"The guy who laughs the loudest is likely the most depressed." That sentence, shared with me by a close friend, is ringing all too true after Robin Williams' tragic suicide. As news has spread, Williams' grief-stricken wife has asked people to focus on his life, not his death. This plea makes sense. Yet looking at his death and its significance is exactly what we should be doing.
Like Williams, millions of people around the world are depressed to the point of considering ending their lives. Men are particularly good at it, completing suicide four to six times as often as women do. These men often don't express depression in ways traditionally used to diagnose the problem. They don't cry or have weight or sleeping problems. Instead, they have what experts are increasingly recognizing as "masked" or "male-type" depression. This framework has been more visible of late, surfacing in recent public health campaigns, academic literature and popular culture.
Of course, it's also not without its challenges. If depression is tough to diagnose, this is even harder. The pain is often invisible and unexpressed. And the person experiencing such pain is often resistant to seeking help -- and will do anything to avoid the perception of weakness or vulnerability.
As a practicing psychologist and a researcher in masculinity and depression, I can tell you that Williams' story is not an isolated one. Approximately 60 men commit suicide daily in the US -- most do not seek help. In masked depression, the person often expresses his or her pain via addictions, anger or irritability. I've frequently seen it come out in the type of personality that Williams apparently had -- the likeable, funny guy who has it all.
Of course, we know Robin Williams had sought help for depression. We also know he had been haunted for years with cycles of addiction to drugs and alcohol. But his death still shocked us.
Because the severity of his depression was also masked. Even when Williams shared news of his addiction struggles, it was often in a joking context. He once said of cocaine, "It's God's way of saying that you're making too much money." Of life as an alcoholic, "You will do @# that even the Devil would go "Dude..." Even when telling stories of his pain, he managed to lighten the mood.
Williams was clearly a special man. As much as people are talking about his talent, more are sharing stories of how caring a person he was. For those who never met him, myself included, he would have been the guy to hang with in Hollywood.
Yet that gigantic talent and lovable character was his persona, what others needed and wanted him to be. He showed us brilliance through his comedy and acting in a wide range of roles.
Who knows who he was when the mask was off. His close family? Perhaps. Given what happened, he was obviously tormented. The pain he suffered, despite endless resources, led him apparently to cut his wrists and then hang himself. No level of money, success or admirers could change that.
All of us need to do a better job of looking out for those who appear the happiest, laugh the most, or like Williams, made others laugh. I can tell you too often, it is these people who have unimaginable struggles or unexpressed sadness.
If you know someone like this, ask the difficult questions. Show you care and offer support. And if you know there is a real risk, drag that person to a competent mental health care provider, even if the person is reluctant, for a thorough evaluation. I always say to my students training to be psychologists, "I'd rather have a mad client then a dead one."
You can make a difference. Be the one to get involved, and remove the mask.
Need help? In the U.S., call 1-800-273-8255 for the National Suicide Prevention Lifeline.