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Grief and Depression

Grief and depression may look and feel the same, but there are some important distinctions.

“Losing Love is Like a Window in Your Heart.  Everybody Sees You’re Blown Apart. Everybody Sees the Wind Blow”

This line is from one of my favorite songs by Paul Simon.  This line of the song Graceland to me paints the picture of grief and the bereaved.

In psychiatry, we seek to distinguish grief from depression, when to consider medication or not.  Responses to a significant loss may include the feelings of intense sadness, rumination about the loss, insomnia, poor appetite, and weight loss; these symptoms look like a depressive episode.  But these feelings are understandable and appropriate. The American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders (DSM-5) talks about differentiating grief from depression in the below synopsis.

Grief

Grief has feelings of emptiness and loss; the sadness is likely to decrease in intensity over weeks, and it comes and goes in waves.  The waves or “pangs of grief” come in the context of remembering those we lost. Grief may also have some positive emotions or humorous reminders, glimpses of happiness.  In grief, the bereaved person’s self-esteem stays the same. People who are grieving may think of their own death in the thought to join the ones they lost, but without a plan.

Depression

Depression is different in that there persistent and worsening feelings of sadness; it may come with and without any reminders or stressors.  Depression may make people feel self-critical, pessimistic, and they may lose self-esteem. With depression, there may be thoughts of death due to feeling worthless, unable to cope, or feeling undeserving.

For You

Both grief and depression respond well to therapy or counseling.  Some people use medications, but I believe it is important not to numb the grief process with drugs.  The feelings of grief are necessary for healing.

These are some techniques I have learned from others in my own grief journeys:

  • Giving the grief some attention. Spend time remembering your person, even if it is only a half-hour.  When we try to ignore the grief entirely, it can cause anxiety, insomnia, and unease.
  • Journal. Journal, draw, write down things you want to remember about your person; they may be silly things, little fights, great vacations, smells, sights, or anything that moves you.
  • You can’t hurry grief. Grief comes in its own time.  There is no magic timeline when one should get over it.  It is something you go through but not get over.
  • Grief is a tribute. Grief is a painfully beautiful tribute to the one you loved so deeply.  The deeper the love, the longer and more painful is the pain of grief.

I hope this helps you in your hard time.  This posting is a tribute to my dad, to my father-in-law, and my friends Danae and Carolyn.  It comes from my own experiences with loss and also the hundreds of families I spent time with through my years as a hospice nurse.  If there is something that helped you during your time, please feel free to share. This journey is unique to each person.

I wish you well in your mental health. ~Allison Sikorsky