Jim Gaffigan, comedian, writer and actor, worries about his health. "I want to lose weight. I figure ... [+] I have a good seven to ten years of performing at the present level." (Photo by Chris Pizzello/Invision/AP)

Okay, I confess. I went for a provocative title. Are comics infected with the bubonic plague? Nope. Are they dropping like flies? Of course not. However, it may be tempting to think this way because a tragically large number of beloved comedic talents have died suddenly and prematurely: John Candy, Bill Hicks, Freddy Prinze, Patrice ONeal and many others.

After interviewing several stand-up comics, comedic actors and writers during the New York Comedy Festival (which wrapped up November 10, 2019), I have a better understanding of the highly atypical lifestyle led by these immensely talented individuals, the wide range of health issues they face, and the role of medical professionals in addressing their medical and mental health concerns.

There is a thin line that separates laughter and pain, comedy and tragedy, humor and hurt.

The plethora of headlines reporting yet another comedians death at the hands of drugs or suicide tempts us to believe that addiction and mental illness are epidemics within the comedy world. Lenny Bruce, Jim Belushi, Chris Farley, Greg Giraldo, Mitch Hedberg and Robin Williams are just a few in a long list of funny folks who have all sadly succumbed to drug overdose, depression and suicide. In fact, the high number of premature deaths prompted the Laugh Factory in Hollywood to hire an on-site psychologist. To get more clarity on this issue, I posed a series of questions to several comedians.

Why do so many comedians experience addiction and mental illness?

This is nothing new, according to comic superstar Jim Gaffigan. There is nothing normal about going onstage and making a crowd of strangers laugh. The Pale Tourist comic compared comedy to addiction: Stand-up is an endorphin rush probably similar to a drug. Its also a strange combination of control (you have a mic) and no control (the reaction of the audience).

Comedian and breast cancer survivor Jenny Saldana.

Stand-up comedian Jenny Saldana: Its really hard to be ON all the time. The breast cancer survivor and patient advocate explained, We struggle with our onstage persona and our personal lives. Combine these issues with access to drugs in the late-night scene, says Saldana, and addiction lurks around the corner.

According to comedian Jim Mendrinos, there are plenty of risk factors: Isolation, long periods of traveling without a support system, and crazy-easy access to drugs and booze. The Gotham TV Writing instructor added, As with all true artists, we feel too much. Most comics I know suffer from some type of depression.

Comedian Jim Mendrinos has experienced multiple health issues including concussions and facial ... [+] surgery.

If youve experienced addiction or mental illness, what kind of treatment did you receive? How did you achieve recovery? If you havent, how did you avoid both conditions?

Pakistani-American comedian Mona Shaikh is well aware of the connection between trauma and addiction. The comedy community has a lot of trauma and pain. A survivor of significant verbal and physical abuse that led to suicidal thoughts, Ms. Shaikh is crystal clear about her recovery: Therapy singlehandedly saved my life. She also finds comedythe love of my lifevery empowering as it allows her to share her pain and trauma.

Comedian and event emcee Mona Shaikh speaks at the Women's March, San Francisco. Abused by her ... [+] father, brother and ex-husband, Shaikh uses comedy to share her trauma, pain and resilience. (Photo by Kelly Sullivan/Getty Images)

Therapy was a recurring theme. According to Gaffigan, therapy helped a lot. Comedians, like most humans, have demons. He added, my wife [and writing partner, Jeannie Gaffigan] has been invaluable in keeping me grounded.

The tragedy of life is what dies inside a man while he lives.

Comedy Cellar regular, Ian Fidance, credits medications and counseling to his long-term recovery from alcohol use disorder. Naltrexone saved my life. He also praised the Greenwich House for providing him with much-needed care. Fidancelike many people with addictionfaced tremendous stigma: I had to divorce myself from the moral-failing paradigm.

Stand-up comic Ian Fidance takes part in SiriusXM host Ron Bennington's annual Thanksgiving Special ... [+] at the Hard Rock Cafe in New York City. (Photo by Cindy Ord/Getty Images for SiriusXM)

What health issues do comedians worry about?

Alas, comedians are people, too. And just like all of us, they experience a wide range of health issues beyond anxiety and drugs.

Jeannie Gaffigan, writer and executive producer of The Jim Gaffigan Show, cited poor diet and lack of sleep affecting her husband. For an internationally touring comedian, waking up at the same time every morning is impossible. As a television writer, she would be awake until 3 a.m., order Indian food. Then during the day, the mother of five young children would receive calls from school about a childs strep throat. Its a manic existence.

