Is It Depression or Grief?

Is It Depression or Grief?

Is It Depression or Grief?

By Kathryn Berlá, Ed.D.

Dear Dr. Berlá,

How do I know if I am experiencing normal grief rather than depression? — A.N., Louisville

Dear A.N.,

Grief is your emotional reaction to a significant loss. The words sorrow and heartache are often used to describe feelings of grief. Whether you lose a beloved person, animal, place, or object, or a valued way of life (such as your job, marriage, or good health), some level of grief will naturally follow. Grieving after a loved one''s death is also known as bereavement.

Anticipatory grief is grief that strikes in advance of an impending loss. You may feel anticipatory grief for a loved one who is sick and dying. Similarly, we often feel the pain of losses brought on by an upcoming move or divorce. This anticipatory grief helps us prepare for such losses. Grief is expressed physically, emotionally, socially, and spiritually.

  • Physical expressions of grief often include crying and sighing, headaches, loss of appetite, difficulty sleeping, weakness, fatigue, feelings of heaviness, aches, pains, and other stress-related ailments.
  • Emotional expressions of grief include feelings of sadness and yearning. However, feelings of worry, anxiety, frustration, anger, or guilt are also normal.
  • Social expressions of grief may include feeling detached from others, isolating yourself from social contact, and behaving in ways that are not normal for you.
  • Spiritual expressions of grief may include questioning the reason for your loss, the purpose of pain and suffering, the purpose of life, and the meaning of death. After a death, one''s grieving process is affected by how one view''s death.

Grieving is the process of emotional and life adjustment you go through after a loss and is a personal experience. Depending on who you are and the nature of your loss, your process of grieving will be different from another person''s experience. There is no "normal and expected" period of time for grieving. Some people adjust to a new life within several weeks or months. Others take a year or more, particularly when their daily life has been radically changed or their loss was traumatic and unexpected. How one expresses grief is influenced in part by the cultural, religious, and social rules of the community.

As a society, we end to underestimate the length of the grieving process, which is unfortunate. It seems there is cultural pressure to “get over it.” A recent poll showed that most Americans think it should only take a couple of weeks to get over the death of a loved one. The reality is that while many aspects of daily life can return to normal in a short amount of time, the real process of grieving is complicated and long.

A wide range of feelings and symptoms are common during grieving. While feeling shock, numbness, sadness, anger, guilt, anxiety, or fear, one may also find moments of relief, peace, or happiness. While grieving is not simply sadness, “the blues,” or depression, one may become depressed or overly anxious during the grieving process. Intense grief can bring on unusual experiences. After a death, one may have vivid dreams about the loved one, develop his or her behaviors or mannerisms, or see or hear the loved one

Although it may be possible to postpone grieving, it is not possible to avoid grieving altogether. If life circumstances make it difficult for one to stop, feel, and live through the grieving process, these individuals can expect grief to eventually erupt sometime in the future. In the meantime, unresolved grief can affect one''s quality of life and relationships with others.

Social support, good self-care, and the passage of time are usually the best medicine for grieving. However, if grief is making it difficult to function for more than a week or two, one should contact a grief counselor or bereavement support group for help. The clinical definition of bereavement is used when the focus of clinical treatment is an individual''s reaction to the death of a loved one. Symptoms similar to major depression are acknowledged, although are not regarded by the individual as being “abnormal” considering the circumstances. Often, the individual has sought treatment because of persistent sleeplessness or loss of appetite. While mental health professionals recognize that cultural issues influence the duration and expression of bereavement, it is generally not appropriate to assign a diagnosis of depression unless the symptoms are still present after two months. There are certain symptoms of depression that are not typical of bereavement and which may help distinguish between the two. They include (but are not limited to): guilt about things other than actions taken or not taken by the survivor at the time of the death; thoughts of death that are unrelated to a wish to have died with the deceased person; excessive preoccupation with worthlessness; marked psychomotor retardation; hallucinations unrelated to the sensations of hearing or seeing the deceased; and prolonged impairment of normal daily functioning.

If an individual experiences any of the above symptoms two months after the loss, they should be speaking with a medical or mental health professional. Adequate treatment can help speed recovery.

Kathryn Berlá, Ed.D. is a licensed psychologist in private practice in Louisville . She may be reached at 502-412-2226.

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