I was saddened this week to read of the tragic death of Robin Williams. The 63-year-old talented actor and performer struggled with substance abuse since the 1980s. He previously admitted to cocaine and alcohol addiction and entered rehab in 2006 for alcoholism after 20 years of sobriety and had again voluntarily checked himself into rehab in June.
Anxiety and depression – a potentially lethal mix
Over the past two decades I have visited high schools and colleges to talk on mental health and how stress can affect the brain and it still amazes me how little the general public understand just how damaging the effects of stress are on the brain can be and how important it is to manage stress in a positive way. While we cannot know Robin’s motivation to take his own life we know that he complained of anxiety and depression and was also suffering the early effects of Parkinson’s disease in the weeks preceding his tragic death.
The amygdala – the brain’s house alarm
Anxiety is brain state associated with the over-activation of two tiny brain regions – no bigger than a thumb nail – called the amygdala (Latin; the almond). These two regions located deep in the brain behind the nose – one on the left side and one on the right side – contain nerves that help to convert alarm into action. Once activated, the amygdala triggers the brain into a state of high alert usually associated with imminent danger. Under normal conditions the amygdala is there to save your life for instance by avoiding oncoming traffic when crossing a busy road. However, you only have to endure one sleepless night as a result of the noise from a neighbour’s house/car alarm to understand the exhausting effect of an overactive amygdala. It is no coincidence then that anxiety which may also include unpredictable panic attacks can lead to the emotional exhaustion found in depression which is a profound lowering of the mood and an inability to appreciate anything positive.
Anxiety is a prelude to depression
If anxiety is not nipped in the bud then emotional burnout sets-in and a spiral of depression starts to take hold. Depression is not to be confused with sadness which is a natural response to the normal ups and downs of life. It is through sadness that we learn and become wise. In contrast, depression is suffocating and blocks us off from the world by making us focus only on the negative aspects of everyday life including for example a loss of self-worth. This phenomenon is also known as situational bias. This type of negative thinking backed-up by a low mood can lead to a dangerous fatalism where the sufferer feels that life is not worth living. In Robin’s case his depression was probably not helped by a recent diagnosis of Parkinson’s disease – for which it is unclear if he was receiving medication.
What is Parkinson’s disease?
Over 4 million people worldwide suffer from Parkinson’s disease – a so-called hypokinetic disorder (Greek; hypo = lack of; kinetic = movement). Parkinson’s disease can be genetic but it can also be triggered by prolonged exposure to some drugs. It is a progressive disease – the symptoms start out small and get progressively worse but it is rarely fatal. With Parkinson’s disease one minute you are working away in the garden and the next you are literally stuck to the spot – totally unable to move. In these situations daily life can become a challenge that can be difficult to endure.
The core defect
The ‘core defect’ in Parkinson’s disease is a loss of a chemical called dopamine. Dopamine acts like hydraulic oil which lubricates those nerve networks involved in executing a movement. In Parkinson’s disease he supply of dopamine dries-up and like a car out of oil the engine seizes-up and movement grinds to a halt.
Trapped and disconnected
We need dopamine to survive. Dopamine allows us to talk, sing, socialize, improvise and take risks. When dopamine flows we don’t see things as being limited by circumstance. We have boundless energy and literally anything is possible! One only needed to watch Robin Williams perform at the height of his career to see dopamine in action as his brain effortlessly converted his thoughts and moods into the mesmerizing performances that made him so loved by a generation. Without dopamine we feel trapped and disconnected. It is not surprising therefore that mood can become low and anxiety and depression are often associated with this illness.
What can we learn from Robin’s death?
Since Robin’s death some media have reported that it is a pity that something like this has to overshadow what he achieved during his life and that a tragedy like this in not of any benefit to anyone.
While I agree with this to an extent, I do think that Robin’s death might be of some benefit if it opens up a debate on how we as a society deal with stress. We have heard that Robin was under a great deal of stress in the days and weeks leading up to his death. In this he is not alone. As the world economy continues on its downward slide, and unemployment and financial worries beset us, are we going to turn more and more to quick fixes to handle our dis-stress?
Probably the most important lesson to be taken from Robin’s death is the realization that the stresses of life and how we manage them IS the difference between life and death. I look forward to developing this theme in greater detail including drug-free tips on how the avoid worry and stress in future posts, but in the meantime, my deepest sympathy go to Robin’s loved ones at this difficult time.