What Anthony Bourdain and Kate Spate Can Teach Us About Mental Health

The recent back-to-back suicides of celebrity chef-CNN personality-bestselling author Anthony Bourdain and prominent fashion designer and businesswoman Kate Spade shocked millions of fans, and for many, raised a question: Why would someone who's attained enormous professional and financial success and seemingly physically healthy kill himself or herself?

Spade, 55, killed herself on June 5 in her home in New York City. Bourdain, 61, took his life on June 8 in a hotel room in France. In a grim coincidence, Bourdain and Spade committed suicide the same week the Centers for Disease Control and Prevention released statistics showing suicide rates are rising across the United States. In 2016, nearly 45,000 people in the U.S. died by suicide. Between 1999 and 2016, suicide rates rose in nearly every state, CDC figures show.

The deaths of Bourdain and Spade illustrate how attaining tremendous professional success doesn't shield someone from depression and suicide, experts (none of whom treated either person) say. "It's a total misconception that success and wealth preclude people from being depressed or having suicidal thoughts," says Dr. Charles Sophy, an osteopathic psychiatrist in private practice and medical director for Los Angeles County Department of Children and Family Services. "Money can't buy health or happiness. It is an innate state of being that has to be attained through having experienced great parenting and the hard work of getting to know yourself, by identifying and working through your issues."

[See: 4 Subtle Signs of Depression in Men.]

In fact, the traits that helped Bourdain and Spade become high achievers -- the drive to succeed, the zeal to make sacrifices to further their respective careers and the willingness to endure public scrutiny -- may have exacerbated whatever mental health issues they were grappling with, says Jonathan Alpert, a psychotherapist in New York City and the author of "Be Fearless: Change Your Life in 28 Days." In his private practice, Alpert says he's worked with many depressed clients with careers in the fashion industry. These patients dealt with the anxiety of trying to succeed in a highly competitive field. "Entertainers and creative types, like Spade and Bourdain, tend to impose lots of pressure on themselves to perform and do well," Alpert says. "People can be their own worst enemies with their perfectionism. Entertainers and people in the public eye may feel greater anxiety, because they have the added pressure of trying to please the public. You're only as good as your last performance, review or earnings report. That can lead to burnout, stress, feelings of failure and depression." Research has linked maladaptive perfectionism, which involves having high performance standards and a tendency toward self-criticism, concerns about being evaluated negatively by others and worries about making mistakes, to depressive symptoms, according to a study published in February in the journal PLOS One. In the study, researchers provided questionnaires to more than 500 Australian adolescents and more than 500 adults. Based on the participants' responses, with both groups, researchers found a strong relationship between maladaptive perfectionism and depression.

The willingness to put in the hard work to become successful in one's career can lead to another drawback, Alpert says: loneliness. "These people didn't get where they are by being lazy," he says. "A lot of highly successful people are type A personalities, they work 12 to 18 hours a day, with a pedal-to-the-metal approach. But the path to success can be a lonely one. People who work that hard can make a lot of sacrifices along the way, losing romantic relationships or friendships. It doesn't set one up for a good work-life balance." Celebrities often feed off the adulation of fans, but that acclaim can be fleeting and illusory. A performer or fashion celebrity might have millions of fans or Instagram followers, but those people aren't real friends, he says. Receiving acclaim from fans can feel like a high, but that can lead to lows of depression and loneliness. A raft of research suggests loneliness is closely linked to depression. For example, a study published in April in the journal Psychological Medicine suggests that lonely young adults in England are more likely to experience mental health problems and be out of work than their peers. Researchers surveyed more than 2,000 British 18-year-olds and learned that 25 percent of them reported feeling lonely some of the time. Lonely young adults were more than twice as likely to suffer from depression, anxiety and other mental health problems and to have attempted self-harm or attempted suicide, the research from King's College London showed.

