Just Behind the Door

Robin Williams, the absolute genius of comedy and from all accounts a wonderfully generous human being has passed away. By now, we have all heard the reports of his untimely death. We are saddened and shocked that a person who appeared to capture the hearts of so many by giving us non stop laughter was so depressed that he could no longer find the strength to go on. Maybe because of his fame, his passing will help all of us learn more about depression and Parkinson’s disease.

Being strong does not mean that we can ignore or talk ourselves out of a serious depression. I’m not talking about a day or brief period in our lives when we feel overwhelmed with life. No, I’m talking about serious clinical depression that can be caused by psychological, environmental, biological or genetic causes. Think of it this way, if Robin Williams the talented and successful comedian was not immune to the ravages of clinical depression is it time to sit up and take notice when we hear or feel that someone we know or love is seriously depressed?

It has been said that if a person feels hopeless, helpless or worthless they are prone to depression and even possibly suicide. That makes sense – if your bucket feels totally empty to you it would be hard to continue to carry it. The World Health Organization estimates that 13% of U.S. men suffer with depression. Studies also show that the older men get the higher the rate of suicide from depression. This is a note to my baby boomer friends. You are more than your career (now retired) your physical stamina (becoming less so yearly) or your physical appearance (with age comes those lines that indicate you gave it your all).

We do a great disservice when we expect men to suppress their emotions, be strong and keep a stiff upper lip. That expectation is not only ill informed it is a tremendous disservice to them. Men are not machines functioning without emotions. Yet, sadly, many men have naively accepted this stereotypical image that is not only wrong but psychologically dangerous. Give me a man that shows honest, heart felt emotions and I will show you a human being who will make a difference in this world. No one is invincible or immune to times or periods in their life where they struggle with their own self worth. What we can do to help ourselves and others is to have enough strength to recognize that we may need a listening ear, a medical intervention or even to seek the help of a mental health professional if the depression is prolonged.

We now understand that Robin was experiencing the early stages of Parkinson’s disease. This disease can fuel the fire of a person already fighting the effects of depression. The first longitudinal study from the national Parkinson’s Progression Makers Initiative was published in the August 15th issue of Neurology (Robin was always the master of timing). The researchers at the Perelman School of Medicine at the University of Pennsylvania tracked Parkinson’s patients rate of depression from the time of their initial diagnosis over a two year period and compared the rates to more healthy peers. The depression rates were TWICE as high in the first year alone (14% to 7%) and even higher in the second year!

What caused the significant increase in depression among Parkinson’s patients? Was it caused by hearing that they had a disease that was serious? No, it is much, much more than that issue. It seems that not only are bodily motor functions affected but the chemicals that affect Parkinson’s disease are also closely associated with mood regulation due to changes in the brain! The physical changes in the brain contribute to depression. It is not mind over matter but the change in brain functioning specifically that makes this disease more difficult. Our vigilance to be sure our friends and family members who are diagnosed with this disease are regularly monitored for depression is essential.

Thank you to Robin Williams for all the brilliant moments he brought to us and thank you also for his last act… not one of selfish indifference – but one that may help hundreds or thousands of people better cope with clinical depression and Parkinson’s disease.

Have a great few days!