Mary Ellen Kelly
Dublin, Ireland

When the death of Robin Williams was announced on August 12, 2014, the world shed a tear. The passing of the acclaimed and adored actor came as a shock to many, the announcement by the Marin County sheriff’s office having specified that the cause of death was suicide and that Mr. Williams had been receiving treatment for depression.¹

It would not have been a wild presumption to view his suicide as due to depression, but a postmortem examination found another contributing cause, namely Lewy body dementia.

There are currently over one million Americans suffering from this incurable disease. Men, in particular those over fifty, are at higher risk of developing this condition. Aged 63 at the time of his death, Williams, in his autopsy, was found to have abnormal deposits of alpha-synuclein (or Lewy bodies) in his neurons; he had unknowingly been suffering from LBD.

The disease’s symptoms are mediated by the alpha-synuclein deposit driven destruction of neurons, affecting neurotransmissions of acetylcholine (ACh), the most common neurotransmitter in the peripheral nervous system. ACh is crucial in the regulation of muscle contraction, and as such heart rate, and glandular secretions. Further, ACh plays an important role in learning and memory. The disease-mediated neuronal destruction also disrupts other neurotransmitters such as dopamine, which regulates mood, motivation, and cognition and has a role in the management of sleep and movement.

The dysregulation of these neurotransmitters leads to devastating symptoms such as hallucinations, disturbance of sleep (enactment of dreams) and mood symptoms (anxiety, depression, and apathy). These symptoms are particularly common in the early stages of the disease. As the disease progresses, motor symptoms become more pronounced, the sufferer can become paranoid, function and cognition decline, and Capgras syndrome (belief that a loved one has been replaced by an imposter) is also common. In the late stages, the patient can experience psychosis, dysphagia, and aphasia.²

When undiagnosed or misdiagnosed, which is often the case, as symptoms resemble those seen in Parkinson’s disease (which Mr. Williams had been incorrectly diagnosed with³), Alzheimer’s disease, or depression, these symptoms can leave the suffering feeling as if they are going crazy.

It is important to learn from the tragic death of Robin Williams and use it to increase public awareness of Lewy body dementia, which accounts for up to 20% of cases of dementia.⁴ Fewer diagnostic errors will allow patients to receive prompt support and treatment.

“Everyone you meet is fighting a battle you know nothing about. Be kind. Always.” —Robin Williams

May he rest in peace.

References

1. Coroner’s Division MCSO. Robin Williams Press Conference Prepared Statement, 2014. Accessed January 3, 2026. https://nxstrib-com.go-vip.net/wp-content/uploads/sites/3/2014/08/marincounty.pdf
2. Stroshane L. Behavior and Mood symptoms in Lewy Body dementia. Stanford PD Community. Published April 10, 2020. https://parkinsonsblog.stanford.edu/2020/04/behavior-and-mood-symptoms-in-lewy-body-dementia-webinar-notes/
3. Siqueira Tosin MH de, Cruz Mecone CA da. Parkinson’s disease: if you can’t change the outcome how can you qualify the journey? Hospice and Palliative Medicine International Journal. 2018;2(2). doi:https://doi.org/10.15406/hpmij.2018.02.00066
4. Hanson JC, Lippa CF. Chapter 11 Lewy Body Dementia. International Review of Neurobiology. 2009;84:215-228. doi:https://doi.org/10.1016/s0074-7742(09)00411-5