When Grief Becomes Depression

“Just as dying is an inevitable part of the cycle of life, bereavement is a necessary aspect of living,” says an article in Psychology Today.[1] However, depression is not the same as grief and may arise as a response to the changes that follow the loss of someone or something. Understanding how depression and grief differ is important as families cope with life changes.

Many Life Changes Bring Grief

Losses include any life-changing event. Death and divorce are more obvious. However, losing a home can be devastating. Loss through fire, tornado or hurricane might seem more difficult, yet the loss of independence and the need to move into assisted living may be unexpectedly traumatic. The death of a pet can feel like the loss of a family member. In all these situations, expect a time of bereavement.

Recognize there is no absolute time line where you can say, “This is a healthy grieving process and that isn’t.” The length of time it takes to work through grief to a place where life begins to feel ‘normal’ again depends on many factors.

  • How close was the loss?
  • Were issues in the relationship unresolved?
  • What role was played post-loss?
  • Was grief addressed or avoided?

Each person is different. Dealing with emotions is more of a struggle for some people than others. Thus it can be helpful to understand the grieving process in the context of the person.

Grief Has Stages

Grief is a healthy and natural response to any life change. It is normal to react initially with denial or to feel nothing at all. If our brains didn’t create one of these sheltering cocoons around our emotions, it would be extremely difficult to move through the essential functions often demanded of survivors. Selling a home to move into an assisted living community and choosing what to keep and what to sell may not be as traumatic as making funeral arrangements or contacting family and gathering documents after a death, yet for some the transition is very distressing.

Even when the passing from one stage in life has been anticipated for some time, grief occurs. It may have taken months to reach a decision to jettison complete independence for assisted living. Cancer may have taken years to claim its victim. A loved one may have lingered for years following a stroke. Regardless of the time that has elapsed between recognition that a change is coming and its actual occurrence, grief will come. It is an essential part of moving on with life.

A healthy grieving process moves through several stages. Anger over the loss is common. Inventing scenarios that could have prevented the loss may occupy the thoughts continuously.

Efforts to rush the process rarely work. However, eventually the reality that life goes on is accepted. Interest in living renews.

For some, this may take as little as three months. For most it takes a year. And almost everyone relapses somewhat on anniversaries of key events such as weddings or birthdays. Sometimes, just hearing something may trigger a relapse in grief. It doesn’t matter that a total stranger has been diagnosed with cancer. It triggers a chain of associated emotions.

Such relapses should be short. If they aren’t, grief may have transitioned into depression or complicated grief (CG).

Depression Differs from Grief

There is a stage in the grieving process where the line between depression and grief are almost indistinguishable.[2] However, when grief doesn’t resolve into acceptance and re-engagement with life, it may mean complicated grief (CG), also known as ‘persistent complex bereavement disorder,’ may be in play. Treatment should be considered.

According to HealthLine, “Doctors once avoided giving treatment to people who were grieving. Grief has long been considered a personal, non-medical struggle. However, new evidence shows that CG can make you feel worthless and suicidal, which is similar to depression.” [3]

Major depression involves thoughts of “worthlessness, exaggerated guilt, suicidal thoughts, low self-esteem, powerlessness, helplessness, agitation, loss of interest in pleasurable activities and exaggerated fatigue.”[4]

While CG doesn’t always arise from the same brain chemistry as depression, similar treatments may be beneficial. For example, complicated grief therapy (CGT) uses techniques such as telling the story about the loss repeatedly, setting personal goals and building personal relationships to help restore an interest in living.[5] Cognitive behavioral therapy (CBT) emphasizes evaluating the truthfulness of self-talk and replacing unproductive thinking patterns with positive ones. Exercise, a healthy diet and social activities can also help restore a healthier brain chemistry.

A grieving person usually finds comfort in warm memories. They are sad, yet they comfort themselves in their sorrow.[6]

Depressed people fail to compensate for loss in this way. Instead they may turn “their energy into attacking the self rather than integrating” the memories. If you suspect this is happening, seek help.[7] Enjoying life again is important.

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[1] https://www.psychologytoday.com/blog/the-new-grief/201203/when-does-grief-become-depression

[2] http://www.webmd.com/depression/guide/depression-grief?page=2

[3] http://www.healthline.com/health/depression/complicated-grief#Overview1

[4] https://www.mentalhelp.net/blogs/the-difference-between-grief-and-depression-the-dsm-v/

[5] http://www.healthline.com/health/depression/complicated-grief#Overview1

[6] https://www.mentalhelp.net/blogs/the-difference-between-grief-and-depression-the-dsm-v/

[7] Ibid.