RIP Robin

With the death of Robin Williams I thought I would share a press release I wrote today about his battle with addiction and depression and how important it is for those who are struggling with mental health issues to get the help they need in order to prevent tragedies such as this one.

Robin Williams’s Apparent Suicide and its Relation to Depression & Addiction

Our hearts go out to one of the great comedians of the era

Aug. 12 – Yesterday, Robin Williams passed away of an apparent suicide. As we remember the many amazing ways in which he enriched media and culture with his comedy and acting, we should also take a look at what drove Robin’s actions to his untimely death.

Robin identified as an alcoholic early in life, all the way back to his days in his hometown. As he gained celebrity status, he also came to battle with cocaine addiction. His drug and alcohol abuse ran rampant until the death of John Belushi – also from drug addiction – in 1982, after which Robin said he remained sober for 20 years. In 2006, Robin entered rehab for drinking, and sought treatment again as recently as June of this year. Questions that come to mind to all of us:

Why did this happen, especially to someone who seems to have had everything? Alcoholism and drug addiction, as well as mood issues such as depression have genetic, physical, and environmental triggers. There is no one single cause. A core precept of alcohol recovery is that alcoholism is a disease; you are always in recovery, never cured.

Did no one see the kind of place Robin was in? He did go into treatment multiple times. This highlights the importance not only of communicating regularly and deeply with our loved ones, but being able to identify signs and symptoms that indicate the need for care. Related to this, it is critical to have a full continuum of care: from 24 / 7 help in inpatient or residential treatment environments for crises and acute situations and aftercare programs that offer ongoing support and maintain recovery.

How did the addiction and depression issues interrelate? There is concept in mental health treatment of “co-occurring disorders”. A person can have depression or anxiety issues from a young age, or develop them later in life as a result of a traumatic event. Some men and women then turn to drug abuse as a coping mechanism. That is why modern treatment focuses on addressing all elements of a person’s mental health, to get at the root of the original issues. Treating only the addiction without the mental health component leads to higher rates of relapse. Robin himself, in a 2009 interview, said he had previously failed to confront the core issues at the root of his addictions, contributing to his own return to rehab.

All mental health and addiction treatment programs offer free, confidential screenings that you should take advantage of if you feel even the slightest need, and will help you find the most appropriate care for yourself or your loved one. Inpatient programs also offer immediate services for those battling with suicidal ideations.

Our hearts go out to Robin’s family. This is a reminder to all of us to remember to communicate with our loved ones regularly, and seek professional care and support when it may be needed.

On a Serious Note: Blood Test for Suicide Risk?

Since it has been a little while since I have done a mental health post, I thought I would bring up a topic that has been receiving some media attention lately. Blood test that will be able to determine an individuals risk for suicide. Yep, you heard me right a Blood Test!

So here’s the deal:

There was a recent study done, which compared brain tissue samples from people who have died by suicide to those who have died from other causes. This test has identified a genetic mutation in the SKA2 gene, found to be common among those who died by suicide. Additionally, a chemical change, called an epigenetic change, was found on the same gene that was more common among people who committed suicide than those who died of other causes. Further research confirmed that these genetic changes correctly identified 80 percent to 96 percent of people who experienced suicidal thoughts or made suicide attempts. If these findings are confirmed, then it could lead to a test specifically designed to look for suicide risk.

The idea here is that with the possible development of this blood test it may be used to screen people in psychiatric emergency rooms or determine how closely an individual need to be monitored for suicide risk.

However, while this new approach sounds promising, it has me wondering if the test is going to add more value in being able to medically identify the risk of suicide versus using traditional mental health evaluations. I could be totally off here, but I have a few concerns.

Is this test really a good idea when dealing with an issue as serious as suicide? What if this test in unable to accurately predict everyone who is having thoughts of suicide? Will it prevent individuals from seeking therapeutic methods that are needed to address the underlying cause for suicidal thoughts and behaviors? Could it cause unnecessary worry and anxiety?

One concern I thought of is that, instead of seeking appropriate mental health interventions, individuals will go for the quickest fix and opt for medication. While medication is effective at reducing symptoms of mental health disorders that can lead to the development of suicidal ideation and behaviors, it does not fix the problem in the long run. Without taking the time to get at the underlying cause for why an individual has begun having suicidal thoughts, or has made suicide attempts, then an individual is not going to fully recover. This can lead to the return of suicidal thoughts further down the road.

Another concern that came to mind is whether or not the test can accurately predict the chance that an individual is going to be at an increased risk for suicide. To my knowledge this current study does not take into consideration if those individuals who died by suicide were born with this genetic mutation or if it developed as the result of something that happened in their life, such as exposure to trauma or substance use. This is an important factor because it would determine if this test only needs to be given once or if it needs to be periodically administered throughout a person’s life.

Finally, having the option to take this test can cause high amounts of stress in individuals who would otherwise have no reason to believe that the risk even exists. Additionally, testing positive for an increased risk of suicide does not mean that a suicide attempt is inevitable.

Like I said before I could be wrong, but it’s something to think about. Anyone else have any concerns or even positive things to say about this potential blood test?