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Robin Williams and anhedonia

The Angriest Man in Brooklyn

Warning: Ahead be spoilers for the little-seen movie The Angriest Man in Brooklyn and a frank discussion of suicide.

Robin Williams’ death hit me hard when it was first reported. I spent about a week watching his movies, comedy shows, television appearances, and even some old Mork and Mindy episodes to remember the depth and breadth of his talent. From the Captain of Dead Poets Society and the unorthodox therapist in Good Will Hunting to the madcap comic hijinks of Mrs. Doubtfire and Good Morning Vietnam to the sublimely creepy photo technician in One Hour Photo and malign Milgram clone in an episode of Law and Order: Special Victims Unit, Williams’ acting talents were uniquely diverse.

His death’s lingering impact struck me when I watched The Angriest Man in Brooklyn tonight. It was the last movie of his released while he was still alive, and it features a scene in which his character jumps off the Brooklyn Bridge to attempt suicide. At that moment, the remainder of the movie didn’t matter to me. That scene was an eerie reminder of the nature of his death; his character’s survival of the attempt rendered even more poignant the death of his portrayer through similar means. Early attempts to explain his suicide focused on his history of depression and substance use, both of which are predictors of suicide.

Williams was reported to be suffering from the early stages of Parkinson’s disease at the time of his death (though later reports suggest he may have suffered from Lewy body dementia instead). Assuming that the Parkinson’s disease diagnosis was correct, Williams becomes one of the most striking exemplars of the anhedonia that frequently accompanies Parkinson’s disease. Specifically, because Parkinson’s disease entails reduced levels of dopamine, it’s reasonable to assume that the anhedonia in Parkinson’s disease relates to a decrease in “wanting”, the part of reward processing that’s involved in yearning for and approaching something that’s desirable. If very little seems truly desirable in your life, it’s difficult to make yourself get out of bed, do the potentially hard work in front of you, and keep going through obstacles that rise up.

One might assume that near the end of his life, Williams’s emotional life was the opposite that of his character in The Angriest Man in Brooklyn. Anger is an approach-related emotion, one that’s related to dopamine binding. Rather than being angry, Williams was described as depressed, anxious, and paranoid toward the end of his life. Clearly, finding good assessments of the anhedonia of Parkinson’s disease patients is critical, particularly to the degree it may share features with the anhedonia in other disorders like depression. If that’s the case, treatments for one form of anhedonia may be applied to other forms, saving the lives of thousands of people – including some of our most creative members of society.