The suicide death of beloved comedian and actor Robin Williams shocked many of his fans. But those who knew him were aware of his ongoing struggle with depression.
According to his publicist, Williams, 63, was completing a 12-step program for drug abuse and had been battling severe depression.
"You're standing at a precipice and you look down, there's a voice and it's a little quiet voice that goes, 'Jump,'" Williams told Diane Sawyer during an interview about his struggle with addiction in 2006. "The same voice that goes, 'Just one.' … And the idea of 'just one' for someone who has no tolerance for it, that's not the possibility."
More recently, Williams talked about the overwhelming fear and anxiety that led him to seek solace in alcohol.
"Having depression and being in a suicidal state twists reality. It doesn't matter if someone has a wife or is well loved," Julie Cerel, a psychologist and board chair of American Association of Suicidology, told USA Today. "They get so consumed by the depression and by the feelings of not being worthy that they forget all the wonderful things in their lives."
Indeed, a major reason people with suicidal thoughts don't seek help is the belief that nothing could possibly make things better, according to the National Institutes of Health.
Ariane Sherine, a writer for The Guardian, recently spoke with The Huffington Post about her struggle.
“When I was suicidal and having suicidal ideations daily, hourly, I never imagined that I would be this happy and this stable again," said Sherine.
"Please don't give up," she told HuffPost Live's Caroline Modarressy-Tehrani. "Life can get better ... It might involve a lot of trial and error, but it's possible to feel normal again, or almost normal again."
Though we can never know what took place in Williams' personal life, the actor's now-public struggles have many people thinking about the difficulties faced by those battling depression and addiction. That's especially important in light of recent evidence that high-profile suicides may inspire young people to take their own lives.
BY THE NUMBERS
Each year, 34,000 people commit suicide, about twice as many deaths as caused by homicide -- about one death per 15 minutes. By 2030, depression will outpace cancer, stroke, war and accidents as the world's leading cause of disability and death, according to the the World Health Organization.
While the elderly have the highest rate of suicide, anyone can be suicidal. Men, in general, are more likely to complete suicide, even though women are more likely to attempt it. About half of all suicides occur in men ages 25 to 65. Risk factors include overwhelming situations, such as aging, substance abuse, emotional trauma, unemployment or financial problems, according to the NIH.
Fully 90 percent of those who take their own lives struggle with an underlying mental health issue. According to the latest estimate, 13 percent of people will experience depression at some point in their lives. And about 15 percent of those with clinical depression will die by suicide.
THE SUBSTANCE ABUSE FACTOR
Substance abuse in combination with a preexisting mental health condition, such as depression or bipolar disorder, can be deadly, according to the website of Suicide Awareness Voices of Education, a suicide prevention organization. Often, someone suffering from mental illness will seek alcohol or drugs to relieve symptoms, but this can lead to impaired judgment and impulsive behavior.
Williams discussed the interplay of substance abuse and suicidal thoughts during a 2010 interview on the comedy podcast WTF with Mark Maron [at 52:00]. Describing a dark period of drinking alone in his hotel room two years earlier and briefly considering suicide, Williams said his "conscious brain" told his drunk brain to "put the suicide over here in 'discussable.' Let's leave it over here in the discussion area" until he was sober.
SIGNS OF TROUBLE
It can be difficult to determine when a depressed loved one has progressed to suicidal tendencies. The SAVE network recommends asking the following questions in a non-judgmental and non-confrontational manner:
Do you ever feel so badly that you think about suicide?
Do you have a plan to commit suicide or take your life?
Have you thought about when you would do it (today, tomorrow, next week)?
Have you thought about what method you would use?
Suicidal individuals may talk about feeling hopeless or guilty, pull away from loved ones and complete tasks that seem geared toward getting affairs in order, giving away possessions or otherwise arranging for family, according to the NIH.
If you or anyone you know has threatened suicide or is displaying tendencies, it is important to seek immediate help.
For a loved one struggling with depression, there are ways to offer support. (Though it is essential to know that depression is not due to a failure of support on the family's part.)
When talking to someone suffering depression, "it's best not to say anything that is going to make them think that what they're dealing with is because of a lack of coping skills, personal weakness or a character flaw," Dr. Adam Kaplin, an associate professor in the departments of psychiatry and neurology at Johns Hopkins University, told The Huffington Post for a previous article. "The worst part of depression is that it narrows the field of vision into a very small tube so they can't see the options. A lot of [the goal of helping] is giving people a hope that things will get better."
Have a story about depression that you'd like to share? Email firstname.lastname@example.org, or give us a call at (860) 348-3376, and you can record your story in your own words. Please be sure to include your name and phone number.
Need help? In the U.S., call 1-800-273-8255 for the National Suicide Prevention Lifeline.