The Death Of Robin Williams

By Fred Von Stieff, MD, AAFP, ABAM, CSAM, ASAM

Death Of Robin Williams

The shocking tragedy of Robin Williams’ death has left many with questions. Why did this comic genius suffer such severe depression that he was moved to take his own life? What possible role did his past struggles with drug and alcohol addiction play in this decision? Could a change in common treatment practices have prevented this from happening? These questions, and many more like them, have been brought to my attention after weighing heavily on the minds of patients I treat for depression and chemical dependency.

As an addictionologist and family medical practitioner, I only wish I had had the opportunity to meet and treat him before it was too late. Robin Williams’ life shows that drug and alcohol addiction and depression have nothing to do with one’s intelligence or artistic talents. Rather, it is all in the neurotransmitters.

Often at the source of severe depression and substance abuse, there lies a genetic neurochemical imbalance. Each individual’s genetics contain the code that builds the nervous system, including the neurotransmitters our brain needs to function properly. Many of us are born with deficiencies in one or more of these neurotransmitter systems. People with depression often have genetic imbalances within their serotonin, dopamine, and/or noradrenaline neurotransmitter systems.

People struggling with these imbalances are more inclined to become addicted to certain kinds of substances. Cocaine, for example, is one of the most powerful dopamine stimulants out there. High doses of alcohol result in a highly euphoric dopamine release that is commonly achieved right before a person blacks out. Hence, it is easy to see why people who suffer from depression due to a deficiency in their dopamine neurotransmitters so easily become addicted to alcohol and other dopamine stimulants.

Recent findings reveal that the culprit behind countless cases of alcoholism, drug abuse, and depression is a dopamine neurotransmitter deficiency. In fact, the driving force behind heavy drinking, methamphetamine and cocaine abuse is almost always cravings for the stimulation that only high dopamine release can provide. But the dopamine neurotransmitter system is not an isolated entity. Understanding the connections that
exist among the eight neurotransmitter systems involved in chemical dependency is absolutely vital to finding solutions to most chemical dependency problems that exist in our society. Even certain cases of opiate addiction have been found to result from the addictive dopamine release that comes from opiate neurotransmitter stimulation.

Why does this knowledge matter in cases like that of Robin Williams, and millions of others who suffer from depression and alcoholism or perhaps cocaine addiction? Because once doctors know the source of the problem, they can then prescribe the best-suited medication. Typically when a patient comes to a psychiatrist with depression, the doctor will go through every drug in their armamentarium, trying to find the right combination of neurotransmitter-stimulating medications, usually trying those that stimulate the various subtypes of serotonin first. (Serotonin adjusters do work well for many kinds of depression, but usually not for the more severe cases.) Meanwhile, during the weeks or even months of trying medications that don’t work for their particular kind of depression, the slippery slope of suicidal depression can overcome the patient, leading to catastrophic decisions.

On the other hand, if psychiatrists or medical doctors look into patients’ past substance abuse and find cocaine use, high dose alcohol use, or even opiate abuse, they can guess the person has a dopamine deficiency. They can then proceed to prescribe the best corrective medication the first time, pulling them out of their deep depression.

Robin Williams’ history of cocaine use and heavy drinking are strong indicators of a dopamine deficiency. Cocaine is one of the most powerful dopamine drugs out there. Additionally, a dopamine release occurs only after extended heavy drinking. It appears he chased after the dopamine high. Studies with rats show tracks that excite the nucleus accumbens to release dopamine and cause an imbalance that’s formed in the brain with even just one dose of cocaine, meaning the brain immediately gets ready for the next dose. Once those tracks have been placed and the imbalance created, individuals crave more drugs to help stay one level above depression. It can be an endless cycle.

Unfortunately, there are not many medications that increase dopamine production, aside from Wellbutrin, Abilify, and some benzodiazepines like Xanax (which carries its own addictive dangers). It would be of great help if pharmaceutical companies could come out with other safe dopamine stimulant medications. Finding the right dopamine medication can do wonders. I have seen lives completely turned around due to finding the right medication that provided patients with the correct neurotransmitter stimulation required to feel normal, escaping the pit of depression. Aside from the right corrective medications, intense therapy is a vital component to treatment.

My job as an addictionologist is much like being a mechanic, using the tools of the mind, adjusting neurotransmitters until that ideal balance is attained, where thoughts are clear and cravings are eliminated. If more psychiatrists and other doctors focused on the vast influence that neurotransmitters have in behavioral and mental health, there would be a lot more successful detoxifications and treatments, with fewer relapses and more lives saved.

The death of Robin Williams deeply affected many in this nation because many of us saw a little of ourselves in this extraordinary man. One out of ten Americans struggle with some form of substance abuse and many more suffer from depression. Robin Williams suffered from depression and had bouts with alcohol and drug addiction, yet he was known for his phenomenal career, candid approach to life, and outstanding acts of kindness with his charity work. Robin Williams’ life reminded us to not let our struggles define us, but rather continue to overcome them and strive to be something better. Let his passing remind us of the necessity to seek help and reach out to those in need of our support.

Addictionologist, Dr. Fred Von Stieff is one of the most sought-after doctors in California due to his discoveries surrounding imbalances within the neurochemicals of the brain, and his pioneering methods of preventing relapse. His research proves there is more behind addiction than previously realized. Genetic neurochemical imbalances are the culprits behind countless cases of alcoholism, substance abuse, depression, bipolar, and other psychological disorders. Pinpointing the exact sources of these mental health issues takes away from the guesswork previously inherent to chemical dependency treatment, making possible administering effectual treatment the first time. You can learn more about Dr. Von Stieff’s highly effective methods in his book, Brain in Balance: Understanding the Genetics and Neurochemistry behind Addiction and Sobriety, available at:

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