Tuesday, August 12, 2014

Robin Williams and Bipolar Disorder

Robin Williams
I know he denied it, but it does seem that Robin Williams had bipolar disorder. So based upon the presentation, at the very least I'm going with a Bipolar II. You only need one manic episode for that one.  A depressive episode took his life.

I get my first world news updates from Robin Meade's early morning show. Her voice is calming. In therapy, people who work on a morning news show are at work at one a.m. They will tell you that to get through that shift: You drink a lot of caffeine.

Many of us do, too, drink a lot of caffeine, if only in the morning, and it makes us a little  manic (I am typing fast) and we wouldn't trade the feeling. Half-caf is a suitable alternative. 

There is a world of difference, however, between the manic feeling associated with two cups of coffee and the "manic" in manic-depressive, or bipolar disorder. We now really only use the term, bipolar disorder. I don't know why.

One of my first posts on this blog, back in June, 2006, hosts a long list of celebrity sufferers, including Mark Twain, Agatha Christie, Abraham Lincoln, Plato, Graham Greene, and Sir Isaac Newton. Dozens of Hollywood stars rate inclusion, celebrities gone public about their disease.

We have to add Robin Williams, now. He killed himself to escape the disease. He was in Hazeldon for rehab only last month and had treatment for depression, too, fairly recently. His daughter Zelda just turned twenty-five. Susan Schneider, his loving wife, is "utterly heartbroken." Millions of fans, everyone, mourns with the family. It is a dark day, and it isn't just the weather.

When I see the montage of photographs it seems as if the actor is crying in most of them. The editors on television shows know how to relate, convey empathy. There is a sadness in Mr. Williams, a sadness in his eyes.

It is not the sadness of Lesley McSpadden who lost her son, Michael Brown, on the same day, although her eyes are sad, too. A policeman in Ferguson, Missouri shot the boy down; Michael's hands up in surrender. A riot ensued, teargas to contain the mob. Ms. McSpadden shouts to police:
"You took my son away from me."
The shooting, racially motivated. Had it been a white teen on the street, it is unlikely this would have happened. So Ms. McSpadden has fellow mourners, millions, too.

It is not the sadness of the family and friends of Rabbi Joseph Raksin:
Rabbi Raksin: Victim of hate crime
In cold blood.

Homicide victims, symbolic of the racial tensions of the day, are now common. And we haven't even discussed Knockout, a video game encouraging players to take to the sidewalks. One rolls the camera while the other casually knocks out an innocent pedestrian. Victims happen to be Jewish in New York. It is rumored to have happened a few weeks ago in Chicago, and the victim died. So scary that some of us think, "I should buy a gun and learn how to use it."

Then there is Robin Williams, who died with a belt around his neck, a man who brought the world happiness and tears, the tears we love to cry at the movies. It feels like a crime, too, his suicide. He describes his quiet childhood, and tells NPR that he certainly suffered sadness, but everyone does. Yet others speak of disabling depression. A person can take only so much. He probably thought he had tried everything. 

But he hadn't. We know that because he's gone.

To "treat" his disease, among other interventions, he used alcohol and drugs as "controllers." He suffered a dual-diagnosis, most likely: bipolar disease and poly-drug dependence, hence the stay in Hazeldon, a popular, effective, addiction treatment center. Following his release, clearly, he should have been evaluated to be sure he didn't kill himself, to see exactly where he might be falling, alcohol-free, on the depressive continuum. For those with dual-diagnoses, treating one and not the other is futile. Easy to see this with hindsight, but Mr. Williams should have been admitted for a long stay in a psychiatric facility, a nice one, of course, for observation. He could afford it.

We can assume he had been there and done that in the past, probably plenty of it. It is a cyclical disease, however, and a cycle can last. A depressive cycle can be so painful that the patient wants to make it stop lasting. We might say Mr. Williams needed a much longer inpatient stay, longer than he had ever had before. Again, twenty-twenty hindsight, but we're talking about a legendary actor, and there are other legendary actors who suffer, much like Abraham Lincoln, Sir Isaac Newton, Mark Twain. . . Not that they all killed themselves, maybe none of them did, but one in ten with bipolar disorder do. We have to learn from these suicides, don't we?



Dawn Hurst-Stultz said...

thanx for this, Doc. it made sense to me. I have (and live w/) a brother who has bi-polar disorder. he used to be an alcoholic and used drugs too. But he's clean now; thank God!
the irony of all this is when you're in the throes of severe depression nothing is seen as hope for tomorrow, only pain in the littlest effort to climb out of the black pit you are in. But the joy if and when you do and can! Robin got stuck in the pit. I grieve his loss; he gave us much happiness! But he couldn't save himself unfortunately.

Kathie S. said...

I was expecting something a little more coherent from a "therapy doc." The tragedy in losing Robin Williams is no "should haves" would have saved him. It is pretentious to say so. No doubt, Robin Williams had fought a long, hard battle and was very, very tired. The Suicide Prevention pundits are mad, but Genie is finally free.

therapydoc said...

Really? You don't think that had Mr. Williams communicated that he wanted to die, that a trip to an island wouldn't have helped? Or something of that nature? A person fights his whole life, wins the battle each time, then loses the war because of bad news. Parkinsons (we hear). Could be, certainly. We're just not in the business to give in to what is de riguer,, which is that if a person wants to kill himself, he will find a way. I prefer to think of ways to change the brain, not necessarily with electricity or medication, but venue change. And people with means can do that, change their venue. It is the tunnel vision of the disease that stops them. It is our job to take off the blinders. The French Riviera, perhaps. Or the Italian Alps.

therapydoc said...

Not that I don't appreciate the comment! Thank you, and thanks, too, DAWN for sharing with us.

Samantha Anderson said...

I really enjoyed your comments on such a tragic death. I found your points about treatment for multiple diagnoses very pertinent and interesting. It can be so easy for those around a person suffering to believe that they can be "fixed" with treatment for just a period of time. Unfortunately, however, these diagnoses can be for a lifetime. That's not to say that they cannot improve, but it is important to be aware of every aspect of every diagnoses, and to consider treatments at all stages to keep improving. Mental health is so important and proper treatment for all aspects is a dire need.

Samantha Anderson, Miami University (OH)

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