Behind the facade.

Many people were shocked this past week to learn of the death of Comedian/Actor Robin Williams. As tributes poured in from celebrities and fans, it became clear that taboo surrounding the subject of mental illness is, thankfully, lessening.

But it is not gone completely.

There are still many misconceptions and prejudices surrounding mental illness. Perhaps Hollywood is, in part, to blame — all those depictions of “crazy” people over the years may have become the stereotype by which we consider mental illness.

Many people, no doubt very well-meaning, will offer advice to those who are suffering, saying things like “buck up” or “cheer up” or “just hang in.”

Listening to the CBC’s Cross Country Check-up, yesterday, I heard one caller address this sort of advice. She stated that depression — clinical depression — is not simply feeling sad; in most cases it manifests in a lack of feeling. One simply doesn’t care about what’s going on around them.

Let’s look at the definition of depression…

depression (n.) severe despondency and dejection, typically felt over a period of time and accompanied by feelings of hopelessness and inadequacy.

It is not merely feeling sad. That is called “sadness.” 

When a beloved pet dies, when a family member passes away, when a dear friend moves away… those are all occasions when we feel sadness. Typically, however, we stop feeling sad soon enough.

When what we feel is beyond sad, when we feel hopelessness and despair, that is depression.

One peculiar trait of depression, for many, is that it does hide behind a façade, often one built upon humour. 

Some people are just naturally funny, and Robin Williams was surely a natural comedian. But those comedic talents can be — and obviously were — used to mask the depression he felt.

There are many who mistake success for happiness. 

Often, when a celebrity attempts or commits suicide, people wonder aloud why someone who seems to have had it all could throw everything away so readily.

But it’s not about what you have. 

Stuff doesn’t make you happy — or rather, it might make you happy for a short while, but ultimately, depression is not about whether or not you feel happy.

Some people accumulate stuff in an effort to find happiness. In reality, what they find is that they never have quite enough stuff. They are hap for a while, but then the happiness fades, and they need to find and acquire more stuff.

Sometimes this is a symptom of depression — trying to satisfy that empty feeling by chasing that elusive quality of “happiness.”

For others, the lack of feeling caused by depression causes them to seek other ways of feeling. Happiness would be good, but they will settle for what they can get: the brief sense of euphoria from a drug high is common.

As we know, that euphoria does not last, and quite often the low that follows that brief high is lower than the person felt before. A viscous cycle of ever briefer highs followed by ever deeper lows can spiral out of control.

Similarly, some people turn to alcohol to bolster their mood. Unfortunately, alcohol is a central nervous system depressant, so despite the exuberance that comes from its inhibition-lowering qualities, the end result is again a lower low. And a hangover.

I’m not going to make this an academic treatise of clinical depression, discussing the cause and affect and treatment of depression. My intention is simply to bring the matter further out into the light of day, and encourage people to talk about it.

Chances are you know someone who suffer from depression. Perhaps it is you. Studies show that one in three people will suffer from some sort of mental illness.

Many people suffer in silence, hiding their symptoms from friends and family.

Robin Williams made no secret of his depression and his addictions — a product of his depression.

Williams was wealthy enough to seek the best treatments available, and we know that he was seeking counselling for both depression and addiction at the time of his suicide.

And that is probably the most shocking aspect, to many people. How could someone who could afford the best treatment still commit suicide?

I can’t explain it, and I doubt many could, other than to suggest that it is the result of that feeling of hopelessness, of despair, of abject despondency that depression imposes.

When I first heard the news, my initial response was surprise, but it was only a few moments later that I decided it wasn’t that surprising.

Williams made no secret of his depression, and anyone who has seen or even read of his antics on set, or during an interview, is well aware of his manic improvisations. But all too often, the laughter is simply a façade.

The laughter is a way to cope, to cheer oneself up while also giving the gift of laughter to others.

For laughter is a gift.

There are those who cannot find reason to laugh, even for a moment. People whose depression is so deeply rooted, who are so divorced from their feelings, that they cannot respond to humour.

