Debbie Voll knows severe depression well, the kind that drove beloved actor and comedian Robin Williams to take his own life this week.
By the time she was in her 30s, Voll had been hospitalized twice for cutting and purging and had made multiple suicide attempts.
"The agony he went through, tormenting himself like that, it's a two-headed beast," said Voll, now 57 and living in Kentucky. "It brings up the demons in all of us who suffer from depression."
But the news, tributes and Internet chatter about Williams have also created an opportunity for people to open up about their own struggles — with many speaking out for the first time about depression to their friends and social networks.
"I have never talked about it. I have never said it out loud. I have never said how much suicide or depression has played a role in my life, and I thought it was time, it was time to just stop hiding," author Mary Curran Hackett, 38, told NBC News. "It affects so many people, people that you never thought it would happen to — somebody as wonderful as Robin Williams, if it can happen to him it can happen to anyone."
Each year, 38,000 Americans die by suicide, according to the National Institute of Mental Health — more than those who die by homicide. In fact, self-harm has been taking more lives annually around the world than war, murder and natural disasters combined.
Williams' death opened a new forum to open up about the disorder. Buzzfeed published a compilation of depression confessionals from its own staffers. Writer John Tabin took to Twitter to say he had attempted suicide five years ago, while Slate's David Weigel opened up about checking in to a mental hospital.
Gabrielle Manross-Mazzone, a young mother from Cotuit, Mass., said Williams' death allowed her to speak more openly about her bipolar disorder with other members of her moms Facebook group.
"I was kind of a closet case," she told NBC News. "My bipolar is mild... But there is such a stigma attached to it. And my family thinks I should just deal with it and not be on meds."
Voll had suffered sexual abuse as a child, a violent husband and found it difficult to raise her daughter. At one point, before getting professional help, she held a loaded gun to her head.
"You go through the tunnel and get to the light at the end, and now a superstar goes and hangs himself," she said. "A guy with all the money in the world who is loved and is now dead."
But, she said, Williams' public death "brings to the attention of the world that every Joe Schmo and Tom, Dick or Harry can have depression. It's not a nasty word."
"Stitches" author Anne Lamott's post on Facebook, which had more than 40,000 shares, resonated with patients and therapists alike — "Our brother Robin fell into [the abyss] yesterday. We are all staring at the abyss today."
"Her piece was particularly empathic," said Linda Hoff-Hagensick, a Chicago-based therapist who reposted Lamott's thoughts on her own Facebook page for her clients, some of whom suffer from depression.
Hoff-Hagensick, who worked with psychiatric patients for 13 years, said reaction to Williams' suicide is "individual."
"It's sort of like a Rorschach test — you project what you want on it," she told NBC News. "But it can be an opportunity, especially for family members who have lost someone to suicide, to relive it and reprocess it as part of their journey of healing."
"If someone is living on the edge and struggling with that impulse, I suppose it could be triggering to them," said Hoff-Hagensick. "But they are already there already struggling with that impulse."
Sometimes suicides can be "contagious," particularly among adolescents, she said.
"But we have no way of telling" if the death of Williams, whose films touched on multiple generations, will have that impact.
More often, it is mental health conditions that trigger a suicide attempt. Hoff-Hagensick advises those feeling like they are "on the edge" to "just talk about it, to anyone."
Nicole Cannon, 32 of Hoboken, N.J., copes with depression and told NBC News she had "mixed emotions" about the actor's suicide.
"On the one hand I see awareness being brought to this disease," said Cannon, an event planner and real estate agent. "On the other hand, there are still so many people and articles arguing that our country pushes antidepressants and maybe it was a side effect of the drugs."
"This infuriates me," she said. "And it also makes me feel like I'm doing some-thing wrong, because I need to be on medicine for my depression. … I think there is a real lack of understanding about the disease."
Hackett says when she attempted suicide in her 20s, alone on the floor of her apartment in Nebraska, she couldn't imagine that she would ever have another happy day and thought her friends and the world would be better off without her.
But now with a 14-year-old daughter and 8-year-old son, she can see how irrational that was. She says her daughter saved her life — showing her how much she mattered to someone else.
"I held my daughter and I was amazed because she is amazing and she still is, and my son is amazing and I found love and I found joy — the more I opened my heart and the more I gave, the more I got back," she said.
As for Voll, she said her depression was "paralyzing." She endured seven years of therapy, multiple medications, numerous hospitalizations and even electroshock therapy.
"I still have some mild depression, but I have found my light," she said. "There is hope."
Voll says those affected by the news of Williams' suicide should reach out to others.
"Find a close friend and talk to them," she said. "Find someone you can trust - a minister, a teacher, somebody who will listen. And start talking.
"Find someone who is not giving directions, but there for support. If you need to go to the hospital, they will do that. Don't be ashamed."
For help, contact the National Suicide Prevention Center Lifeline at 1-800-273-TALK (8255) or see this list of resources.