Robin Williams:Depression, Suicide & Our Shared Parkinson's

Robin Williams: Depression, Suicide and Our Shared Parkinson’s



Like millions of others, I’ve found myself deeply sad and surprisingly preoccupied with Robin Williams’ suicide, scouring news articles and brooding over possible explanations for his “tipping point.” (As a licensed CSW and family therapist, retired due to my own Parkinson’s, this kind of speculation is unsurprising.) I loved Robin Williams! He was such a brilliant, funny, gifted comic and improvisator, and his performance at Brooklyn’s BAM 6 months after 9/11 gave me my first belly laughs since that day of horror. For that, I will be forever indebted to him. But, the news today, as I awoke from an afternoon nap, that Robin Williams was in the early stages of Parkinson’s Disease, blew me away.

On Robin Williams: Depression, Suicide and Our Shared Parkinson’s


Like millions of others, I’ve found myself deeply sad and surprisingly preoccupied with Robin Williams’ suicide, scouring news articles and brooding over possible explanations for his “tipping point.” (As a licensed CSW and family therapist, retired due to my own Parkinson’s, this kind of speculation is unsurprising.) I loved Robin Williams! He was such a brilliant, funny, gifted comic and improvisator, and his performance at Brooklyn’s BAM 6 months after 9/11 gave me my first belly laughs since that day of horror. For that, I will be forever indebted to him. But, the news today, as I awoke from an afternoon nap, that Robin Williams was in the early stages of Parkinson’s Disease, blew me away.
It was a devastating revelation, because my personal guess is that Williams wasn't told that depression is one of the lesser-known, but common, and easily treated Parkinson's symptoms, as I learned early into my own PD experience. (I was diagnosed 15 years ago). His suicide is such a terrible, terrible tragedy, and a wake-up call to physicians and institutions of higher education to educate themselves, their trainees, and the general public about the many non-motor, debilitating symptoms which can signal the arrival of young-onset-Parkinson's, especially in adults over 30.  Not doing so is patently and ethically irresponsible and potential dangerous medical practice, as unrecognized organic, treatable depression with identifiable organic origins can lead to suicide.


These earliest symptoms of Parkinson’s -not infrequently-can include insomnia, depression, apathy, anxiety, the loss of a sense of smell, a softening of the voice, a stiffening of facial muscles (often called “a facial mask”), fatigue, and the gradual appearance of slow cognitive changes which can resemble Attention Deficit Disorder.  These new symptoms can feel quite unsettling to those used to
highly effective functioning in their work and home lives, because multi-tasking skills can often begin to go downhill as Parkinson’s takes root in the nervous system. Many people who are quite successful in their careers, (like Robin Willams, I suspect,) can feel mystified by a growing depression or new anxieties that may seem oddly disconnected from an otherwise relatively happy life. In addition, those who have been previously highly competent and organized can begin to find the completion of tasks somewhat difficult, and experience a new and puzzling sense of disorganization. Their intelligence and creativity is still available to them, but they inaccurately interpret these new behaviors as the onset of early Alzheimer’s, and, frightened, keep silent about these changes. Silence and hidden distress about one’s possible mental deterioration can lead to thoughts or acts of suicide.

 Four years into my own PD diagnosis, I was lucky enough to attend a presentation at Beth Israel Hospital in NYC, about cognitive changes being part of a common Parkinson’s package. These
changes can include depression (which can appear as crankiness), and a loss of motivation and apathy. The presenters emphasized that not treating these syndromes can interfere with our ability to keep ourselves otherwise healthy, and with our relationships with those who we live with, along with our other support systems. I recognized some of this to be true in my case, and began treatment with an anti-depressant. Two months later, I was back to my old busy self; parent of a special-needs, pre-teenager; a part-time, private-practice family therapist; a resident-poet in the public schools; a writer; and a political activist. My new treatment also gave me the energy and hopefulness to attend the new, free Parkinson’s dance classes offered by Brooklyn Parkinsons Group at the Mark Morris Dance building. My Parkinson’s still slowed me down, but, depression now lifted, I felt able to take on the world again, and do what I needed to do to live as fully as I could.


 The simple truth is this: young, working, vital folks in their 30’s, 40’s, 50’s and 60’s can develop Parkinson’s; it is not only a disease of the elderly! Furthermore, a shaky hand (tremor), is not present in everyone's PD, but many lesser known motor and cognitive symptoms can be evident, including all of those mentioned above. Thus, for a patient to report the perplexing appearance of any of these aforementioned cognitive and emotional distresses, coupled with a slowed gait, or the softening of her/his voice, or a friend's observation of a limp, or one arm not swinging when one walks, or one hand not typing accurately, anymore, or one arm no longer accurately throwing a ball, can serve as an alarm to recommend a consultation with a Movement Disorder Neurologist in order to diagnose, and hopefully treat, possible Parkinson's Disease.

 Tragically, most physicians, and the general public, incorrectly believe that Parkinson’s is best represented by the stereotype of an old person shuffling along with a shaking hand or arm, and thus many miss the disease’s other earliest, pre-motor manifestations in people as young as those in their thirties. Because physicians are rarely trained to recognize these other indicators, far too many in my Parkinson’s community report numerous lost years of Parkinson’s treatment-including the vital recommendation to begin a consistent exercise regimen to slow down disease progression. Often, I’m told, physicians tell these younger patients reporting an inexplicable growing sense of general anxiety, low-level depression, and fatigue, that their problem is psychological. This is simply unacceptable.



In my opinion, with any patient presenting reports of depression, all clinical physicians need to be trained to do a full physical examination of these patients, whether they be elderly, non-elderly, middle-aged, or in their child-bearing years.  Reports of depression without obvious external sources should require the physician's requesting the patient for a close family’s member’s report of any other recently observed new symptoms. This could reveal a possibly early onset of what many refer to as “Young-Onset Parkinson’s.” As we’ve just learned from Robin Williams’ story, this could make a life or death difference