By Patrick Page:

The suicides of Kate Spade and Anthony Bourdain have left many people baffled. How could two people who seemed to have it all, who showed no external signs of despair, who brought so much joy to others, take their own lives?

I didn't know them, and I can only speculate, but their deaths are not baffling to me.

Spade and Bourdain died of an illness that had nothing to do with the circumstances of their lives. They died of depression.

Depression is an illness shared by about 9 percent of adults in America, including me. It is frequently fatal. It claims its victims by suicide. It is an insanity that convinces you there will never again be a moment of peace, joy or tranquility in your life.

Four years ago, when Robin Williams died, I first wrote on this subject. The night his suicide was revealed I slept very little. And it wasn't just grief keeping me awake. It was fear. I know my depression is lurking just around the corner-waiting. As my friend Harvey Fierstein brilliantly said, "All it wants to do is get you alone in a room and kill you."

I started talking about my own Depression publicly six years ago. It happened suddenly, during an interview with The New York Times conducted by Patrick Healy. He was writing a feature story that would cover my life and career. At the end of the interview Healy said: "That's all the questions I can think of. Is there anything else you'd like to say?

I paused for a long, long time.

"Yeah. I have Depression. I've had it most of my life. I'm better now. But it's one of the defining factors of my personality, so I guess we should talk about it."

My confession had been brought on by the fact that a couple of months earlier a member of the Spider-Man-Turn Off the Dark family-Jason Lindahl, who worked on our video projections-had killed himself. His body had been found in the Hudson River and a suicide note was discovered in his apartment. I hadn't known Jason well. He was, as his Twitter account said: ""The dude sitting in the theater behind the wall of computer monitors." But we shared something crucial. He was a Depressive--like me.

If he had known about my struggle and my eventual recovery he might have asked me for help. He might have asked for my doctor's number. I might have told him anti-depressants had worked for me after 20 years of psychotherapy and suffering. I might have mattered.

But I had been ashamed. I had been afraid. I had been hiding.

And I knew how to hide. In over twenty years of recurring and crippling depressions I had never missed a performance. Never been late to a rehearsal. Never let on that I was frequently in agonizing pain. No one knew, except my therapist and my wife. Depressives can fake it better than Meg Ryan in "When Harry Met Sally". A Man For All Seasons with Frank Langella. Roundabout, 2008

When this picture was taken I was very, very ill.

My last depression was in 2009. I had just finished playing King Henry In A Man For All Seasons and was rehearsing to play Claudius in "Hamlet" at Theatre For A New Audience. Because depression is so notoriously hard to describe-and (once the insanity has lifted) so difficult to remember precisely--I made an effort to keep a journal:

February 20, 2009

It feels like it's been winter forever. I grew up with gloomy skies in Oregon, but the green of the trees and the grass was some compensation for the constant drizzle and dreary skies. In Manhattan when January comes the snow covered city seems to be shot in black and white, like those old Life Magazine photos of The Great Depression. The holiday lights are gone, along with the tourists and their pastels, and the city is drained of color, dressed in black, laid out like a corpse in a casket lined in muddy white velvet. Then, when the snow melts, it's just grey. Grey skies, grey buildings, grey pavement, grey people.

Depression, the kind I have been fighting for the past couple of decades, is notoriously hard to describe. Closer to horror than to grief, a feeling like a stomach full of old newspaper soaked in dirty ice-water. This time, in addition to the all consuming heaviness and torpor, I feel an oncoming rush of panic. Today's symptoms include irrational crying jags (embarrassing when they happen, as one did today, on the subway), generalized physical pain, tightness in my throat like strangulation, and an inability to take a full breath. This last symptom is the most pervasive and the most troubling-the constant feeling of suffocation puts me in a fight or flight state of mind.

It also prevents me from being able to act. Olivier said that the one thing an actor needs is breath. Without it there is no relaxation, no freedom, no voice, no access to the emotions or the imagination.

The final symptom is dread. Dread as a physical sensation--like the onset of a sneeze or a vomit. Dread as a certainty that tomorrow will be worse than today. That there is no light at the end of the tunnel. Or rather, that the end of the tunnel is actually behind me--I remember feeling happy in the past, although I cannot imagine it in the future. Memory, not hope, keeps me going.

We need a new word for the illness called depression. Depression is not a mood. It's a life-threatening brain sickness. As Dick Cavett said "A depression is a dip in the road. And this thing is much, much more than a dip in the road. It's a horror I wouldn't wish on Joseph Goebbels."

