What We Can Do about Depression

I am one of many who would say that Robin Williams was among my favorite actors.  His portrayal of a psychologist in Good Will Hunting is my all-time favorite. A colleague of mine told me her kids said to her last night, “Mrs. Doubtfire is dead.” They were crushed by this news which seemed so unbelievable based on their experience of the character. He was a figure that transcended generations. It was a very sad day for many, and my heart goes out to his family, who will bear the incredible pain of his death long after the news cycle ends.

I recalled that he had a history of struggles, but I was still shocked to hear that he had died by suicide. He was a genius and had many supports. But of course depression doesn’t calculate those things. Severe depression distorts rational thinking and can lead to the fixed idea that hopelessness and pain are to be your experience forever. I have heard this from patients who have lived after suicide attempts. They told me they had lost all perspective and simply wanted to end their pain. They often reported simply losing a sense that they mattered to other people and forgot that they too were loved.

Depression distorts reality and causes a risk of death. It is a persistent and serious public health crisis that doesn’t get enough coverage. It can happen to anyone and is associated with a great deal of the suicides in our country. When combined with a substance use disorder it becomes even riskier and harder to treat, and when it is part of a bipolar disorder it requires extra attention. Other public health problems like heart disease have seen great results in the past several decades—we cannot say the same about suicide.

What can we do about this public health crisis that takes so many from us?

• Advocate. Fight for better treatments and for research into the underlying causes of psychiatric illnesses.
• Be proactive. Work to be sure that people get screened for this depression and that help happens earlier. National Depression Screening Day is October 9.
• Get medical. Get checked for medical causes of depression like thyroid disease.
• Take the long view. We can encourage people to stay with treatments as some do work even after others have failed. That is well established from the STAR*D study by NIMH.
• Integrate. Co-occurring disorders (like depression and substance use) often are poorly integrated into a persons care plan. This needs to change as substance use can be a failed self medication strategy to treat depression.
• Change the field. We can demand more cognitive behavioral therapy, which clearly helps with depression, but many mental health professionals aren’t trained to provide it.
• Open up. We can change the dialogue about depression—it is a condition that needs to be talked about. Isolation and silence are the dangerous traveling partners of depression.
• Come together. Our voice is more powerful together than alone.
• Love. Like Robin’s character in Good Will Hunting we can reach out and love those we know who are struggling and let them know we are here for them.

Chances are someone you know is struggling with depression, and this is a simple way that can make a difference.

Rest in Peace Robin. We shall all miss you.