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Thursday, September 4, 2014

From Tragedy and Despair, Maybe Some Enlightenment Emerges?

Now there's some sad things known to man
But ain't too much sadder than
the tears of a clown
When there's no one around

~Smokey Robinson

Robin Williams, a very respected and talented actor/comedian, recently committed suicide after a long battle with cocaine, alcohol, and depression.  When I heard that he had hanged himself, I was in such shock and felt terrible for the man who has made me laugh so many times throughout my life.  All I can say is there are but a handful of comedians who were so good at the brutal gladiator pit of stand up comedy as well as dramatic movie roles as well.  The world has suffered a tremendous loss.  A shining star that comes but once every few lifetimes in our world is now gone forever.  How could this have happened to, what on the surface, appeared like such a happy and successful man? For God’s sake, the man was absolutely hilarious, why would such a funny and brilliant person ever feel they had no other options left in this world, but to die at their own hands?
It turns out that, unfortunately, depression and other mental illnesses are extremely prevalent in our society, with over 22% of Americans over the age of 18 suffering from some type of mental disorder according to depressionperception.com.  This is equal to over 46 million individuals.  This same source also indicates that 90% of suicide victims in the United States suffer from a mental disorder that is diagnosable, demonstrating how the two can be related.  Impulse control disorders are predominant as well, affecting over 24% of the population according to psychiatrictimes.com.  It also reports that many impulse control disorders can be more common among men than women. 
Robin Williams specifically suffered from depression, as do many other suicide victims says the Washington Post.  His battle against alcohol and cocaine were also ongoing throughout his life.  This source also outlines Williams’ entrances to rehab including a stay about two months ago, and another reported back in 2006.  He entered rehab in 2006 after a relapse in his alcohol addiction after being sober for twenty years.  The article goes on to explain how depression was a long fought battle for Williams’ as it is for many. 
Depression is not always a disorder that can be treated and expected to simply go away.  Many people who suffer from depression, although they seek help, continue to endure it their entire lives. It is something akin to being an alcoholic, once you are an alcoholic, you are for the rest of your life because any certain trigger, crisis, or pressure point can cause a sober person to go right back to alcohol no matter how many years of sobriety they have managed to live.  It also explains how suicides are normally extremely impulsive acts that are prompted by depression and other mental disorders. 
An article from aol.com discusses another recent battle with alcoholism and mental disorder.  Elizabeth Vargas, (an ABC News Reporter) recently checked herself into rehab due to her ongoing battle with the disease of alcoholism.  Vargas claims that the reason she has continuously turned to alcohol is due to panic attacks and anxiety that she has suffered from since childhood.  Cases like these, are way too familiar and the number of people who self-medicate is extreme because the treatments that we have readily available to people such as Vargas, for some reason, just don’t seem to be working in the long run. 
According to Communities Digital News, depression is so common among comedians that the Hollywood Laugh Factory has an office where therapists are available for the comedians that perform. Isn’t it ironic that the highly intelligent and hilarious people who make us laugh the hardest, often suffer the worst cases of depression?  The source also reports that the eccentric behavior of individuals such as Robin Williams and other comedians often stems from bipolar disorder (an illness with which Williams had also been diagnosed).  Many other famous people have suffered from mental illness, depression being the most common, such as Winston Churchill, Billy Joel, Owen Wilson, Catherine Zeta Jones, and Princess Diana.  
A troubling part of this is that there is such a negative stigma associated with bipolar disorder, anxiety disorders, depression, and other mental illness. This causes people to try and ignore the seriousness of these illnesses and the importance of seeking treatment for what can become a deadly illness.  
ABC News describes the close tie between depression and substance abuse.  The two ailments occur at a tremendously high rate in combination with each other.  Depression can lead to substance abuse, with individuals trying to find ways to cope when treatment is either ineffective or not readily available.  Substance abuse can also lead to depression, creating a very closely and many times deadly relationship between the two. 
Williams had access to treatment and the means to attend rehab for this terrible disorder which sadly still was not enough, but many do not share the same ability to treatment and have nowhere to turn.  Mentalillnesspolicy.org states that 250,000 of the reported 744,000 homeless individuals suffer from some type of untreated psychiatric illness, and this number only continues to escalate.  So the next time you are in a bad mood and you think a homeless person should just “get a job,” keep in mind that most people in the right frame of mind would probably rather not live on the street and beg for their meals.  The homeless person’s mental and physical health is generally far worse than those with homes.  Many of those who become homeless battle some type of mental disorder and have no means to treatment.  The lack of treatment, in turn makes it harder for them to function and carry out every day lives.
