When Is Depression Not Depression? Part 4

You feel sad and the world seems without color or flavor. You do not see the point of getting out of bed, but you have felt like this for several days and there are things that need to be done, so you get moving. This feels a lot like a depression, but there is a good reason to feel this way: you are grieving.

When depression is grief, the feelings can be very similar, and can last for some time. Traci was only 23 when her mother rapidly died from a late stage ovarian cancer. Traci welled with unpredictable tears and found it hard to go to work after her 2 days off for the funeral. After a couple of weeks her doctor wanted to put her on antidepressants. Paul, on the other hand, was ready to jump into marriage with the love of his life when she said she could not do it, she took a job in another city and left home with no notice. He could not eat or sleep, lost 15 pounds in 2 weeks and alarmed his daughter who wanted him to get on medication that would ease his depressed mood. Kimberly went to work and went home and did nothing but sit on the couch, watching some TV, ordering pizza for dinner and spent hours looking at pictures and videos she had taken of her dog who had disappeared from the yard one recent morning.

The biggest, and most common cause of deep grief is losing a loved one: a parent, a spouse or worse, a child. But grieving at the loss of a pet who was part of family life and even grieving the loss through divorce of a relationship or a way of life that was valued, can throw a person into a depression-like state. These behaviors and moods all make sense when put into the context of loss, but in our culture there is tremendous impatience with grieving. It is too often labeled as depression, and too often medicated, thereby blunting the normal process of grieving that allows people to move forward.
There are important differences between depression and grief.

  • One obvious one is that the cause of the grief is a distinct and important loss, where depression may not have a distinct beginning.
  • Another is that even in grief people’s sadness can be interrupted by joyful moments. Just think of funerals or wakes you may have experienced when people vacillated between tears and laughter as they remembered stories and events from the life of the person who died.
  • We know that even when we are in grief, we can think of the future being less sad. We may not feel energy to move toward it at the moment, but we believe we will eventually feel less sad, less alone, less overwhelmed.
  • We also know that we can remember a loved person, pet or even life situation with joy once we are done grieving the loss.

Sometimes grief becomes complicated, and it looks even more like depression when the grieving person cannot get out of the pit of sadness, low motivation, and tearfulness. It seems that in this grieving, the person gets stuck in process of moving forward. Among the reasons for getting stuck is the idea that leaving behind the sadness is a betrayal of the relationship that ended. I recall working with Consuela, whose daughter died in a car accident. It became apparent that she did not want to give up her grief because she felt it meant she would no longer love her daughter if she did not feel sad every day. Her grieving in some ways kept her close to her daughter. She warded off every attempt family and friends made to get her to move on, and it seemed as if she was in a deep depression, barely getting herself to work. She was refusing to eat meals with her husband, have a coffee date with a friend and she even got angry when told she would benefit if she got outside for a bike ride, saying, “How can I ride a bike when my daughter cannot?” No one understood she was using her grief to hold on to memory of her daughter or staying actively sad and tearful to demonstrate love. When she began to explain her fear of losing the close connection, we could then talk about other, less debilitating ways to remember and honor the daughter she lost.

The process of resolving grief includes knowing and acting on the following:

  1. You cannot get over grief without feeling it. This is not depression.
  2. Allow for the fact that grief comes in waves—a person may be knocked flat by a wave of grief after a day or several of feeling less sad. If you are grieving, expect that you will have moments, then hours, then days, then even weeks when you do not actively feel sad. You are not ‘relapsing’ to feel keenly what you thought was past. Grief can be triggered by so many things that cross your attention – a song, a picture, a sweet smell in the air, even a specific time of year (first holidays without your loved one are especially evocative of grief) but it also passes quickly.
  3. Try to keep self care in place as much as possible so grief does not negatively affect your health. Lots of people lose weight or have trouble sleeping for a few weeks, but that should subside gradually and without professional help. It is quite common to need a sleep aid for a few or several nights, but once you get back in rhythm of sleep, sleep comes without help and it can become healing.
  4. Take on the changes in your living environment carefully and attentively. This means removing possessions with attention to what and how. A widow may find it fairly easy to clean out a closet of suits and donate them, but almost a impossible to remove the stack of magazines from the floor next to ‘his’ chair. Being attentive to how it feels to clean a room, sell a car, clean out desk drawers when someone you love is not in the house anymore can help you remember what is good and what is lost in a way that helps you hold on to the good memories.
  5. Plan how to remember the lost love, appropriate to the relationship, and plan when to remember them. For example, Consuela eventually decided she needed to write her daughter a letter, expressing all of her feelings about how she died, and then she went to the gravesite to read it. After that she decided she would visit the grave on her daughter’s birthday and on New Year’s day but no longer would she stop every day she drove past the cemetery. Traci bought new hymnals for her church and inscribed them, donated in memory of her mother. People can find many opportunities to memorialize a loved person, such as donating bricks in a walk or benches in a park or like many organizations, put up a picture and plaque honoring the founder of their group.
  6. Find a productive effort you can make to respond to the loss. Consuela founded a cheerleading camp scholarship in her daughter’s name at her high school. Marie decided to walk dogs for the humane society after the death of her beloved pet. Many fund-raising and awareness-raising organizations have started from using productive work to move beyond grief, such as cancer support walks, mothers against drunk driving, efforts to locate missing children, and even new legislation.

Grief is a lot like depression, and while the loss is permanent, the deflated feeling is not. Moving on can be the best way to remember what is lost with joy.