[orthodoc]

I'm not sure there's any good answer to the conundrum. We are all grieving and trying to make sense of the death of someone who gave us so much joy, laughter, awe ... and make sense of the fact that, in spite of how much he made us feel better, he was in such pain that he chose to end his life. We wonder what we could've, should've done.

The answer is: nothing. When someone is that depressed, it is nearly impossible to stop a suicide. A severely depressed person will join in a family reunion picnic, joke with everyone, play with the kids, and then walk up the path to the cottage and use a shotgun to end his life. Depression, at that level, doesn't manifest itself in overt sadness, or anything that most people would recognize as 'depression'.

If a suicide is prevented, it's often more by luck than by design. That's how depression is. It has a 15% mortality rate.

A confidential example (as confidential as can be here): one of my meds post-chemo gave me major depression. Over a few weeks, I descended to the point of planning and being angry that my first few choices weren't immediately available. Then, one morning as I opened the garage door before starting my car, I smacked my forehead and thought, Of Course! I can just start the car and NOT open the door. I held it to myself as I went off to work, knowing that I had that option when night fell. For the day, I would see my patients and do my academic work and fulfill my obligations. Sing Happy Birthday to the staff member turning 48 and wear a funny hat, chat with everyone, take care of people, and come home to my option.

I stopped the med the day that I had that thought, and the depression and suicidal thoughts lifted quickly. But I understand how you can appear 'normal' in public while planning your death in the next few hours. It's not a matter of will; it's biochemical, and it's almost irresistible. For Robin Williams, my love and sympathy.