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Parkinson's and depression: A deadly combination for Robin Williams?

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Robin Williams’ wife Susan Schneider released a statement Thursday revealing that the late actor had recently been diagnosed with Parkinson’s disease, prior to taking his life earlier this week.

Those who suffer with Parkinson’s disease produce too little dopamine in parts of the brain.  The deficiency of dopamine leads to problems with movement, including rigid muscles and tremors.

Parkinson’s disease and major depression sometimes coexist and, when they do, they can make one another worse.  People with both conditions, for example, tend to be more plagued with anxiety than either, alone.  And people with both conditions can have even more trouble with movement than those with either, alone.  The ability to concentrate may decline precipitously.

Interestingly (and, perhaps, tragically) a medication called ropinirole, which stimulates dopamine receptors in the brain, not only helps many people with early stage Parkinson’s disease, but also helps some people with depression, when more traditional medications (like Prozac or Cymbalta) haven’t done an adequate job.  If Williams had had the time to be adequately treated for his Parkinson’s disease, it might have also helped his symptoms of depression.

Psychologically, of course, being diagnosed with Parkinson’s disease, while already battling a history of substance dependence and major depression, could have felt like a crushing blow to Williams.  I never spoke with him about his conditions, but I have treated others with both Parkinson’s and depression who can feel doubly slowed down and spiraling downward, too.  That’s why it’s so important in these cases to deploy treatment strategies that work—and work fast.

For an actor, of course, the specter of Parkinson’s disease is of special and great concern, because facial muscles can become immobilized, leading to the “mask-like” expression some people with the disease develop.  I don’t know, of course, whether Williams, through the distorted lens of depression and anxiety, saw that possibility as an unbearable one.

However, for those who might read about Williams’ conditions and worry that he made a reasoned assessment of his future and saw it without any light ― I promise you that his depression had stolen his ability to be rational about his prospects. 

Many, many people with depression and Parkinson’s disease, combined, defeat both—living long and productive lives with real joy.

Dr. Keith Ablow is a psychiatrist and member of the Fox News Medical A-Team. Dr. Ablow can be reached at info@keithablow.com.

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