Robin Williams’ Suicide: a case study by Tariq Rehman

Robin Williams’ Suicide: a case study by Tariq Rehman, an Educationist & Psychotherapist affiliated with Child Surgical Foundation.

INTRODUCTION:

The world-renowned comedian and four-time Oscar-nominated actor Robin Williams died on August 11, 2014. From the outset, the news indicated that his death was believed to be a suicide and this was later confirmed to be true by the autopsy reports.

Case description:

Robin Williams was suffering from relationship problems, financial problems, drug addiction, and major depression. All of these factors led to his suicide.

Comments:

The chances of committing suicide drastically increase in the presence of any of the key risk factors. Unfortunately, the actor Robin Williams was dealing with four of the major risk factors altogether, which put him at a high risk of committing suicide and eventually led to his tragic death.

Events leading to suicide

It is reported that Williams became addicted to cocaine during the late 1970s and early 1980s.^15,16 He quit cocaine after a friend’s demise. However, this event led Robin Williams to major depression, which is thought to be a leading cause of his death. In 2003, he was admitted to a substance-abuse rehabilitation center in Newberg, Oregon, to deal with his alcohol addiction.¹⁶  in March 2009, he was hospitalized because of heart problems and had aortic valve replacement surgery.^17,18

Furthermore, fighting two divorces with two of his ex-wives not only proved to be emotionally and psychologically stressful but was also an immense financial burden for the superstar. Divorce settlements cost him more or less tens of millions of dollars according to one estimate. This led to financial problems, which itself is a contributing risk factor leading to depression and suicide. He had to sell his 29.9 million dollar 640-acre ranch in Napa, California, which he had owned for more than ten years. Furthermore, another trigger for his depression was when CBS announced that his series, “The Crazy Ones,” would not get a second season. Robin’s close friends claimed that this news was emotionally draining for Williams. This happened a little after his famous heart surgery, further aggravating his symptoms of depression.²⁰

The suicide

Williams committed suicide on Monday, August 11, 2014, at his home in Tiburon, Paradise Cay, California.²¹

According to the actor’s wife, his pre-suicide activities included placing some wristwatches in a sock and dropping them off to keep them safe,²⁷ which could be considered bizarre behavior. At 7:09 p.m. on the night before his demise, he called his wife to tell her that he was buying magazines for her at a bookstore. He returned home fine and handed the magazines to her. He then spent some time searching through their closet, grabbed his iPad, and left the room at 10:30 p.m., which is when his wife saw him last. She left the house the next morning assuming he was still sleeping. At around 11:45 a.m., William’s assistant became worried due to his lack of response to text messages and phone calls and later found him hanging by a nylon belt in a closet door frame wearing a long black T-shirt and belted black jeans slightly suspended in a seated position, with superficial cut marks on the inside of his left wrist; with rigor mortis evidently visible.

The actual cause

The final autopsy report, released in November 2014, affirmed that Williams had committed suicide as initially described; neither alcohol nor illegal drugs were involved, while any prescription drugs present in Williams’ body were at “therapeutic” levels. The report also included that Williams had been suffering from a recent increase in paranoia.²⁵

An examination of his brain tissue found Lewy bodies indicating “diffuse Lewy body dementia” which manifests with Parkinsonism symptoms.³⁰ Williams’ doctors believe that Lewy body dementia “was the critical factor” that led to his suicide.³¹

Williams’ wife Susan stated that in the period before his death, he was sober, but that he had been diagnosed with early-stage Parkinson’s disease, which was something he was “not yet ready to share publicly.”^32,33

The above case description clearly shows that the actor was indeed suffering from major depression, substance abuse including alcohol addiction, relationship troubles, financial problems, and newly-diagnosed Lewy body dementia. All of these problems, except Lewy body dementia, have been described as risk factors for suicide. A significant psychiatric problem such as severe depression is often found in people who die by suicide or attempt suicide. In addition to depression, alcohol abuse is also considered one of the most common disorders associated with suicidal behavior.

Certain other factors such as religiosity, spirituality, or faith, have been found to be useful in helping people with suicidal ideation.⁴⁵ People who take religious support to deal with their stress usually find a way to bring their lives back on track rather than choosing suicide as a solution.

