LIFE

Robin Williams reminder of depression's reach

Darla Carter
@PrimeDarla

The death of Oscar-winning actor Robin Williams serves as a reminder that suicide is no respecter of persons.

"Suicide and depression hit every part of the social strata, from the very rich and famous to people who are struggling to put food on the table," said Dr. Jesse H. Wright, a psychiatrist who directs the University of Louisville Depression Center. "There are many instances of people that are very well-known that have suffered from depression and some that have committed suicide. For example, (writer) Ernest Hemingway committed suicide."

Suicide claims about 1 million lives worldwide each year, resulting in one suicide every 40 seconds, according to the American Association of Suicidology. In the United States, there were more than 39,000 deaths by suicide in 2011, with an estimated 645 occuring in Kentucky. There were 691 suicides in Kentucky in 2012, according to Kentucky Vital Statistics.

There were 935 suicide deaths in 2012 in Indiana, according to the Indiana State Department of Health.

Often, the person is male and middle-aged like Williams, a beloved pop culture figure since the '70s when he starred in "Mork & Mindy."

Williams, 63, who was famous for his frenetic comedy riffs as well as more serious performances, was found dead in his Tiburon, Calif., home Monday after reportedly hanging himself.

His publicist, Mara Buxbaum, said in a statement that he had been "battling severe depression," according to The New York Times. Williams' widow, Susan Schneider, later said in a statement that her husband was in the early stages of Parkinson's disease, which experts say can lead to depression.

"Major depression is the most common form of significant depression that requires treatment," Wright said. "About 17 percent of people in the United States will experience that during their lifetime, and it's characterized by at least two weeks of feeling down and depressed, not being able to enjoy things anymore, having very negative thoughts about yourself, self-condemning thoughts, being unable to see the positives."

People with major depression also may have problems with sleep and appetite, low energy and poor concentration, and some, but not all, have suicidal thoughts, Wright said. "It's the type of depression I see every day," he said.

Amanda Newton, marketing director for Seven Counties Services, said people who are very successful are under a lot of stress that could make them prone to suicide, and she urges the public to look out for warning signs, such as feeling hopeless or voicing thoughts of suicide. "Sometimes people say, 'Oh they're just trying to get attention,' " Newton said. "Well, we always err on the side of safety ... because it takes a lot for somebody to say they're going to kill themselves or they've been thinking about it."

Wright said people's risk is much higher if they have a plan and intent, rather than just fleeting thoughts. Talk to them and offer to help them get a doctor, he said. "If you're worried about harming yourself right now, let's go down to the ER together," you might say.

Wright said it's also important to get treatment for significant depression, rather than allowing the illness to linger. This depression " really takes a piece out of you and a piece out of your relationships" and "erodes your self-confidence, and if untreated, typically gets worse and may be recurrent," he said.

Treatment options include taking antidepressants alone or combining medication with cognitive behavior therapy to acquire the skills to get rid of depression and keep it at bay.

Cognitive behavior therapy "is a highly effective treatment that's been shown to be useful in lots of research studies," said Wright, co-author of the book "Breaking Free From Depression" (Guilford Press, 2011). But "probably the best treatment is a combined approach, particularly if you have really severe depression."

Williams had acknowledged past problems with substance abuse, including cocaine and alcohol, as well as stints in rehab.

Such abuse "can make depression worse," Wright said. "It can make it much harder for you to recover from depression, and it can play a role in getting you depressed if you weren't depressed before. When people have both depression and a substance abuse problem, it's essential that the substance abuse be treated effectively and be brought under control for the depression to get better."

Reporter Darla Carter can be reached at (502) 582-7068 or on Twitter @PrimeDarla.

NOTICE THE SIGNS

The following signs may mean someone is at risk for suicide. If you or someone you know exhibits any of these signs, call the National Suicide Prevention Lifeline at (800) 273-TALK (8255).

• Talking about wanting to die or to kill themselves.

• Looking for a way to kill themselves, such as searching online or buying a gun.

• Talking about feeling hopeless or having no reason to live.

• Talking about feeling trapped or in unbearable pain.

• Talking about being a burden to others.

• Displaying extreme mood swings.

For more possible signs, go to www.suicidepreventionlifeline.org/gethelp.aspx.

Some additional places to call for help

• Seven Counties Services: 24-hour Hope Now Hotline, (502) 589-4313 or (800) 221-0446.

• University of Louisville Depression Center: (502) 813-6600 or https://louisville.edu/depression.

• National Suicide Prevention Lifeline: (800) 273-8255 or www.suicidepreventionlifeline.org, which includes a crisis center locator that's searchable by ZIP code and state.