Everyone feels they have been depressed because everyone has been deeply sad. But sadness is not depression. Rotten circumstances can sometimes trigger a depression or make it worse, but favorable circumstances cannot make it better. The inability to experience joy or happiness is its hallmark. Nothing brings pleasure. Your favorite food? Nothing. Your perfect lover? Nothing. A trip anywhere in the world? Nothing. A long lost family member? Nothing. A role in the next Spielberg movie? Nothing.

If someone says "I'm depressed because bad things are happening in my life" you can be pretty sure they are not depressed. Sadness is the natural response to bad circumstances. If they say "I'm depressed even though wonderful things are happening in my life" it may be a real case of depression.

In my case I am depressed even though I recently worked opposite one of my idols---Frank Langella-- on Broadway. I am depressed even though I have a loving and incredible wife. I am depressed even though I am playing a leading Shakespearean role at a major New York Theatre. I am depressed even though both my parents are living and I was able to take them to London last month. And I am depressed even though I have been in therapy for twenty years in an effort to fight it.

Suicide fantasies help a little, but I have to be careful-careful never to tell Paige, or my shrink, or anyone else -(enforced hospitalization is my greatest fear) and careful never to let the fantasies become so attractive that acting on them becomes easier than not acting on them. Today's reverie is of jumping in front of the express train. If it was done at the last second no one could ever really be sure whether it was an accident or on purpose. The easiest way, of course, is with pills---I have plenty of Ambien, Tramadol, muscle relaxers, beta blockers and alcohol. But this would surely be ruled a suicide and I wouldn't want Paige to find my body. These daydreams make the hours a little less stressful-like knowing where the fire escape is in a crowded building. But the fact is I don't want to die. I just want to feel better. The difficulty is that I cannot imagine ever feeling well again. I don't experience a single moment of comfort, joy or peace all day long. Every day is a battle from the time I wake up until I go, fitfully, to sleep. How to get through the day without anyone knowing I feel my sanity is slipping?

My situation this year is worse than I can remember. I have very few moments when I function well and the crying jags now come about every half hour. I have not slept more than a few hours at a time for the past month, and I know I am keeping Paige awake too. The guilt of knowing she has to put up with all this adds fuel to my fantasies of putting an end to it all. She would certainly be better off if I were gone. I also seem to be losing more weight-eating is pretty torturous and done only because I know I have to. Worst of all is the complete inability to deal with people-I frequently cross the street to avoid having to talk to a friend, and I worry about the damage I may be doing to my relationships. Finally, the feeling that I am being physically strangled and suffocated is constant and overwhelming.

I have not missed any rehearsal and I hope to be able to use the symptoms I am experiencing for the character. Claudius is a man on the verge of a nervous breakdown and so am I. Maybe that is why I am getting so many lovely and baffling compliments about my work from fellow cast members. Luckily, acting is perhaps the only profession in which you can lay in a fetal position in a corner of the room until you are called upon do your work, and then return to your corner when your scene is done. I could never make it through a full day in a "normal" job, but as an actor one's colleagues are likely to consider your peculiarities simply a part of your "process".

March 2-42nd Street Studios

Today is scheduled for a run-through of the first half of the show for designers and staff. The brightly lit rehearsal hall is buzzing with new energy. Normally this would be a favorite day for me. It would be exciting to have an audience for the first time. But my situation is very bad today. I will just have to get through it. Perhaps I can use this feeling to tap more deeply into Claudius' shame and self-hatred. Before the run-through I approach Gertrude to let her know that if I act remote or distant it is because I am not feeling well. She thanks me for the courtesy. As actors we are always afraid that our partner's moods are about us.

I get through the first scene, but it's as if I am watching everyone else through a pane of glass. I can hear the words coming out of my mouth--as if they are coming from another room-but I have no connection to them. The need to scream and weep is pulsing inside of me-as undeniable as the need to release the bowels when one has diarrhea, or the urge to vomit when one is nauseous--but I hold it back and retreat to my corner next to my big green parka underneath the ballet bar. The next scene begins-Hamlet confesses that he wants to die, Horatio informs him of the spectre on the battlements---and I hear I high pitched wail like a police siren that then widens into something like a dog howling in pain. It takes a second or two for me to realize the sound coming from my own mouth. Instantly, I am surrounded by people looking down at me. I'm sobbing hysterically and repeating over and over "I'm sorry. I'm sorry. I need a doctor. I need a doctor."

