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WILLIAM’S CONDITION PRIOR TO HIS SUICIDE

1. Starting in October 2013, Robin began to experience a series of physical ailments, varying in their severity and seemingly unconnected to one another. He had stomach cramps, indigestion, and constipation. He had trouble seeing; he had trouble urinating; he had trouble sleeping. The tremors in his left arm had returned, accompanied by the symptoms of cogwheel rigidity, where the limb would inexplicably stop itself at certain fixed points in its range of motion. His voice had diminished, his posture was stooped, and at times he simply seemed to freeze where he stood.

2. A few months before he died, he has been diagnosed by Parkinson's disease.

3. A few months before his death in 2014, he was admitted to the Hazelden Foundation Addiction Treatment Center in Lindstrom, Minnesota, for alcohol-related problems.

4.In the month before his death, Robin Williams was besieged by paranoia and so confused he couldn’t remember his line while filming a movie, as his brain was ambushed by Lewy body dementia.

5. Robin’s weight loss was severe and his motor impairments were growing harder to disguise.

6. How Mr Williams would have been diagnosed regarding his depression is DSM-IV Criteria for Major Depressive Disorder (MDD)

• Depressed mood or a loss of interest or pleasure in daily activities for more than two weeks.
• Mood represents a change from the person's baseline.
• Impaired function: social, occupational, educational.
• Specific symptoms, at least 5 of these 9, present nearly every day:

1. Depressed mood or irritable most of the day,nearly every day,as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful).

2. Decreased interest or pleasure in most activities,most of eachday

3. Significant weight change(5%)or change in appetite

4. Change in sleep:Insomnia or hypersomnia

5. Change in activity:Psychomotor agitation or retardation

6. Fatigue or loss of energy

7. Guilt/worthlessness:Feelingsof worthlessness or excessive or inappropriate guilt

8. Concentration:diminished ability to think or concentrate,or more indecisiveness

9. Suicidality:Thoughts of death or suicide,or has suicide plan

References:
https://www.scielo.br/scielo.php?script=sci_arttext&pid=S2237-60892016000300178

https://www.scientificamerican.com/article/how-lewy-body-dementia-gripped-robin-williams1/#:~:text=In%20the%20months%20before%20his,case%20of%20Lewy%20body%20dementia.

https://www.vanityfair.com/hollywood/2018/05/robin-williams-death-biography-dave-itzkoff-excerpt

https://emedicine.medscape.com/article/286759-clinical#b4

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Robin Williams’ widow: ‘It was not depression’ that killed him

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Susan Williams gives first interview since her husband’s death last year and reveals the actor had a debilitating brain disease called Lewy body dementia

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FACTORS THAT CAUSES MR WILLIAM TO HIS SUICIDE

1. Depression - Robin William addicted to cocaine for about 10 years and he quit after one of his friends died and led him to have major depression (Tohid, 2016).

2. Substance abuse and Alcohol -  He admits it in public about his drink habits in his several interviews  (Tohid, 2016).

3. Relationship troubles - Willian has been divorced twice as his first wife does mentioned that he loves women (Green,2018).

4. Financial problems - The divorce process make William had to sell his 29.9 million dollars 640-acre ranch in Napa, California which he has owned for more than 10 years (Tohid, 2016).

5. Lewy Body Dementia - An examination of his brain tissue found Lewy bodies which indicate  diffuse Lewy body dementia which manifests with Parkinson's symptoms (Dillon, 2014).

References:
https://www.thesun.co.uk/tvandshowbiz/6884766/robin-williams-first-wife-valerie-velardi-opens-up-about-the-actors-infidelity-before-he-left-her-for-the-couples-nanny/

https://www.nydailynews.com/entertainment/gossip/robin-williams-coroner-report-no-drugs-alcohol-system-article-1.2003220

https://www.scielo.br/scielo.php?pid=S2237-60892016000300178&script=sci_arttext

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Even though he undergo therapies, rehabilitation and medical intervention,  he still commit suicide. These may be the reason:

a)  Comorbid condition
other than depression,  he also diagnosed with few other disease and disorders such as anxiety, substance-abuse, heart problem and also Parkinson.
- It show comorbid condition which increase the risk of suicide.
-Comorbidity is the presence of more than one disorder in the same person
- Physical disease also lead to stress and plus his mental disorders might be the cause of why he suicide.
-In clinical samples of patients who had attempted suicide, as many as 84% had comorbid psychopathologies (Rahel, Pavi & Paul, 2016)

b) Difference in coping and resilience
- all the help he got from specialist does not guaranteed he will be completely free from mental disorder. He also fill his pill box the day before suicide but it remain intact which also means medication compliance.
-Different people react differently depending on various factors such as environment, situation, personality and also interaction between these factors.

