try there’s always this time in my life where I feel that the past hits me hard. I get restless,Moody and start feeling stupid for all the things I have ever done in my life for every wrong I said. But then I try to understand that every negative has a positive side. I thank GoodTherapy.org for being there always. I love the articles they post and I have been their fan from quite a few years now. When I tell people how I have been on medication they always tend to give me this look that makes me feel I am some kind of a pshyco. Which is WRONG!TOTALLY WRONG!
    Not everyone who goes to a pshyciatrist or pshycologist is mentally ill. If only people would start helping each other instead of judging I believe the world be a much better place to live for me and for thousands out there who feel this way

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