Others seek out laughter, watching comedies and comedians, seeking time with friends and family who make them laugh, with whom they can share a sense of humour.

It’s not a cure, but it certainly helps.

There were comments online that claimed that his suicide was — and indeed, any suicide is — a selfish act. While I understand why people might believe that, I disagree.

Certainly, it seems as though the person who has committed suicide has not considered how friends and loved ones will themselves feel following their passing.

Quite likely, however, the opposite is true. The person contemplating suicide believes that by dying not only will they be free of the demons that are plaguing them, but that their family and friends will also be freed from the demons, from themselves.

For even though many suffer in silence, attempting to put on a brave face, or living behind a façade of normalcy, chances are that their closest friends and family members are aware of the problem.

In fact, it is family and friends who often recognize the problem first, before the person themself is aware of the problem.

Suicide is neither noble nor cowardly. For the person contemplating it, it just seems like their only option.

Sadly, today, teenagers and even some pre-teens are experiencing symptoms of depression and other mental illnesses.

One caller on Cross Country Checkup related a time when she was suffering, and was admitted to hospital. Well-meaning friends suggested that they should take her on a vacation to Mexico, and that would help lift her from her depression.

As she stated, her friends attitude is all too common, that depression is just a deeper form of sadness that can be cured by some fun, care-free time with friends.

André Picard, health reporter and columnist, reminded listeners that mental illness should be considered to be a brain disease. It’s impact is greater than heart disease, and affects not just the person suffering but their family, friends and co-workers, too.

The brain is the least understood organ, and while much progress has been made over the last few decades, we are far from having a complete understanding of how the brain works.

Treatments, including drugs and cognitive behaviour therapy, can be effective, and the vast majority of those seeking treatment do get better. 

It is a scary disease, however, because it is “invisible.” We may see some of the symptoms being manifested, especially in Schizophrenia, but since discussion of mental illness has for so long been very hush-hush, we remain fearful of mental health problems.

I was profoundly affected by the news of Robin Williams suicide. As many callers and posters stated, that someone with his resources, who was actively seeking treatment, could still take that final step… what hope is there for anyone else? For me?

I won’t go into detail about my own depression, other than to say that I am not contemplating suicide. For me, that is not an option.

But there are days when I have no interest in doing much beyond sitting in my chair and contemplating my situation. Other days, I can function quite well through whatever activities I have planned.

For me, there is occasionally a bit of a façade, but for the most part my smile is genuine. When I am with other people, things don’t seem quite so bad.

It is more often when I am alone that I sink a bit lower.

I tell you this not in an attempt to gain your sympathy, but merely to gain your understanding.

And don't get me wrong... contemplating suicide is not the yardstick by which to judge depression.

YES -- if someone is contemplating suicide you must have them seek help immediately.

But just because someone is not suicidal does not mean their depression is a trivial matter.

For many, the stigma surrounding mental health and mental illness is one of the greatest stumbling blocks.

One caller wants to eliminate the label of “mental illness”, saying that it is degrading to have someone offer that label. I understand what she was saying, but I disagree. 

I think that what she refers to as “stigma” is more likely a feeling of shame.

We certainly need to eliminate the stigma, but not by ridding ourselves of a particular — and descriptive — label, but by encouraging acceptance of mental illness as just another disease.

When we hear that someone has cancer, or heart disease, or some other physical ailment, we can talk about this.

When we hear that someone is suffering from a mental illness, there is less discussion; often we are afraid to bring the topic up.

There have been efforts to dispel misconceptions and break down the stigma, including Bell’s Let’s Talk initiative. 

Many workplaces now offer Employee Assistance Programs (EAP) that offer mental health services.

Suicide prevention hotlines, and various helplines and online chat resources are available for adults and young people.

The more openly we talk about mental illness, be it depression in its many forms (ie: manic-depression, postpartum depression), schizophrenia, bi-polar disorders, etc, the more we will reduce the stigma.

With one in three people experiencing some form of mental health issues, it is essential that we do more to bring awareness to all forms of mental health issues, and encouraging those who need it to seek help.

No one deserves to suffer in silence.

But… that’s just my opinion.