Furthermore, personal well-being and positive coping strategies help reduce the chance of committing suicide.⁴⁶

Conclusion

Depression affects about 16 million people in the United States, according to the National Institutes of Mental Health, and more than 350 million globally, according to the World Health Organization, and it is a result of interacting social, biological, and environmental factors. It can be a risk factor for suicide.⁴⁷ Alcoholism and drug abuse are also prevalent in society and are among the first few leading causes of suicide.^48,49 Moreover, financial and relationship problems are also considered risk factors for depression and suicide.^50,51 Unfortunately, all of these risk factors or contributors to suicidal behavior were present in the legendary actor Robin Williams’ life.

A careful examination of the life of the apparently pleasant, funny, and happy Robin Williams indicates that he was indeed suffering from major depression, alcoholism, drug abuse, financial problems, serious relationship issues leading to multiple divorces, and Lewy body dementia, all of which are considered risk factors leading to attempted and successful suicide. In this case, a combination of all these factors, or the comorbid condition of such severity, even though not apparent to the world, ultimately led to his suicide. His symptoms, as described, also point toward a possibility of acute psychosis, although this diagnosis remained unconfirmed.

It is therefore recommended that patients, physicians, and psychiatrists should not take these risk factors lightly, but should take appropriate measures as soon as the symptoms of depression or alcoholism are observed in a patient because these kinds of medical problems can be life-threatening, as is evident from the case of the actor Robin Williams.

References

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Lipton J, Williams R. Inside the actor’s studio. Season 7. Episode 710. Bravo. 2001 Jun 10.

• ¹⁶

Aitkenhead D. Robin Williams: ‘I was shameful, did stuff that caused disgust – that’s hard to recover from’ [Internet]. The Guardian. 2010 Sep 20 [cited 2014 Aug 12]. theguardian.com/film/2010/sep/20/robin-williams-worlds-greatest-dad-alcohol-drugs
» theguardian.com/film/2010/sep/20/robin-williams-worlds-greatest-dad-alcohol-drugs

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» latimes.com/entertainment/movies/la-et-mn-robin-williams-last-days-20140813-story.html

• ²¹

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» news.sky.com/story/1317742/san-francisco-neighbours-mourn-robin-Williams

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» cnn.com/2014/11/07/showbiz/robin-williams-autopsy/

• ³⁰

Dillon N. Robin Williams coroner’s report finds no illegal drugs or alcohol in system [Internet]. Daily News. 2014 Nov 07. nydailynews.com/entertainment/gossip/robin-williams-coroner-report-no-drugs-alcohol-system-article-1.2003220
» nydailynews.com/entertainment/gossip/robin-williams-coroner-report-no-drugs-alcohol-system-article-1.2003220

• ³¹

Robin Williams dementia hallucinations triggered suicide [Internet]. TMZ. 2014 Nov 11. tmz.com/2014/11/11/robin-williams-dementia-lewy-body-parkinsons-suicide-death/
» tmz.com/2014/11/11/robin-williams-dementia-lewy-body-parkinsons-suicide-death

• ³²

Robin Williams had Parkinson’s when he died [Internet]. BBC News. 2014 Aug 14. bbc.com/news/world-us-canada-28796277
» bbc.com/news/world-us-canada-28796277

• ³³

Ryder T. Wife: Robin Williams had Parkinson’s disease, but his sobriety was intact before death [Internet]. Yahoo! 2014 Aug 15. cafemom.com/group/115189/forums/read/20191046/Wife_Robin_Williams_Had_Parkinsons_Disease_His_Sobriety_Intact_Before_Death_ETA_Michael_J_Fox_commen
» cafemom.com/group/115189/forums/read/20191046/Wife_Robin_Williams_Had_Parkinsons_Disease_His_Sobriety_Intact_Before_Death_ETA_Michael_J_Fox_commen

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Van Praag H. The role of religion in suicide prevention. In: Wasserman D, Wasserman C, editors. Oxford textbook of suicidology and suicide prevention: a global perspective. Oxford: Oxford University; 2009. p. 7-12.

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• ⁴⁹

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• ⁵⁰

Yip PS, Yousuf S, Chan CH, Yung T, Wu KC. The roles of culture and gender in the relationship between divorce and suicide risk: a meta-analysis. Soc Sci Med. 2015;128:87-94.

• ⁵¹

Inoue K, Fukunaga T, Okazaki Y. Study of an economic issue as a possible indicator of suicide risk: a discussion of stock prices and suicide. J Forensic Sci. 2012;57:783-5.