Four days after the devastating news of Robin Williams’ suicide, I’m still feeling the loss of someone I never even knew personally. Perhaps it’s because his genius acting work has been a part of my life pretty much ever since I can remember (oh, yes, I was watching when he first hit the airwaves with “Mork and Mindy”). I can mark important times in my life with what movie he was doing at the time; for instance, my husband and I saw “Aladdin” on our first date nearly 22 years ago. Even now, our family quotes from that movie.
But another part of the reason this event has affected me so deeply is that it strikes close to home. I started this blog to write, in part, about mental illness, to just put my own experience out there. And Williams’ death has had me thinking a great deal in relation to how I can understand it and how I want to be able to continue to share my feelings with others. There have been some poignant tributes and some spot-on blog posts and articles about suicide, about depression, about the almighty struggle some experience with their mental health. I don’t think I can do any better, but I can just share my viewpoint.
Just a few weeks ago, I participated in a study focusing on cognitive issues in women who have breast cancer (I was part of the control group). I was happy to do my part for science, even if I had to drive a few hours away to get to Stanford University. Since the study is looking at cognitive effects of cancer or the treatment for it, it included questions and assessments not only about impairment of cognitive processes overall but also about emotional status. Since I had indicated on the questionnaires and intake forms that I take medication for depression, the researcher who worked with me asked me at the end of our time a little bit about my feelings and opinions on it. She said she focuses on psychology and has noticed in her time studying it that there are still not nearly enough treatments available for depression and other mental illnesses. Some people in the blogosphere and media have wondered why Williams, for example, didn’t just “get help.”
Here’s the sad truth: there isn’t nearly enough adequate “help” out there, whether it’s in the form of medications and other medical interventions and treatments or it’s in the form of professionals and non-professionals who really are good at what they do and can give superior guidance.
There is still an epic shortage (in my experience and opinion) in the number of qualified professionals who can treat people from all economic and health-care-coverage situations. This is particularly true in the case of the number of doctors or other practitioners who specialize in and are licensed to provide medications. In my experience, for instance, there are three psychiatrists covered by my health insurance (which might also be the total of all the psychiatrists in my city), and only one is taking new patients. That one I didn’t particularly like, and it’s crucial to have a certain level of rapport with someone who’s treating you for your brain chemistry. So I was lucky enough to hear about another provider who ended up being a better fit for me, but her office is an hour’s drive from my home, and her practice is not covered by my insurance. I am also lucky enough to be able to afford paying out of pocket for her care. But what about those who don’t have insurance at all, who can’t afford out-of-pocket costs, who don’t have access to transportation, etc.? There are a LOT of people not being served.
Then we move on to the issue of actual treatments available, even when one has unlimited access to doctors, therapists, and whatever medical intervention is available. And as the researcher and I discussed a few weeks ago, there are far too few options. I’m on an antidepressant that’s worked well enough for me the past couple of years to get me to where I can cope adequately with life’s challenges without being taken down completely. But there have been times medications weren’t doing enough for me, and it was hard.
There have been at least the number of times I can count on one hand, and possibly up to two hands, moments I’ve been in the blackest and deepest abyss and felt suicidal, even if it was only briefly. And I could go on and on about how if you haven’t been there, you can’t possibly know what it’s like. Logically, in a part of my brain, I knew I didn’t want to hurt my loved ones, didn’t want to deprive them of me. (That’s addressing the “selfish act” observation…) But it was a very distant part of my brain and one that was clouded over by the overwhelming despair and hopelessness of my feelings. As I’ve written before, it’s those times and others that I now feel my brain chemistry betrayed me. And it’s a very weird, unnerving feeling to have your brain working against itself and yourself. Even though I could logically call to mind times I enjoyed life and felt fulfilled and useful and vital and important to others, to the world, I just didn’t FEEL it. And it became impossible to imagine or believe I would feel that way again.
No amount of love and support and encouraging words from others (assuming the best, that one does have that kind of support system — believe me, there are plenty who don’t have that, making things even worse) can make that feeling go away. If your brain chemistry is off, it’s off. And that’s why we absolutely MUST find more options to treat that chemistry. There are far too few options now.
I appreciated this one article on Mashable, for example, that asserted, “Finally, We’re Talking About Mental Illness Like Adults.” People have generally been very thoughtful this week as they’ve discussed Williams. I sincerely and strongly hope that this discussion can continue, that a few important good things may come from this tragedy: 1) Let’s stamp out the stigma for good. Let’s work towards a culture in which people who experience any kind of mental illness can talk openly about it without fear of being judged or misunderstood or mistreated. Let’s make it as easy to talk about as any other illness that’s more “physical.” 2) We need to push for more research into more varied medications. There are a number of drugs out there (but not nearly enough) that are made for the treatment of mental illnesses, but a lot of them are similar to each other and work the same way. Pharmaceutical companies need to branch out and work on far more kinds of medications that attack mental illnesses in different ways, from different directions, etc. 3) We need more doctors. We need more prescribing practitioners available everywhere to everyone. This will not only be the kind thing to do, but one that will contribute to reducing many other existing societal problems: homelessness, joblessness, some violent crimes.