Being the object of adulation can have another downside, adds Katie Hurley, a child and adolescent psychotherapist based in Los Angeles. "We put some people, like actors, musicians and fashion designers, on a pedestal," she says. "How hard must it be for them to acknowledge they feel depressed and need help?"

For all their achievements, Bourdain and Spade had both struggled with serious life issues. In interviews, Bourdain had openly talked about his past struggles with heroin addiction and his use of other drugs, such as cocaine, marijuana, LSD and quaaludes. He said he stopped using heroin in the 1980s. The celebrity chef had also known heartache and joy in his personal life, going through two divorces and fathering a daughter, who's now 11. In 2016, Bourdain began dating Italian actress Asia Argento; he publicly praised her in 2017 for having the courage to speak out against Hollywood film producer Harvey Weinstein, whom she accused of sexually assaulting her.

[See: 7 Ways to Build Resilience for Crises and Everyday Life Challenges.]

Spade worked as a fashion magazine editor before launching her brand in 1993, which didn't turn a profit for three years. In 1999, the Nieman Marcus Group purchased 56 percent of the brand, for more than $30 million. Her collection grew into an international brand worth $2.4 billion, Forbes magazine reported. After her death, Spade's husband and business partner, Andy Spade, released a statement revealing Kate had suffered from depression and anxiety for years, and was taking medication for both conditions. "She was actively seeking help and working closely with her doctors to treat her disease, one that takes far too many lives," the statement said. He wrote that "there was no indication and no warning she would do this."

Certain aspects of Bourdain's and Spade's respective lives -- like the ability to obtain high-quality medical care -- may have been easier because they had ample financial resources, but that didn't give them a pass from suffering from a mood disorder, says Dr. Madhukar Trivedi, the director of the Center for Depression Research and Clinical Care at UT Southwestern Medical Center in Dallas. Depression is a brain disorder that cuts across social, ethnic and racial lines, he says. "We see it in the rich, the poor and people in the middle," Trivedi says. "This is a brain disorder that can cause people to have depressive episodes, during which the patient's brain circuits aren't functioning properly."

During depressive episodes, which can last for months, people can feel deep sadness and a sense of hopelessness, Trivedi says. "Some people describe it as having a persistent cloud over their heads." These thoughts and feelings can lead to suicidal ideas. "Just because you're wealthy doesn't protect you from suicidal thoughts; the same as being in overall good health doesn't necessarily protect you from heart disease," Trivedi says. In that regard, depression is similar to substance use disorder or any other chronic illness, he notes, in that some highly accomplished people can struggle with an addiction to alcohol or drugs like opioids or experience a medical condition.

Grappling with a substance use disorder or other social determinants of health -- such as poverty, unemployment, unstable housing and suffering from multiple traumas, can increase the odds of a person becoming depressed and suicidal, says Dr. Paula G. Panzer, chief clinical and medical officer at the Jewish Board of Family and Children's Services in New York City. Doing well professionally and financially may protect you from some of these challenges, but they don't guarantee good emotional health, she says. It's important to keep in mind that achieving certain goals doesn't hold the same meaning for everyone. "We make a lot of assumptions and draw conclusions about the attainment of wealth or acclaim," she says. "We assume if I could be rich, famous, married or whatever, then all our problems would go away. It doesn't work like that."

[See: 11 Simple, Proven Ways to Optimize Your Mental Health.]

Another factor that could make individuals vulnerable to depression and suicide, regardless of their career achievements and financial status, is their family history, says Camilla Nonterah, an assistant professor of health psychology in the department of psychology at the University of Richmond. "Genes play a role -- your susceptibility to depression increases when you share genes with a family member, such as a biological parent, with a history of depression," she says.

Ruben Castaneda is a Health & Wellness reporter at U.S. News. He previously covered the crime beat in Washington, D.C. and state and federal courts in suburban Maryland, and he's the author of the book "S Street Rising: Crack, Murder and Redemption in D.C." You can follow him on Twitter, connect with him at LinkedIn or email him at rcastaneda@usnews.com.