28 Aug 2014
HEIDI DOUGLASS | firstname.lastname@example.org
Since the devastating death of respected American comedian Robin Williams nearly three weeks ago, the internet has been rife with speculation on the underlying factors behind this tragedy. Respectfully, this conjecture should be left as a matter for his family and physicians, but what the rest of us can do to honour this remarkable personality who warmed the hearts of many generations is strive to increase awareness and understanding of clinical depression and its significant relationship to brain diseases and ageing.
In a recent interview with SBS radio, CHeBA’s Co-Director, Professor Perminder Sachdev said that it is important to recognise that for many men, a reluctance to seek help continues to plague those at risk.
“When we look at the risk factors for suicide, we recognise that psychiatric disorders are often one factor but there are also social or personal factors. We know that middle-aged men are less likely to see a doctor for psychiatric problems or report mental health issues to family and friends and therefore often go undetected. Men are also more likely to succeed in attempted suicide in comparison to women,” said Professor Sachdev.
According to Professor Sachdev, his understanding is that Robin Williams had been diagnosed with major depression and possibly bipolar disorder. People with bipolar disorder have periods of elevated mood but they also have periods of severe depression, sometimes even to a psychotic degree and very often that kind of depression is a prelude to a suicide attempt.
In a statement shortly after his death, publicist Mara Buxbaum said that Robin Williams had “been battling severe depression of late.”
There are also issues in relation to career roles and isolation in society. Middle-aged men are often transitioning from highly successful careers in society or heading into retirement, which increases social isolation and reduces the opportunity or ability to develop connectedness, which in some people increases the risk of depression. Substance abuse is also a possible precursor to or concomitant of depression.
In the book Managing Depression, Growing Older, co-authored by CHeBA’s Co-Director Professor Henry Brodaty, we discover that depression is also no stranger to old age. Older people who are afflicted by pain or with a condition affecting the brain such as stroke, Alzheimer’s or Parkinson’s disease have particularly high rates of ‘clinical depression’.
However, figures released from the Australian Bureau of Statistics this year indicate that men over the age of 85 are more likely to die by suicide than Australians of any other age group, with the main cause widely accepted to be depression.
Professor Brian Draper, from the Academic Department for Old Age Psychiatry at Prince of Wales Hospital, purports that 17% of suicide deaths reported to the World Health Organisation were recorded for the age group 65 years and over, despite it being estimated that only 8.2% of the world population is in this age bracket.1
The American Association of Suicidology reported that males over the age of 65 were at highest risk of suicide with a rate of approximately 29 suicides per 100,000, each year.
“One obviously cannot necessarily attribute Robin Williams’ suicide to being either isolated or having a history of drug or alcohol abuse but it could well be that he was in a period of severe depression, and this was a devastating consequence of that depression. We have also learnt since his death that he was possibly suffering from early Parkinson’s disease, and this could have been a factor in his depression,” Professor Sachdev said.
“Often the psychic pain that one experiences in depression is so severe that the rational mind cannot overrule that strong urge to self harm.”
“In our public campaigns against suicide, we should keep middle aged and older men well in mind,” he said.
We extend our thoughts to the family, friends and admirers of Robin Williams, and wish everyone strength in the days ahead.
1 Draper BM. Suicidal behaviour and suicide prevention in later life. Maturitas (2014)