August 11, 2014 was, to some, the day the laughter died. The top story of every media outlet in the country, maybe the world, revolved around the shocking death of comedian and actor, Robin Williams. Even worse was learning the cause was suicide. It went against every rational thought that someone beloved by millions, someone capable of provoking laughter out of even the most dourly of souls, would find death preferable to life, until, that is, the fact emerged that he had been diagnosed with Parkinson’s Disease.
That seemed to take the sting out of his death because of preconceived ideas of what Parkinson’s can do to a body. But, did Robin Williams really take his life because he had Parkinson’s disease? Not necessarily. He had pre-existing depression, according to Dr. Jeff Bronstein, a professor of neurology at the University of California, LA, that, coupled with the diagnosis of Parkinson’s created in his mind, “the perfect storm”.
Depression and Parkinson’s Disease
Parkinson’s itself can cause depression, even in someone who has never suffered from it before. The statics vary, but it is thought that depression affects approximately 40% possibly as high as 60% of Parkinson’s sufferers. It is a clinical fact that anxiety and depression are symptoms of the disease. Research suggests that the disease itself causes chemical changes in the brain that may lead to depression.
So, does that mean that Parkinson’s sufferers are doomed to a life of darkness and gloom on top of having a debilitating disease? Not at all. Dr. Bronstein suggests that the perception of Parkinson’s by the general public is worse than the disease itself. According to him, the majority of people who have been diagnosed with Parkinson’s are doing well, so well that no one would know they are affected. But the small fraction of those who are not doing well are the ones who get the attention, and people identify them with the disease.
Which Comes First?
Very often depression is one of the first symptoms of Parkinson’s Disease. US News and World Report/Health indicates depression may predate a diagnosis of Parkinson’s by 5 to 10 years. Since the sufferer may not even realize anything is wrong, it may be up to family, friends and care givers to be alert to changes in behavior. Such changes include a lack of enjoyment for activities that used to bring joy. When did Dad give up his weekly golf game? Why doesn’t Grandma go to her club meetings anymore? Other warning signs include change of appetite, difficulty with concentration, inability to sleep or sleeping excessively, to name a few. An early diagnosis can be helpful in the long run as certain things that are vital in the overall treatment of Parkinson’s, like being socially active and exercising can be lost if depression is not controlled. According to the NIMH (National Institute of Mental Health) some of the common treatments for the depression associated with Parkinson’s are:
- Cognitive behavioral therapy, a psychotherapy or talk therapy designed to change people’s negative thinking and behavior
- SSRI (selective serotonin reuptake inhibitor) type of antidepressant, commonly known as Prozac and Zoloft
- SNRI (serotonin and norepinephrine reuptake inhibitor) type of antidepressant medication similar to SSRI commonly known as Effexor and Cymbalta.
So, while it is too late to save Robin Williams, his death has brought depression and Parkinson’s Disease into the spotlight. More people are aware of the effects, the drugs and treatments to help sufferers. The internet is chock-full of websites devoted to helping Parkinson’s sufferers and their care-takers deal with and treat depression that can accompany a debilitating but not necessarily deadly disease. And as more information is put out there the chances are better that it may save someone else – and that cannot be a bad thing.