This week we are remembering Robin Williams. Rightly so; his unique genius had us laughing and crying, sometimes in the same performance. Through the mainstream media, across social media, and in person with friends, family and colleagues, this week we are all sharing the same conversation. How could he take his own life? Unfortunately, we're sharing the wrong conversation. We talk about Robin Williams' depression and his struggles with addiction -- which caused his suicide? Instead, for the sake of the many thousands of people like Robin Williams (and Philip Seymour Hoffman and Heath Ledger), it's time to start talking about addiction and depression as symptoms of one disorder, and one for which there is treatment and hope of recovery.
Substance abuse? Depression? No, it must have been Mr. Williams' recent diagnosis with Parkinson's that caused his suicidal actions! At least that's what the latest news reports suggest. We'd like to think that's true, because it would comfort us. It is easier for us to believe that someone with a disease or disability would find the future too much to handle rather than accept that one more shining light has gone out because he didn't get the right treatment for mental health issues that he needed. Yes, those who are diagnosed with serious diseases do often suffer a period of depression after the diagnosis, but they do not often kill themselves because of it. Depression. Addiction. Those are the psychological disorders that bring on suicide. And we don't give those with those kinds of disorders the appropriate treatment.
Substance abuse and depression are the right and left hands of a heartbreaking condition that often includes both. For example, research suggests that nearly half of people in treatment for alcohol addiction have co-occurring depression; at my treatment center, we find the rate somewhat higher. Of people treated for major depressive disorder, nearly 40 percent will struggle with alcoholism at some point in their lives. Not only do these two challenges tend to happen together, there's strong evidence they may actually create each other. If you treat one without treating the other, the challenge that remains can cause relapse of the other.
This combination is especially dangerous in addicts who have been abstinent for many years and who may also have held their depression in check during that time. For them, it can be as if there's no way out. No way but suicide or overdose.
So why, in light of all this evidence, in light of all this death, do we continue to insist on talking about depression and addiction as if they were two different things? Why do we continue to treat them separately? We are talking about people in pain, and not only must we treat the symptoms of that pain, addiction/depression/suicidal ideation, but we must also treat the root of the pain -- and that's what few treatment programs ever manage to achieve.
It's time for the addiction treatment industry to get hip to mental illness and for the mental illness treatment industry to get hip to addiction treatment. Every addiction treatment center in the nation should be qualified to treat dual-diagnosis clients, and if you aren't qualified to do that, for goodness sake, send the dual-diagnosis client to a facility that can help them. If you are not using evidence-based methods to treat the underlying causes of addiction and depression, you're setting your client up for relapse. Expect overdose or suicide. That's what the research and our experience tells us.
Certainly our conversations this week should remember the genius of Robin Williams. But we should also be talking about how to help prevent yet another tragedy. The way to help is to start seeing addiction as more than the craving for a substance relief. Addicts want what the substance promises. They want to feel better or nothing at all. Those with depression often cannot feel, cannot see their value or experience joy. These are issues that go hand-in-glove. We need to advocate for higher quality, more accessible treatment, concurrent treatment for mental health issues. Even with all his resources, Robin Williams likely did not receive the proper care he needed. Yet it's out there, and we need to make it more widely available. Only that will keep safe the next brilliant man or woman who knocks on a treatment center door, overwhelmed by addiction, depression, and suicidal ideation.
Richard Taite is the founder and CEO of Cliffside Malibu Addiction Treatment Center, and coauthor of the book Ending Addiction for Good.
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Need help? In the U.S., call 1-800-273-8255 for the National Suicide Prevention Lifeline.
Need help with substance abuse or mental health issues? In the U.S., call 800-662-HELP (4357) for the SAMHSA National Helpline.