Wednesday, August 13, 2014

Robin Williams is on my mind...

Just like he is on a lot of peoples' minds today.  He was an amazingly talented performer who happened to struggle with depression and drug and alcohol addictions.  His sudden death hits close to home for a lot of people, because many people suffer from depression and addiction.  Many people have these problems and have never gotten help for them because there's still a lot of shame associated with mental illness and substance abuse.

My dad, who died last month at age 81, suffered from depression and alcoholism.  He wasn't a bad person, but sometimes he acted like one due to his demons.  I know for a fact that he occasionally thought about suicide, only because he mentioned it to me in a private moment once some years ago. And yet, somehow he was able to hang on to his life until his life became a mere existence.  He medicated his psychic pain with booze and was never able to give it up.

My dad passed his tendencies to me.  I know what depression and suicidal ideation feels like... for me, at least.  Like any other illness, depression manifests in different ways with different people.  I've always had a tendency toward depression, but it got especially acute in 1998, after I'd been home from the Peace Corps for about a year and was living with my parents.  I started to feel hopeless, helpless, and miserable.  Then I started to feel crazy and paranoid.  I started to see a therapist after I had a minor accident in my parents' driveway and was referred to a psychiatrist for antidepressants.

The first one I took-- Prozac-- didn't work very well.  I was on it for about three months and was eventually taking huge daily doses because I wasn't responding very well.  One day at work, I had a complete meltdown.  I was feeling very overwhelmed with stress to the point at which I couldn't work.  I couldn't think.  Not long after that, I switched to Wellbutrin and it was like a miracle.  Within days, I felt much better.  I was on that drug for about five years; then I got off it because I was hoping to get pregnant.  Also, I had to get on Tricare, which meant switching doctors.  I wanted to see if I could go it alone.  I could and did.  I haven't been on antidepressants since 2004, but it's comforting to know they're out there if I need them.  In my case, they really were a lifesaver.

Yesterday, someone left a comment on my blog (since deleted) that Robin Williams probably killed himself over antidepressants because antidepressants "kill people".  Folks, I'm here to tell you, in most cases that is not true.  Moreover, I have no idea if Robin Williams was using meds or not.  Even if he was using meds, their efficacy could be affected by alcohol use.  I don't know if Robin Williams was drinking alcohol in the days before his death, but I suspect it's likely.  And if he was drinking and using antidepressants, I would say the antidepressants wouldn't have been at fault.  Fair disclosure...  when I was taking Wellbutrin, I did drink alcohol.  Fortunately, there never seemed to be an ill effect from doing that, at least not in my case.  But everybody's different and everyone responds to drugs differently.  That's why it's important to get your prescription drugs from someone who knows what they're doing.

Another issue that has come up in the wake of Robin Williams' death is that suicide is a "selfish" act.  I have seen some friends address this.  I believe the vast majority of people who attempt or commit suicide are doing it because they think the world will be better off without them.  Suicidal people get "tunnel vision".  They lose the ability to be objective and see beyond the pain of the here and now.  They aren't thinking about the pain other people will feel after they've died.  They are thinking about the relief of being out of pain and anguish.  And depression is a nasty illness that makes its sufferers think that no one cares about them.  This may seem like unattractive self-pity to those who are mentally healthy; my mom often told me to stop being "dramatic" when I was depressed.  Many people may be repelled by the self-pitying aspects of depression, especially when the person in question is someone like Robin Williams, a guy who seemed to have anything.  They may then think the person is being stupid or selfish or just trying to get attention.

Money and fame and adoration by perfect strangers isn't enough to buy happiness.  Happiness comes from within and is nurtured by loving relationships with others and satisfying activities.  But it's also tempered by one's physical health.  Depression can be caused by a chemical or hormonal imbalance.  Before I was clinically depressed, I had no understanding of what depression actually is.  I'd seen it in my father and one of my sisters.  I'd probably seen it in other people, too, though I didn't recognize it in myself.  When my doctor first recommended antidepressants to me, I balked.  I thought it was a cop out.  I reluctantly took the meds and it took months before I really started feeling better.  In the meantime, I annoyed family and friends and myself.  Some people thought I was an unstable attention whore.  Some people probably still do think that about me.

All I know is that within four days on Wellbutrin, I felt like a new person.  It was incredible and it really drove home to me that depression is a physical disease as much as it is mental an emotional.  Wellbutrin is not for everyone, of course; but for me, it really was the right drug.  I was suddenly feeling like a normal person instead of someone about to fall apart at the drop of a hat.  I could make rational decisions and plans.  And fortunately, by the time I had this breakthrough, I was no longer feeling suicidal.  I think this is where people can get into trouble with antidepressants-- when you are really depressed, you feel lethargic and lack the energy to do anything.

Antidepressants can help lift the fog of lethargy and that's where people find the energy to plan and carry out a suicide.  They are responding to the drug, but aren't completely in balance and are still experiencing irrational thinking. So now they have the energy they were robbed of by the depression, but their brain chemicals are still so unbalanced that they see suicide as the best answer to their problems.  Just so you know, I think there are some situations where suicide might even be a viable and reasonable choice-- say, for instance, when a person has a chronic, debilitating, and painful disease that will kill them anyway.  For most people, though, suicide is likely not the most reasonable choice  But it can happen, just like death is the end result in many serious diseases.

Since those five years on Wellbutrin, I feel like a different person.  I used to cry a lot more than I do now.  I used to have a lot of emotional meltdowns and things would hit me harder than they do now.  While I'm sure I'll always have a tendency to be pessimistic and easily upset, I bounce back faster and easier than I used to.  I was resilient then, but I am even more resilient now.  And I don't ever want to go back to the way I used to feel when I was clinically depressed.  It's a horrible way to go through life.

After my own experience with depression, I find it very hard to judge people who kill themselves.  I am sorry Robin Williams finally succumbed to his depression.  Having experienced depression myself, I firmly believe that depression, while treatable, is exhausting, expensive, and just plain difficult to deal with.  Robin Williams was a very talented and much loved entertainer, but even with all he had, he wasn't immune to the scourge of depression.  All I want to do is remember him for who he was and enjoy the many indelible marks he left in this world.  He lived a full and accomplished life and gave so much until he couldn't anymore.

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