How very appropriate, I’m thinking to myself as I self-soothe with another bite of my (forbidden) bagel with berry cream cheese.  It’s raining…tears.  From Heaven, right?  How cliché.  Do you know how many articles I’ve scanned, Facebook posts I’ve glanced at, Twitter commentary I’ve witnessed, news reports I’ve absorbed in the last 24 hours?  The news about Robin Williams’ “apparent suicide” resonates everywhere.  People relating to his disease, the major depression, that exhausted him completely as well as the drug addiction he may have begun in order to make himself just feel human again, have once again made the world shutter.

Did we not just lose Phillip Seymour Hoffman?  He was a talent so breathtakingly genuine and so similar to our beloved Robin Williams that I want to weep.   Is the value of life any less precious to those that commit suicide?  I dare say no.  It is not any less valuable.  Both of these men were humanitarians.  Both loving, caring, highly sensitive individuals.  Were they possibly too sensitive for our chaotic world?   I don’t think so.  What made them extraordinarily talented was their ability to grasp human nature, tell a story through tear-streaked eyes and make us think.  They made us believe in them and in the message the story was trying to convey.

Maybe despite each of their flaws, which we empathized with, it comes down to that.  We believed in them.  We are craving the depth-ridden talent that can juggle alcohol, drugs and mental illness and still set the world on fire with their mastery of the human condition on screen.  Why then?  How come, on the average, 30,000 Americans per year commit suicide, according to Suicide Awareness Voices of Education (SAVE)?

Robin Williams and Phillip Seymour Hoffman are indeed a huge loss to the world; but what about my cousin, Jimmy?  Was he any less important because he wasn’t dancing on some stage?  Did he disrespect life?  Maybe he watched so much TV that he was desensitized to death and violence and desperation.  No.  I don’t think so.  I don’t think a person’s natural response is to kill or be killed, nor is it to wake up dreading the day.  And sadly, I probably know more about those I would never meet, like Robin Williams and Phillip Seymour Hoffman, than I do about my own cousin, a person with whom I shared a childhood.  That’s part of the tragedy for me personally.

These three beautiful souls fought battles most of us haven’t a clue about. I couldn’t even begin to tell you what a tortured mind tells itself to convince one to put out their own brilliant light for good.  Robin Williams and Phillip Seymour Hoffman were two of these raw human beings that had some significant mental health issues that hopefully they were being treated for, but more likely it was the well known, much more socially acceptable drug addictions that were being treated when push came to shove.  It’s no surprise that mental illness and drug abuse/addiction go hand in hand.

This dual diagnosis is a lethal one.  In fact, according to DualDiagnosis.org “co-occurring mental health conditions and substance abuse affect nearly 8.9 million yearly. Only 7.4% receive appropriate treatment”.  Bottom line: People with co-occurring disorders need specialized integrated treatment.  The Epidemiologic Catchment Area study conducted by the National Institutes of Health reported that almost one-third of individuals with depression had a co-existing substance use disorder at some point in their lives (Regier et al, 1990).  The National Comorbidity Study found that men with alcohol dependence had rates of depression three times higher than the general population; alcohol dependent women had four times the rates of depression (Kessler et al, 1997). Women often develop the mood disorder first then the addiction, while men frequently develop the addiction first.

For many, these disorders become linked over time, with symptoms of each worsening the other.  These conditions are often chronic and must be managed.  This is obviously no joke.  One feeds on the other eventually.  Sobriety does not guarantee improvement in mood.  I’ve seen this too many times when I worked at a drug rehabilitation center called Second Genesis in Maryland for recidivist addicts.  This was more years ago than I care to count, but the premise remains.  Clients and families come in with the expectation that ridding the person of the addiction, or drug itself, will fix everything.  Unfortunately, for some, maybe Robin Williams even, getting sober may actually have made the mood disorder worse.  If the drug that masks the mood disorder isn’t present then you’re left with just the mood disorder and no way around it.  Suddenly you must deal with you.  Your demons.  Your financial affairs.  Your fears of the unknown. Your relationships.  And if you are sensitive to the world around you and live with a family that sees you are clean and of course, clean = fixed, then expectations, or assumed expectations of yourself or others creep into play.  When really without wraparound services you’re just a “dry drunk”.  Which means to say that you are an addict minus the fuel.

You still have poor boundaries, you still have poor coping skills and you still have habits that rely on being back on the drug of choice to make you “feel good” or “normal” again.  If there is no complete and utter lifestyle change for you and your loved ones then you are that much more at risk of falling back into potentially deadly habits.  It’s that simple and that incredibly difficult.  Have YOU ever tried to overhaul your entire life?  From friends to social engagements to jobs to neighborhoods to family members who must be on board and support all of this…hell, I can’t even keep from eating carbs when I’m weepy!!!

Studies conducted by Dennis C. Daley, Ph.D (The Double Demons of Depression and Addiction, DualDiagnosis.org) and colleagues at Western Psychiatric Institute and Clinic of the University of Pittsburgh Medical Center show that clients with addiction and depression are at high risk for suicidal and homicidal behaviors, poorer treatment adherence, higher relapse rates to either disorder, and higher hospitalization rates (Cornelius et al., 1997; Salloum et al., 1996; Daley & Zuckoff, 1998, 1999).