More and more people are being diagnosed with disorders, many of which are heavily medicated, which in some cases cause extreme side effects.  Many children and adolescents suffer from ADD and ADHD specifically and there has been a rise in the number of children and adolescents being diagnosed recently.  Additudemag.com reports that 1 to 3 children in every classroom of 30 students suffer from ADHD/ADD.  This source reports a laundry list of consequences that these children suffer including but not limited to defiance, serious learning problems, comprehension problems, language deficits, poor memory, and a higher rate of school drop out.  So what is being done to help these children?
Many children are treated with medications according to psychcentral.com, but medications alone may never be successful.  Commonly used medications include Ritalin, Concerta, Metadate, Dexedrin, and Adderall.  These medications have a long list of side effects including reduced appetite, irritability, depression, anxiety, and sometimes side effects can be as serious as psychosis.  So the real question is, do the so-called benefits of these medications outweigh the side effects that many of these children encounter and the unknown long-term effects of medications that affect the development of children? This source also reports that there are many other ways to help deal with ADD/ADHD including behavior therapy, adequate attention, and more healthy living and diets.
Mental illness affects us in other ways. For instance, our prison system is one of the largest housing units for individuals with mental disorders.  An article from hrw.org points out that over the past six years, the number of inmates with mental disorders has quadrupled.  Over 50% of all inmates report mental health problems.  This number does not include those who go without reporting it.  One of the main complaints is severe depression.  This correlates to a number of 1.25 million inmates battling these disorders.  This rate is five times higher than the rate of mental health disorders present in the general population outside of the prison system.  Surprisingly, this number is even higher for incarcerated women, with almost two-thirds experiencing mental health issues. 
The even more troubling fact pointed out by hrw.org is that prisons are not operationally equipped to deal with mental illnesses, nor do most who are incarcerated receive much concern or compassion for the mental disorders that may have been the major reason they are locked up in the first place.  The thought that pops into my head is although these people are incarcerated inmates; does untreated mental illness have something to do with what landed them in prison in the first place?  Is our society in general not able to handle mental issues and problems, such as depression and impulse control, which can in turn increase the amount of people in prison, or who become homeless?  If these people had been given adequate treatment could their lives have turned out differently? All hard questions, but my general feeling is, yes, if mental illness was diagnosed and treated as early as possible---we would have less people incarcerated or living on the streets.  In my mind, it is analogous to the morbid obesity problems we are currently experiencing in the United States. If we educated and treated children and adults much more aggressively in an attempt to lessen the rates of obese individuals, we would obviously have fewer people dying of heart attacks, diabetes, strokes, and other weight-related illnesses.
It is not only the prison inmates and homeless that we should be concerned about. NBC News reports that 1 in 8 soldiers returning from deployment are diagnosed with PTSD.  This number does not include other mental illnesses that may affect them upon arrival to the United States again. NBC News also says that less than half of these diagnosed soldiers seek treatment for the disorder due to negative stigmas surrounding PTSD and out of fear of possibly hurting their careers.  There have been many violent events in recent years linked to soldiers returning from overseas.  An article from worldissues360.com reports that combat soldiers are more likely to engage in violent crimes than non-combat soldiers and civilians.  Many undergo extreme turmoil due to the emotional and physical toll combat has on them.  
The Washington Post identifies that the largest barrier to mental health care is the cost.  As of right now, the United States spends approximately 113 billion dollars on mental health treatment every year, and even with this amount of money being spent, 45% of those with mental health disorders report that the reason they do not have access to mental health treatment is due to its price.  Even though mental health problems are increasing, the budget to deal with the issue is decreasing.  
Due to our country’s recent economic recession, states have opted to reduce the mental health budget by 1.8 billion dollars.  Many people with mental disorders receive disability, versus early treatment which could possibly make them more functional and productive in our society, which is also a huge burden on the system. 
As usual, our government does not recognize the long term picture that mental illness related issues are going to end up costing us a lot more in terms of loss of life and economics because we are ignoring the causes and failing to emphasize early treatment. We seem to have no problems building prisons to put away all of the “defective” people, but do not have a care in the world how the “defective” people got that way.  It’s like that old joke that a famous comedian used to tell.  He would tell a newlywed to turn to his wife and ask him, “is your wife a great lover?” The excited and happy newlywed says, “Why yes, she is a great and passionate lover!!” Then, the comedian would ask the funny and difficult question to answer, “Do you have any idea how she got that way?” The point obviously being, things don’t just “happen,” something leads to them being that way over a period of time.
Employers also suffer a financial toll due to employees who have mental illnesses.  The Americans with Disabilities Act was passed in 1990.  The law was meant to give those with disabilities (which include mental illnesses) the right to disclose their disorders and receive necessary accommodations.  Psychcentral.com outlines the significance of this law, and how many employers do not correctly follow the law in order to avoid the strain of hiring individuals with disabilities.  If an employee discloses this information to the employer, the employer is obligated to provide necessary accommodations, which can include specific work hours and quieter workspaces, which may become burdensome and expensive to employers who therefore attempt to avoid hiring people that may require them.
