This past summer, the world lost one of its most beloved, storied artists of all time, actor and comedian, Robin Williams. And of late, his tragic suicide has shed incredible light on a shaking reality: the persistent, disparaging battle between addiction and depression. 

Addiction and depression are two internal demons that have housed themselves in individuals all over the world. Their common coexistence in a single person is a frightening fact to face: the line between the disorders is often obscure, their symptoms can be difficult to separate, and yet, their mix can be toxic.

Robin Williams committed suicide on August 11, 2014, but had been handed a double dose of this muddled cocktail long before his disorders had been disclosed to the public. Just as one-third of people with depression also struggle with alcoholism, Robin Williams found himself afflicted. He admitted to heavily abusing both alcohol and cocaine at the height of his career in the 1970s, and after remaining sober for two decades, relapsed to drinking in 2003. “For that first week you lie to yourself, and tell yourself you can stop, and then your body kicks back and says, no, stop later,” Williams exposed in a subsequent interview with The Guardian.

Drug addiction is a mental illness—one that takes an individual’s normal hierarchy of priorities, and replaces them with uncontrollable cravings and compulsive needs to procure and use the drug. Such behaviors result from drug-induced changes in brain structure and function, changes that simultaneously occur in the same areas of the brain that host other mental disorders—including depression, anxiety, and schizophrenia. “It’s not caused by anything, it’s just there,” Williams said on addiction. “It waits. It lays in wait for the time when you think, ‘It’s fine now, I’m OK.’ Then, the next thing you know, it’s not OK.”

While Robin Williams publicly entered rehabilitation for addiction, his depression carried a social stigma that he, as a comedic genius, never outwardly addressed. 

Depression is among the most common mental health disorders in the United States. It manifests itself in symptoms of sadness, hopelessness, and worthlessness. Those suffering may feel the self as powerless, the world as unfair, and the future as fixed. It’s no wonder, then, why so many lose hope in finding proper treatment. 

Individuals who suppress these negative emotions often use alcohol or drugs as an escape. But depression is chronic, and regular substance abuse will inevitably spiral into a ruthless addiction. The link, though, is somewhat inherent—drug abuse changes brain composition, kindling an underlying susceptibility for developing a mental illness, and vice versa. The National Comorbidity Study found that men were especially predisposed: those with substance dependence had rates of depression three times higher than the general population. 

In 2013, the National Survey on Drug Use and Health determined that an estimated 43.8 million adults experienced mental illness, depression being the most common. 20.3 million suffered from a substance use disorder. Of these, 7.7 million adults habited both, allowing the mental illness and the addiction to develop as comorbid disorders.

Perhaps what’s most shocking about uncovering the depths of Williams’ death is not his suicide itself, but rather, the fact that we hardly saw it coming. How could someone so invested in bringing joy and laughter to the world, simultaneously be so—sad? 

Depression and addiction are complex diseases to identify, but can be fatal if they continue to stir. Those with these co-occurring disorders have a much higher risk of adopting suicidal behaviors, poor treatment adherence, higher relapse rates, and higher chances of re-hospitalization.

In approaching comorbidity, we at Turnbridge believe that the treatment of each disease, mental and addictive, be integrated: at the same place, at the same time, and with the same amount of attention. A patient must recover both mentally and physically, and in order to do so, should accept that this is an ongoing healing process. 

Integrated drug treatment recognizes that a long-term, staged approach is most necessary. We strongly commit to engaging our patients emotionally, physically, and socially, and encourage them to create goals for the future. With group counseling, self-help, behavioral therapy, and the utmost support, we develop individualized drug treatment programs to prevent relapse and maintain a steady recovery. 

“It is our hope in the wake of Robin’s tragic passing that others will find the strength to seek the care and support they need to treat whatever battles they are facing,” said Susan Schneider, the widow of the comedic prodigy, “so they may feel less afraid.”