Going into rehab doesn’t mean you come out squeaky clean.  It means you come out “dry”.  You are free of the drug that took over your body. literally. NOT YOUR LIFE.  That’s it.  If you happen to connect brilliantly with your psychiatrist or therapist while living there and your loving family surrounds you in your family therapy sessions weekly while making their own changes to accommodate your needs upon your mutually agreed upon release then, well, you definitely have a better chance at a life outside the confines of a more secure, vigilant, routine, regimented rehabilitation center – even the best of them.

People want to be happy or at least have some pleasurable feeling as a perk to having to wake up in the morning.  For many of us coffee will do.  For some of us it isn’t a question of what will give me joy first thing in the morning.  It’s can I face another day in a life that has no meaning for me? AGAIN.  How can I be “on” all the time?  What must people think of me if I fail to be funny? Pretty? Interesting? Inspiring?  Smart?

If I don’t feel good without drugs and you take away my drugs I have several choices: I can use coping skills I probably haven’t learned, with people who still don’t understand; I can keep using drugs and continue on this cycle of hell, similar to “Groundhog Day”, waking up feeling like excrement and killing my liver or whatever else is dying inside, OR I can stop the f’g madness, the voices the achiness, the sadness and desolation because people won’t like what I am without them.  I don’t like who I am with or without my addiction anymore.  I don’t even know who I am without the addiction counteracting the moods.  How in the hell can you be the funny man when you aren’t feeling funny?  How can you make people laugh when all you want is to sleep?  How can you get on stage when you can’t get out of bed?  How can you take care of your family when you can’t take care of your own damn self?  You can’t…you tell yourself.  Put an end to it, you say.  It’s not selfish when you feel like it’s better for everyone.  You see?  It’s exhausting, this life.  They’ll be better off without me, you think and you really honestly mean it this time.  You believe the lies you tell yourself.  You have “failed” at life too many times to keep up the façade.  You are a phony…a fraud.  You are empty.  You’re tired.  Enough already.

RIP Robin Williams.  RIP Phillip S. Hoffman.

RIP Jimmy♥

PLEASE HEAR WHAT I’M NOT SAYING

Don’t be fooled by me.  Don’t be fooled by the face I wear for I wear a mask, a thousand masks, masks that I’m afraid to take off, and none of them is me.

Pretending is an art that ‘s second nature with me, but don’t be fooled.  I give you the impression that I’m secure,  that all is sunny and unruffled with me, within as well as without, that confidence is my name and coolness my game, that the water’s calm and I’m in command and that I need no one, but don’t believe me.

My surface may seem smooth but my surface is my mask, ever-varying and ever-concealing.

Beneath lies no complacence.  Beneath lies confusion, and fear, and loneness.  But I hide this.  I don’t want anybody to know it.  I panic at the thought of weakness exposed.

That’s why I frantically create a mask to hide behind, a nonchalant sophisticated façade to help me pretend, to shield me from the glance that knows.

But such a glance is precisely my salvation, my only hope, and I know it.

That is if it’s followed by acceptance, if it’s followed by love.  It’s the only thing that can liberate me from myself, from my own self-built prison walls, from the barriers I so painstakingly erect.  It’s the only thing that will assure me

of what I can’t assure myself that I’m really worth something.  But I don’t tell you this.  I don’t dare to, I’m afraid to.  I’m afraid your glance will not be followed by acceptance, will not be followed by love.  I’m afraid you’ll think less of me, that you’ll laugh and your laugh would kill me.  I’m afraid that deep-down I’m nothing and that you will see this and reject me.

So I play my game, with a façade of assurance without and a trembling child within.  So begins the glittering but empty parade of masks, ad my life becomes a front.  I idly chatter to you in the suave tones of surface talk.  I tell you everything that’s really nothing, and nothing of what’s everything, of what’s crying within me.

So when I’m going through my routine do not be fooled by what I’m saying.  Please listen carefully and try to hear what I’m not saying, what I’d like to be able to say, what for survival I need to say, but what I can’t say.

I don’t like hiding.  I don’t like playing superficial phony games.  I want to stop playing them.  I want to be genuine and spontaneous and me but you’ve got to help me.

You’ve got to hold out your hand even when that’s the last thing I seem to want.  Only you can wipe away from my eyes the blank stare of the breathing dead.  Only you can call me into aliveness.  Each time you’re kind, and gentle, and encouraging, each time you try to understand because you really care, my heart begins to grow wings — very small wings, very feeble wings, but wings!

With your power to touch me into feeling you can breathe life into me.  I want you to know that. I want you to know how important you are to me, how you can be a creator — an honest-to-God creator — of the person that is me if you choose to.

You alone can break down the wall behind which I tremble, you alone can remove my mask, you alone can release me from my shadow-world of panic, from my lonely prison, if you choose to.  Please choose to.

Do not pass me by.  It will not be easy for you.  A long conviction of worthlessness builds strong walls.  The nearer you approach to me the blinder I may strike back.  It’s irrational, but despite what the books say about man often I am irrational.  I fight against the very thing I cry out for.

But I am told that love is stronger than strong walls and in this lies my hope. Please try to beat down those walls with firm hands but with gentle hands for a child is very sensitive.

Who am I, you may wonder?

I am someone you know very well.  For I am every man you meet and I am every woman you meet.

Charles C. Finn, September, 1966.