Stages of Grief: Depression

This is the fourth of five posts focused on “The Stages of Grief”. In this one, we will be looking at depression, which can create a great deal of confusion for grievers.

The problem for many of us who suffer a loss is that the majority of us have had little or no training of any value regarding how to handle grief. While we may have had a lifetime of experience with how to accumulate new things, we have very little education on how to deal with the emotions associated with loss. When we are suddenly faced with grief causing experience, we are lost.

Some friends will respond to grievers with cliché ridden advice about keeping busy or suggestions why they should not feel sad. These suggestions may seem logical, but grief is hardly logical. It is emotional. No amount of logic can truly overcome emotional pain.

Eventually, some well-meaning friend will mention the stages of grief, including the stage of depression, as a way of defining what a griever must experience. Most grievers are so desperate to feel better, that they never question the viability of this model as related to their particular situation. What they hear is that they must go through each step, in the order presented, to recover.

The first place most people depend on today when they discover that their friends’ suggestions on how to cope with their loss don't seem to make things better, is the Internet. Since most grievers suffer from a reduced sense of concentration, they are not looking for extensive studies, but rather short and simple answers.

If they search the word “depression” on the internet, one of the first things they will encounter is “clinical depression”. Grief is the normal and natural reaction to any change in our lives. It's a normal reaction, not a mental illness. However, the griever doesn 't understand this distinction and may self-diagnose themselves as clinically depressed on some level.

It's understandable that grievers don't understand the difference between true depression and the overwhelming feelings of loss associated with grief. They simply know that something is not “right”, and will often call their regular physician.

Sadly, while general practitioners and internists have extensive training in medical issues, most have very limited knowledge concerning grief and loss. It's highly likely that the stages of grief concepts were presented at some point in medical school, but it's equally likely that they never fully explored this subject unless they went on for advanced studies in psychiatry or mental health.

The symptoms of grief are similar to that of depression and other medical issues. Grievers have a reduced sense of concentration and often have trouble focusing, suffer sleep-related issues, find completing tasks difficult, and are easily upset. It's also common for them to self-identify as being depressive since they have been told by others that this is a “stage of grief”. Given the shortage of time most physicians face and the desire they have to treat what has been presented to them as a medical issue, it is not uncommon for them to prescribe a mood-altering medication.

Doctors may even prescribe antidepressants when they are fully aware of all of the details. These physicians are trying to help in the best way they know-how. Dealing with the intricacies of grief is not necessarily in their medical training. The problem comes in when they are treating the presenting symptoms, without dealing with the underlying issues of what is causing the pain of the emotional loss.

The emotional pain of any loss can be intense. Whether we try to deal with this pain by hiding our feelings or by medicating them, to make them less intense, still does nothing regarding processing them. At the end of the day, that pain is still there if we take no substantive action.

Telling a griever that, in the stages of grief, depression is a step that may or must be experienced, simply gives them a label for these feelings. It may not even be an accurate one. It does nothing to help them move beyond those feelings. It actually may serve as a stopping point to their moving forward since they can now just tell people that they are in a stage or state of depression, and since it was due to a loss, there is not a cure.

Grief is not, in and of itself, a medical condition. It cannot be cured in a medical sense. It can, however, be something through which we pass if we are willing to realize that it is directly related to the unfinished business with the relationship lost.

If the griever is willing to take action to identify this unfinished business, and take additional action to deal with that business, there is hope for a better and happier tomorrow. A permanent solution cannot be accomplished with a pat on the head or a pill, but rather requires honest work in dealing with these feelings in their rawest form.