The sadness behind comedic talents
WHEN you think of Ellen DeGeneres, Conan O'Brien, David Letterman and Robin Williams, the first word that comes to mind is not depression.
But the four comedians have all struggled with the disease suffered by an estimated 350 million people worldwide, according to their own comments or those close to them.
Williams, a comedian known for his manic energy, committed suicide on Monday. He had suffered a period of severe depression, his publicist Mara Buxbaum said in a statement.
According to Marin County's assistant chief deputy coroner, Keith Boyd, the actor, 63, was found dead by his personal assistant in a bedroom. He was suspended from a belt wedged between a closet door and a door frame, in a seated position just off the ground.
"Not everybody who has a depression disorder gets recognised," said Paul Summergrad, the president of the American Psychiatric Association. "It affects rich people, it affects poor people, it affects people across the spectrum."
Symptoms vary and can include feelings of hopelessness, extreme anxiety, appetite changes, insomnia or excessive sleeping, and suicide risk, according to the National Institute of Mental Health in Washington.
In an interview with CBS This Morning in 2012, Letterman said he avoided treatment initially because he feared the drugs could make some symptoms worse.
"I thought it would make me loopy or make me hallucinate or make me drowsy," he said. "It's different than, 'Oh, I don't feel good today'. It's different than feeling sad, it's different than feeling blue."
O'Brien's depression deepened after losing his job as the host of NBC Universal's The Tonight Show in 2010, he told Rolling Stone magazine.
"I felt like I'd just been in a car accident," he said.
DeGeneres said her depression settled in during a lull in her career in 1997 after she first came out as a lesbian, facing a slowdown in advertisers on her show and tabloid attention, according to a report in the Guardian.
Williams had film roles touching on mental illness. As the title character in Patch Adams, he portrayed a man who committed himself to a mental institution and became a doctor. He also played a therapist in Good Will Hunting.
Being highly successful is no protection against depression, said Scott Krakower, a psychiatrist at Zucker Hillside Hospital in Glen Oaks, New York. In fact, it may be a contributor, he said.
"They do have a really nice life," Dr Krakower said. "But there's always a lot of pressure on them being in the spotlight constantly, and sometimes you need almost an escape from that."
Actors, in particular, may feel the extreme level of anxiety that is symptomatic of the disease, according to Dr Krakower.
"When they go on the stage they want to be perfect," he said. "There's a lot of pressure on them and they put a lot of pressure on themselves."
Williams was released from a rehab centre last month, according to reports. He has commented in the past on his struggles with both alcoholism and drug addiction.