These aren’t easily attainable goals. But we certainly need to work towards them. It will make a world of difference to millions.
Life and Lims 
I have never understood how we can grasp that every other physical part of our bodies can get sick–from our spleens to our shins–but not our brains. Brains are physical, chemical, and even electric. Why couldn’t they sometimes go wrong? And why would this somehow be an indication of selfishness or a weak character more than, say, arthritis?
Exactly. My mission president said over and over to me, “My wife has diabetes. She needs medicine for that. You have something that needs medication.” Simple. Straightforward. Compassionate and non-judgmental. If more people felt that way and said it, more of us could just be open and not feel we’re second-class citizens while struggling mostly in silence.
Well put, Emily.
Right on. I wanted to backup your post with more than just a “Like.” I started getting treated for severe depression and suicidal ideation twenty years ago. It’s been hit and miss, to say the least. There needs to be improvements made to the mental health system in order for help to be more effective, and to give more people incentive to seek that help. Honest discussions are paramount to finding solutions. When accurate information is available, only then can realistic and truly effective solutions be formed.
Your post touched on the core of these issues. I’m glad you shared and respect your honesty about the issue. I wish you and your family good health.
Thanks for your input, Andrew. I think “giving people incentive” would include just having better options for treatment, to start with! We have a lot of people who don’t continue treatment if they do get started because the pharmaceutical options just stink. I know on a couple of things I tried (such as Abilify, for example, which is advertised HEAVILY), I felt like a shell of a person, just flat. Who wants to feel like that? Let’s find treatments that really help.
I wonder sometimes if people know that medications can only be recommended. Do you think it’s common knowledge that doctors can’t force a patient to take a prescribed medication? Do you think people are afraid that if they seek professional help a doctor will “force” them to take meds?
Are you familiar with a book called Side Effects by Alison Bass? Published by Algonquin Books 😉 I read it in 2008 or 9; if anyone were to ask me, I’d say it’s great. 🙂 I haven’t yet read much of Dr. Breggin’s or Marcia Angell’s work but it’s along those lines.
I’ve been on several different medicines and hear you loud and clear.
Interesting. It is definitely true that no one, not even doctors, can force you to take medication. But doctors can sometimes get so full of themselves and their own power and “wisdom” that they can probably pressure a lot of people into doing things they don’t feel comfortable with. Or in the case of others, just scare them off some kind of help/treatment entirely.
I haven’t read Side Effects; I’ll have to check that out.
I’ve suffered from depression periodically all of my life and I know the “abyss” you mentioned. For me, the abyss has at times felt impossible to get out of. I’ve felt like giving up much more than a few times. Depression is definitely something you can’t “snap out of”. Also, I think the coping and healing methods are not a “one size fits all”. Which is why I have never gone through with professional treatment. The one time I did meet with a psychiatrist about my depression, before I even had a chance to share anything with him, he wanted to prescribe me something. It scared me and I never went back. Fortunately, I have found what works for me. It was a long process to figure it out, but I am now able to gauge myself and make adjustments when I start to slip into depression-and pharmaceutically free (because that’s how I like it) At least it’s been working for several years now. I can only hope that it continues to work for me. And, I wish for everyone else that deals with depression to find a tailored just for you treatment that really works – whether or not that includes seeking professional help.
Good observations, Dessa. And again, your experience is just another reminder that we need more and better doctors/therapists, and we as “patients” usually have to spend a good amount of time finding a practitioner we feel comfortable with so we can work together, as a team, to find ways to help that will suit us the best on all levels. Unfortunately, psychiatrists are basically just there now to be the med prescribers, and therapists are the ones who do the talk therapy. So if you go to a psychiatrist, they generally just assume you’ve gone to talk therapy and have decided you need medication. All in all, we who need help have to do a lot of work and go through painful trial and error to figure out what works best for us. For those who suffer from particularly debilitating depression or other mental illnesses who can’t figure things out on their own very well, it would be nice for them to have trusted, competent support to guide them as they navigate what can be a tricky process of finding the best care.
Dessa, thanks for sharing that. I’m glad you found a way to manage things.
You are such an extraordinary person.
Hoorah for Elder Jeffrey R. Holland for “LIKE A BROKEN VESSEL”.
I know it’s not the medicine needed by the body, which you speak of, but it surely can give a tiny ray of hope to suffering souls.
“Whatever your struggle — mental or emotional or physical or otherwise — don’t vote against the preciousness of life by ending it. Trust in God. Hold on to His love. Know that one day the dawn will break brightly and all shadows of mortality will flee.”
I pray that those words might be a comfort and strength to any loved one who is silently struggling with mental health issues.
God bless them, literally.