Reading that entry now, I'm amazed at the clarity of the thoughts. I certainly didn't feel lucid. Shortly thereafter, I would be unable to communicate in any way.

Of the breakdown in the rehearsal room I remember little, except the kindness in the eyes of actor John Christopher Jones as he said to the others "I'll take him". Paige was called and I was put in a small room where I laid on the floor bundled in my parka until I was brought into Elma's (my psychotherapist's) office, and she referred me to Dr. Kent Robertshaw who began the process of finding the right medication for me. For the next several weeks I was bedridden. I wanted to return to rehearsal and performance, but I was barely able to speak or walk. It was all Paige could do to get me to my medical appointments.

For the first time in my life, I had to drop out of a show.

I had vehemently resisted medication for 20 years, convinced that it would hamper my ability to access my emotions-both on stage and in life. I knew my depressions might come-- but I felt they were the price I paid for creativity. As I reached the end of my rope that grey winter in 2009 I was still refusing to take the meds Dr. Robertshaw had prescribed when I got a letter from a fellow actor who was in the room that day I lost my wits altogether. He was, and is, someone whose work I greatly admire for (among other things) his depth of emotion--- so his words hit home:

Dear Patrick,

I want you to know that the illness you are struggling with is one that I am intimately acquainted with. I don't know your history with depression but the stigma attached to illness is exactly the thing that can prevent people from seeking help. I've been there. Let me mention one misunderstanding I had, in case you share it. I deeply believed that anti-depressants would kill all my feelings and I would end up a zombie, in life and on-stage. A total myth. I feel appropriate emotions all the time. But I no longer weep uncontrollably because I believe I am worthless and deserve to die. And Patrick, sometime down the line, when you next tackle Leontes or MacBeth or one one of those boys - you will bring a depth of compassion and understanding to the role previously unavailable to you. That's where the good part kicks in - we get to put everything, especially our pain, into our work. We're the only ones who get to take our most private suffering and make something new and better with it. We defeat it by transforming it.

And so I started taking my medication--the medication that saved my life. That one letter made the difference.

I had to hear it from an actor.

I couldn't hear it from my psychiatrist, or my therapist, or even my wife. I needed an actor to tell me that my Art would survive the meds.

It took a long time to get my medications right. I have variously been diagnosed with an anxiety disorder, bipolar disorder, depressive disorder---you name it. It takes constant vigilance to keep up with my sneaky serotonin levels. And-full disclosure-- there were years of dangerous substance abuse as I attempted to self-medicate my symptoms.

Nothing happens overnight. Initially the meds Dr. Robertshaw prescribed did dull my affect, making it harder for me to feel things. Initially they made me sleepy and took away my libido. We added and subtracted meds from my mix until we came up with the right "cocktail" for me. I think it took about nine months. It took patience.

And so, spurred on by the recent and senseless death of one of our most brilliant and beloved artists, I offer these words to you, my fellow players:

If, like so many of us, you have been suffering this horror in secret and in silence, in the fear that medication will deaden your feelings, I hope these words might encourage you to avail yourself of the nearly miraculous treatment now available to you. We live in an extraordinary era-the first era in which the illness that took the lives of Virginia Woolf, Vincent Van Gogh, Sylvia Plath, Mark Rothko, Ann Sexton, Robin Williams, Kate Spade and Anthony Bourdain---among so many others--can actually be treated. I hope you will reach out, ask for help, tell your story and join us again in the light.

Maybe you needed to hear it from an actor.

Page is currently starring on Broadway in Saint Joan. His other Broadway credits include: Casa Valentina, A Time to Kill, Cyrano de Bergerac, Spider-Man: Turn off the Dark, A Man for All Seasons, Julius Caesar, The Lion King, The Grinch, Beauty and the Beast, The Kentucky Cycle. New York: Hadestown (NYTW), Cymbeline (Central Park), The Sound of Music (Carnegie Hall), Coriolanus (Red Bull). Regional: 30 years including Associate Artist of The Old Globe and Shakespeare Theatre Company, D.C. TV: "NCIS: New Orleans," "Elementary," "Madam Secretary," "The Good Wife," "The Blacklist," "Chicago P.D.," "Flesh and Bone," "Law & Order: SVU," etc. patrickpageonline.com

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