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Defeat Depression!!

Robin Williams is dead. Depression is alive.

He made us laugh. Now he makes us cry.

Robin Williams must have been crying too before he ended his life.

We are fascinated with celebrity. We live in the fantasy worlds created on stage and screen. We identify with famous people on the big screen or the theater stage. We envy their talent, their homes, their cars, their exotic travels, their figures (both bodies and financial), their glamour. As they live their life in the spotlight we are allowed to escape our own daily trials and tribulations in the movie theater.

We see the public side of fame and are attracted to the gossip we can gather online, on TV, or in magazines. We do not know what goes on when the curtain comes down or the camera is turned off. We cannot inhabit the minds where depression and its twin, anxiety, can take hold. We create fantasies about the rich and famous. It’s part of the media game.

Celebrities are typically attracted to public adoration and applause. Sadly for some, it is primarily, sometimes exclusively, public adoration and applause that provides self-esteem and self-worth – a reason to live. Love comes from external sources. Appreciation of one’s self intrinsically is unfortunately absent or diminished. Perhaps the Beatle’s song said it best: “Money Can’t Buy Me Love”.

Celebrities go home after work, after glamorous parties, after awards ceremonies, after the curtain falls, the applause stops, and the audience goes home. At some point in the day or night, each of “them” and us must deal with being alone with our private thoughts, fears, and feelings. The famous are no different from you and me. If internal applause is unavailable, mental problems can brew. The worst case scenario is what we heard on the news about Robin Williams.

All of us are vulnerable. What can we do?

In our highly charged, anti-collaborative climate of health care reform, social, economic, and political unrest at home and abroad, global terrorism, invasive insurance companies, illusions of medication magic, demands for quick fixes for long-standing psychological issues that effect self-worth, anxiety and depression, and ongoing stigmas about mental health treatment, it is important that mental health and medical professionals consider themselves teachers, impresa­rios, and ambassadors, as well as clinicians. Collaboration is our challenge and our opportunity regarding recognizing and providing quality psychological and physical health care.

We need to continually emphasize the ideas that the TV ads which promise quick cures, rapid weight loss, potency, and finding our soul mate on a dating site are illusions.

We need to understand that depression and anxiety can exacerbate physical illness and recovery and that physical illness can exacerbate depression and anxiety.

We need to consider that if depression and anxiety are purely conceptualized as biological “brain diseases” we risk overlooking the powerful effects of the mind and what these “illnesses” mean to individuals and their families.

We should consider depression and anxiety are social issues as well as mental and psychological issues.

We must not separate the physical and the psychological aspects of ourselves and others. A whole person is greater than the sum of his/her parts.

We need to look to early childhood development, often involving loss, trauma, neglect, and abuse, as precursors that underlie depleted self esteem, depression, and anxiety.

We must jettison the idea that “mental problems” are the result of being lazy, crazy, not smart, or not trying hard enough.

We must realize that drug treatment in itself may relieve symptoms but cannot not alter long standing maladaptive thought patterns about self worth.

We must realize that short term therapy or drug treatment and symptomatic relief (important as it is to have symptomatic relief) can prevent people from exploring and understanding the origins of their symptoms including working through childhood experiences that can negatively impact adult life.

We must not let long term treatment prevent patients from seeking symptomatic relief through medication when necessary.

None of us is omnipotent. We cannot prevent all suicides.

We can do much better.

More than ever, we are facing a crisis that comes with the opportunity to confront our complex mind/body duality. It is urgent more than ever to emphasize the interdisciplinary nature of recognizing and treating depression and anxiety. It is a terrible tragedy that Robin Williams is the most recent victim of our broken health care system with it’s unfortunate attitudes and stigmas about what constitutes the most comprehensive treatment.

We all have a responsibility. Will all of us rise to the challenge?

Please share your responses and ideas below about how to effectively approach mental, physical, and social problems that could improve and save lives.


Photo by Benjamin Watson

  1. Stephen J. Gill 8 years ago

    Julie, I think that one thing we can do is create supportive, compassionate work environments. Many people spend half or more of their waking ours in toxic workplaces. They have bosses who are demeaning and autocratic and work spaces that stifle social interaction. They work in so-called teams that don’t respect their individual contributions. They work for companies that don’t value work-life balance. They are discriminated against because of their gender, race, religion and age. All of this contributes to mental, physical, and social problems and, for some, depression and debilitating anxiety. We need to pay greater attention to the kind of workplace culture we are creating in our organizations.

  2. Julie Nagel 8 years ago

    Steve, you make important comments here. Supportive work environments can be a win/win situation and foster emotional health and interpersonal relationships. Your important work with leaders and organizations is focused on creating healthy work environments and individuals. Thank you for your reply.

  3. Sonya Lewis 8 years ago

    Unquestionably the mental health system in our country is a mess. Death is not the outcome we wish for our patients. Ever.

    We do not know if Mr. Williams was in any type of treatment prior to his reported suicide (although media reports tell us that he’d been recently treated for substance related issues). It is quite possible that he was under the care of a skilled and compassionate therapist – we will likely never know this. If indeed there was a therapist involved in his care, I can only imagine the anguish that he/she is feeling as he/she absorbs the news of his passing. This hypothetical therapist will likely spend countless hours asking him/herself “Could I have done more?”. However, as we fantasize about the mental life and possible treatment this larger than life celebrity may or may not have received – let us consider the possibility that this imaginary (but possibly real) therapist helped prolong Mr. William’s life and helped him survive for many more years than he might have without care. Like others who complete suicide, perhaps Mr. Williams had attempted to take his life prior to his ultimate demise. Perhaps he’d been successfully talked out of taking his life by this therapist – or someone else dear to him. Perhaps the world would have mourned the loss of Mr. Williams years ago were it not for the skill and compassion of this unknown professional. It is tempting to say that the system failed in this case, but let’s consider the possibility that the “system” – albeit deeply flawed – is not to blame for this tragedy.

    I am reminded of a morbidly obese patient I saw years ago. As he walked into my office he was out of breath and did not fit into my office chair. As I took his history, I was mindful of my own prejudices and attempted to address his obesity without judgment. However, before I could even bring up the subject of his weight, he informed me that he’d just lost 50 pounds and was working hard to continue his journey toward improved health. I have never looked at an overweight person the same way since.

    Perhaps Mr. Williams, similar to my patient, worked tirelessly to optimize his mental health and was served well by mental health professionals. Certainly, we can assume that he had the financial resources to obtain excellent care (although truthfully, I should not presume to know anything about Mr. William’s finances).

    It is easy to view Mr. William’s death as a failure, as a preventable tragedy, as a missed opportunity. However, despite our anger and grief over his demise, we must also give tremendous credit to those invisible souls who helped him persevere through a lifetime that we imagine was riddled with enormous suffering.

    Rest in peace, Robin Williams. And may those who cared for you prior to your death find peace and comfort in your lives.

  4. Julie Nagel 8 years ago

    You make such important points in your reply – it is entirely possible Robin Williams life was lengthened and with quality of life time due to the care he received by his therapist and team of caregivers. These are the unsung heroes who remain anonymous and work in private practice, rigid health care facilities, or with difficult insurance companies to provide unbiased and unconditional help. Yes, RIP Mr. Williams and Live in Peace to his therapists knowing you did the best you could. I know that you, Sonya, are one of those doctors who have extraordinary compassion and skill and that those people who see you are very lucky indeed. Thank you for responding.


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