 When is the last time you looked for a job? If you do suffer from any mental issues (or any physical condition that could potentially affect a job prospect), even extremely mild ones, did you even think of mentioning that you take, or have taken, medication or have received counseling for any type of mental disorder? Of course not, the first thing you think about is, “I need this job and I have to take care of my family,” “I cannot be disclosing issues regarding my mental stability, even if I am totally fine, if I ever hope to land a job and keep my problems out of my personnel file.”
As referenced above, a major reason people choose not to seek treatment is because of the stigma associated with mental disorders.  The Washington Post reveals that 66% of people had made the decision not receive treatment because they felt it would be easier to solve the problem on their own.  Mayoclinic.org reflects on the how strong the stigma towards mental illness is and how it inhibits many from seeking treatment.  Many family members do not understand the issue, and even some parents are reluctant to seek treatment for their children because of what others may think or say. They simply do not want their child’s “record” to indicate that they are anything less than so-called perfect.  Apt.rcpsych.org reports that in a study of 156 parents and spouses who had a first hand family member with mental illness, half tried to conceal or deny the illness when asked about it. 
Autism and Asperger syndrome are other illnesses that are on the rise and can be extremely detrimental to children.  Psychologytoday.com explains how the rise of autism diagnoses is unknown, even though the number has increased dramatically.  In 1996, a study showed that 4 or 5 cases of autism were present in every population of 10,000.  A more recent study has shown that this fractional amount has increased to about 100 cases per a population of 10,000.  One explanation for this is that the term for autism has been broadened dramatically over the past few decades, including more instances and individuals.  It is also more commonly noticed and therefore diagnosed. 
Asperger syndrome according to ghr.nlm.nih.gov, is part of the autism spectrum, and is defined as a group of conditions that mainly affect communication and social interaction.  This same source also reveals that the estimates for how many people are affected by this syndrome vary drastically.  Estimates range from 1 in every 250 to 1 in every 5,000 children. 
Children who are diagnosed with Autism or Asperger’s go on to experience side effects later on in life as adults.  Autismspeaks.org explains how those diagnosed with Asperger’s specifically can face limited or inappropriate social interactions, repetitive speech, the inability to understand the social issues or needs or others, and many other so-called awkward moments throughout their lives. 
There are many organizations set up that allow people to donate money and time to help fight autism.  There is no cure, but ninds.nih.org explains that with continued research into the illness, a cure is hopeful.  There are treatment plans in place that include educational and behavioral interventions, medications, and other types of therapy.  Research continues to progress regarding the issue, in the hopes of finding a cure and better medical treatments. 
The Kelty Mental Health Resource Center, reveals that there seems to be a very distinctive connection between autism and other mental disorders.  The precise numbers regarding the connection vary, but it has become more apparent in recent years.  Most studies suggest that between about 50 and 75 percent of all children diagnosed with autism suffer from some other mental disorders as well.  One main mental health problem that goes hand in hand normally with autism is anxiety.  One study reports that up to 84% of people living with autism suffer from anxiety related difficulties as well. 
            As you can see, the mental issues suffered by different segments of our society affect all of us dramatically and in ways that we probably have never even thought about. The failure to recognize and admit that problems exist—and refusal to treat mental disorders—only serves to compound mental issues that are not going to solve themselves. As we saw with Robin Williams, serious mental disorders require a lifetime of work, and even then, tragedies still occur because no treatment is perfect and the frailty of the human mind can succumb to intense emotions and feelings based on mood and impulse that can lead to loss of liberty in the case of prison inmates, homes and family in the case of the homeless, extreme mental trauma for combat veterans, and the loss of life for those who simply see no relief on the horizon and ultimately give up hope.
            My sincere request to all of those who personally have experienced mental issues or have friends and loved ones who are going through an extreme rough patch, I urge you to do the best that you can to provide support and do not pretend that that mental illness does not exist, or is something to be embarrassed about.  Time and advances in medicine and treatment have shown us that all is not lost when a person hits a low point in their life, or has biological imbalances that affect their ability to function.  We should always be ready to lend our support in a time of need rather than avoid, judge, or ignore serious problems that do not go away by themselves.
            God bless Robin Williams and his family. I wish someone would have been there when he really needed them and I am sorry that sometimes the very best that humanity has to offer is senselessly taken away from us too early. But from all of this tragedy, the open discussion and dialog that has resulted from Mr. Williams’ death is still something positive that this great comedian has left us as yet another part of his enduring legacy.

            ~Leonardo G. Renaud