Saturday, July 14, 2007

Is it Grief or Depression?

By Jo Winkowitsch

When our daughter died of cancer, we were of course sad. I began my journey through grief thinking I would feel better as time went on. But after about six months, my grief became a deep hole I wondered if I would ever climb out of. What I thought was probably normal grief became a constant, dark, heavy blanket I felt covered by. I became more and more weary of living. Finally, a wise person suggested that I might be depressed, and I sought help. Eventually my life became one I could enjoy again. But it took time and effort.

Through my experience I came to see that it can be challenging to distinguish between depression and grief. Many of the traditional signs of depression are also present in those who are grieving. This article will attempt to point out some of the similarities and differences. Perhaps it will help you or someone you love.

Grief is a very real and painful experience. It is the price we pay for having loved someone. It is extremely complex, consisting often of sadness, anxiety, fear, doubt, guilt, loneliness, helplessness, and despair. A griever can experience sleeplessness, loss of appetite, an inability to concentrate, and extreme physical weariness or exhaustion. Grief can be understood as the physical, emotional, social, spiritual, behavioral and intellectual changes that occur in response to a loss.

Symptoms of Grief: Symptoms may include any or all of the following: * Unintended weight loss or gain of 10 or more pounds * Ineffectiveness at work or thinking * Inability to function well * Loss of interest in things that previously interested you * Feelings of worthlessness or hopelessness * Insomnia * Obsessive thoughts about death or suicide * Hallucinations Symptoms of Depression: If any of these or other disturbing symptoms persist constantly for several weeks, you may be developing clinical depression. Often it is helpful to speak with a pastor or friend or grief counselor about what you are feeling. Sometimes it is necessary to intervene with medicine, due to the intensity of the symptoms.

Grief changes. In most cases, people progress through the symptoms of grief, and these symptoms slowly diminish over time. People may periodically experience intense times of grief (an acute grief reaction), but the overall intensity wanes. Grief is often experienced in waves, which is usually in response to a specific loss. New waves of grief may be predictably triggered in response to recognizing a new loss or part to your grief, or unpredictably triggered by incidents that happen (for example, hearing a treasured song or noticing a stranger's resemblance to a loved one). The ability to feel pleasure is not lost in persons who are grieving. Most will still look forward to special occasions and visits from family and friends. Depression often causes a stuck state. It can become pathological. There are persistent grief symptoms that don’t go away, covering all aspects of a person’s life. This is characteristic of what depression is. A depressed person often loses all joy in living, and loses hope that they might ever enjoy life fully again. Seek immediate help if you or someone you know is talking about committing suicide, homicide, or is engaging in another destructive behavior.

Social Interactions when in Grief: People who are grieving often need social interaction to help them through the grieving process. Social support enables patients to tolerate the pain of loss while providing the necessary assistance for feeling and talking about their grief. Social Interactions when Depressed: People who are depressed often do not derive pleasure or solace from social interaction and may appear isolated and withdrawn. While temporary social withdrawal might serve a purpose in the grieving process (as in taking time to review life and consider choices), it contributes to a worsening spiral of isolation and depressed mood in persons who are depressed.

Agitation with Grief: Persons who are grieving may be agitated during the early stages but usually respond to support and counseling. Agitation and overreaction often diminish or resolve with time as grief is dealt with. Agitation with Depression: When agitation is present in persons with depression, it may persist without much response to supportive measures. Overreaction can become even more extreme over time, often with little provocation.

Grief and depression, as distinct but related processes, can result in intense suffering. Fortunately, much can be done to help people deal with grief and depression. Grief can be supported and facilitated, and depression can be treated. Whether grief or depression, it is important to work on the causes or underlying issues, and not just the symptoms you are experiencing. But recognizing and knowing the reactions to grief and their duration can help you to know what kind of help you need.