c) Social  support/ connection
- He faced household dysfunction in which in his case is divorces.
-Even though he has everything (money,popularity, fans) it does not mean he is socially and emotionally sufficient.
-The conflict he face with anyone (ex wives) may give huge impact for him (emotionally and psychologically)

d) Response to any event
- something really trigger what already at the edge.
- Maybe for his case, the recent news that he was diagnosed with Parkinson disease trigger him to suicide.
-the feelings of fear and loss maybe too overwhelming for him to cope

e) Medication increase/worsen the risk of depression
- example: Statins, Accutane, Beta-blockers
- Some medication used to treat mental disorders and sleep disorders can worsen the cause of depression to some people

SOURCES
https://www.verywellmind.com/why-are-some-people-more-prone-to-depression-1067622#citation-44

file:///C:/Users/Anisah/Downloads/Gunther_Stress.pdf

https://www.psychiatrictimes.com/view/comorbid-clinical-and-personality-disorders-risk-suicide

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Discuss possible intervention or ways which could be done to prevent his death.

1. Make psychotherapy appointment with therapist. One of the common treatment methods which is Cognitive Behavioural Therapy (CBT). CBT is a form of talk therapy that can help him to handle stressful life events, manage their suicidal thoughts and encourage him to have more positive thinking in themselves. Another similar treatment is Dilaectical Behavioral Therapy (DBT) can also be used.

2.      Take medications that have been prescribed by doctors such as antidepressants to ease symptoms of depression and lower the risk of suicide. For instance, lithium which can help in reducing suicidal thoughts. Even though there is controversial in using of medication in adolescent but is proven that medication can help in decrease suicidal thoughts in adults (Hooley, Butcher, Nock & Mineka, 2017).

3.      Seek help from family members and friends. Whenever suicidal thoughts come to mind search for accompany and do not be alone. By having someone his side can avert his attention from keep on thinking of having suicide.

4.      Attending religious events which could help him in find another way to bring his back on track rather than choosing suicide as a solution. People who take religious support can reduced suicidal thoughts as their time will be occupied with benefits things rather than being alone.

References:
Hooley, J. M., Butcher, J. N., Nock, M., & Mineka, S. (2017). Abnormal psychology

https://www.healthline.com/health/suicide-and-suicidal-behavior#suicidal-signs

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Personally, what are your views on the circumstances of Mr Williams' death?

According to Tohid (2016), it was reported that since the late 1970s, Robin Williams had a history of using cocaine, to which he later became addicted to. Throughout his career Williams’ had opened up to the public about having depression and anxiety. Many had believed that the cause of his suicide is due to his depression, which is often linked to his usage of cocaine. After quitting cocaine, he then moved on to being addicted to alcohol. However, he managed to seek professional help and got admitted into rehab.

It was reported that his health became to take a serious turn, from his alcohol addiction in 2003, to being hospitalized and having surgery for an aortic valve replacement as a result of heart problems.

In 2014, the year that he passed away, Williams’ was dealing with a lot of issues in him personal life. He relapsed in his alcohol addicted and was then admitted to rehab. Along side this, the emotional stress from trying to resolve his 2 divorces from his ex-partners were also taking a toll on him. During the divorce, millions were spent on the settlement (more than 10 million to be exact). He was starting to face a financial slump, forced to sell his estates and the second season of his tv series “The Crazy Ones” was cancelled.

In hindsight, he was dealing with stressful divorce separations, which ended on emotionally draining terms. He was facing a financial plunge from having to spend tens of millions in the settlement, forced to sell things which meant a lot to him, and one of his sourced of income had been cancelled. He was then diagnosed with Parkinson’s-like symptom, which had been report to have been the catalyze of his anxiety, restlessness, sleep-taking, paranoia, hallucinations, and finally he was diagnosed with Lewy body dementia. All of this happened shortly after his recent heart surgery.

In my personal opinion, it seemed as if Williams was in a tight spot where everything didn’t seemed right in the world. He already had depression and anxiety, when you mix them with other mood disorders and comorbidities  it seemed to have deeply effected his suicidal tendencies. It seemed like bad things were happening one after another for him. When looking at what he was going through mentally, and comparing it to the percentages of suicidal risks, in a way, even though it is immensely saddening to think about, it was not surprising to see that he had chose to go down that route.

Personally, I would not be able to pinpoint as to what exactly is the single cause of his death. This is because, there is not single cause, it cause of it is a combination of everything that he was dealing with at that time. His third wife mentioned in an interview with The New York Times that apparently every month it was a different symptom that he had to try and overcome (Robin Williams’s Widow Points to Dementia as a Suicide Cause, 2016).

After reading on Lewy Body dementia it mentions how people start to behave not like themselves. It is a progressive diseases, thus, it gets worser and worser, until eventually everything becomes too much for them to handle.

Tohid, H. (2016). Robin Williams' suicide: a case study. Trends Psychiatry Psychother, 38(3), 178-182.
What is Lewy Body Dementia. (n.d.). Retrieved from https://www.nia.nih.gov/health/what-lewy-body-dementia
Robin Williams’s Widow Points to Dementia as a Suicide Cause (November 3, 2015). Retrieved from https://www.nytimes.com/2015/11/04/health/robin-williams-lewy-body-dementia.html