Ms. Gaffigan, author of the recently released memoir, When Life Gives You Pears: The Healing Power of Family, Faith, and Funny People, shared her life-altering journey with a pear-size brain tumor, followed by intubations, infections and vocal cord dysfunction. So how, if at all, did this major neurosurgical health problem impact her life, including comedy writing? It made me bolder. She publicly discusses J-tubes, PEG tubes, colonoscopies and other humiliating topics that arent exactly dinner conversation. The comedic power couple documented their post-hospitalization dietary ritual in a very funny and candid YouTube series, Feeding Frenzy.

NEW YORK, NY: Jeannie Gaffigan and Jim Gaffigan visit SiriusXM Townhall at SiriusXM Studio on June ... [+] 28, 2016, in New York City. (Photo by Robin Marchant/Getty Images)

Many other health issues impact comedians. Stacy Kendro worries about back and neck pain as well as migraines. But lack of health coverage can be a barrier. Im mostly part-time with comedy and need to pay cash out of pocket. Ms. Saldana agreed: Most comedians dont access health care and go a long time without seeing a medical professional.

What would you like medical professionals to know? How can we better serve the comedy community?

Ms. Kendro: I would go to a therapist if I could afford one. Health insurance needs to be accessible to performers, especially those in the trenches, on the road, working clubs.

Mr. Mendrinos: Artists need help. We often dont have access to health insurance. I know five comics who have died by suicide. We tend to self-medicate with drugs and comedy.

Ms. Gaffigan: Doctors need to be creative in their advice. Tailor it to the comedians late-night work hours and travel schedule.

Ms. Saldana: I guarantee that if doctors started a free clinic at a comedy club, offering flu shots, STD screening and basic counseling, theyd be overbooked in minutes.

Comedian Stacy Kendro feels that "real comedy comes from pain." The funniest people she's ever known ... [+] "were the most emotionally fraught."

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Personally, I always found laughter to be therapeuticwell before I became a physician. From a young age, I gravitated toward funny films and television sitcoms. I cherishedin fact, enviedmy friends who had a natural ability to make others laugh. Years later, I became an avid fan of stand-up comedy. To this day, I have tremendous admiration for any person who courageously stands alone on stage and makes complete strangers laugh. A unique skill set I will never possess.

It turns out that comedians provide a genuinely therapeutic skilla reality that Im sure many comics discovered at least intuitively at a young age. Evidence shows that laughter has many short- and long-term health benefits. According to the Mayo Clinic, laughter acutely stimulates our heart, lungs and other organs by increasing oxygen intake; it also activates the brain to release endorphins (the happy hormone); and relieves tension by relaxing our muscles. In the long term, laughter can improve our immune system, which fights infections and illnesses; reduce pain; and improve mood.

Women enjoy a laughter yoga session at a laughing club in Kolkata, India. Laughter yoga helps to ... [+] increase happiness, but it also strengthens the immune system, reduces pain and lowers stress. (Photo by Avijit Ghosh/SOPA Images/LightRocket via Getty Images)

Substance abuse and mental illness are clearly underaddressed in the comedy community, not unlike the general population. The way to tackle this? I will reiterate Mr. Fidances remark: We need to reduce the stigma faced by people with addiction and mental illness. Globally, both remain THE most stigmatized social problems, according to the World Health Organization. A key way to decrease stigma is through widespread education. Addiction and mental illness are chronic illnesses of the brain, NOT signs of moral weakness or failure. Treatment like medications and behavioral therapies existand work! But health care access needs to be widely accessible. Perhaps comedians should have a union, as suggested by Ms. Kendro. Maybe comedy clubs could partner with local hospitals or clinics and offer basic health services. We need to be innovative.

The comedy and addiction medicine worlds taught me a key lesson: the importance of community. A common mantra in my line of work is The opposite of addiction isnt sobriety, its connection. The Gaffigans feeding tube videos led to an outpouring of stories. Pain and suffering are universal. People connect with openness and authenticity. On that note, I am deeply grateful to the comedians who have generously shared their stories. To every comedian out thereamateur and professionalyour humor is truly healing!

Read more:
If Laughter Is The Best Medicine, Why Are So Many Comedians In Poor Health? - Forbes

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