Robin Williams' suicide is a tragedy that broke the hearts of his family and friends and an entire nation. But with the stunning revelation that the famous comedian had recently been diagnosed with Parkinson's disease, the actor's death is particularly hard felt in the Parkinson's community.
In the first few days after Williams' widow revealed the comedian's diagnosis, my email inbox began filling up with notes from patients and their concerned family members expressing dismay and fear.
If someone of Williams' stature could be made so despondent by the diagnosis as to commit suicide, how could the average Parkinson's patient possibly be expected to cope?
As one patient wrote me, "Hearing this makes me feel hopeless."
I have been telling my patients at the Hoag Neurosciences Institute that while there is a link between depression and Parkinson's disease, the situation they are reading about in the papers is unique.
I was not Williams' physician, but I believe we're dealing with different demons. The actor had had a well-documented history of depression and addiction and had strongly been associated with bipolar disorder. It is more likely that this history, and not Parkinson's disease, played a part in Williams' tragedy.
Because Parkinson's disease involves the death or impairment of nerve cells in the brain that produce dopamine, a mood stabilizer, people will often suffer from depression or anxiety for years before receiving a diagnosis of Parkinson's.
But the type of depression typically experienced tends to affect a person's motivation, sleep patterns, weight management and energy level. Rarely does it inspire suicidal ideation.
That said, it is still difficult to face a diagnosis, and a good support system of family, friends, physicians, movement specialists, psychologists and psychiatrists is necessary to help a person cope, manage and thrive.
That is why at Hoag Hospital, we approach the disease comprehensively — offering not only top-rated neurologists but also physical, speech and occupational therapists, as well as mental health and social work specialists, to help patients maintain a good quality of life.
There are many misconceptions about the disease. Parkinson's is a disorder of tremors, stiffness, slowness and motor control, but too many people confuse it with Alzheimer's or dementia. Also, contrary to what too many believe, the disease is not life-threatening.
Many of my patients live full and active lives. Thanks to innovations in medicine and physical therapy, some of my patients are so active and mobile you would never guess they have the disease.
One of my patients, in fact, said that thanks to his current medication and treatment plan — which includes better sleep hygiene, physical therapy and attention to mood — his golf swing and score post-diagnosis is actually better than it had been in 20 years.
Another important point to bear in mind is that Williams was an individual, not an emblem of any of the diseases or disorders he may have had. Depression and suicide involve many factors, and no one should assume that a greater risk for suicide exists because he or she shares a trait with the actor.
For most people with Parkinson's disease, life can be just as fulfilling as it can be for anybody else. We're in a revolutionary stage in neurosciences, with a great horizon of therapies ahead of us, including medications that buffer the effects of the disease.
Williams' death is terrible, but it shouldn't spell doom for people with Parkinson's disease. For them, as for the rest of us left grappling with this tragedy, there still exists hope.
Dr. SANDEEP THAKKAR is a movement disorders specialist at the Hoag Neurosciences Institute Parkinson's and Movement Disorders Program.