One of the most difficult features of aging is the loss of those we love. If we live long enough, the loss of people we know and who have been close to us is bound to happen. Grief is the natural response to loss and can be a very difficult and often lonely journey. Grief is typically layered with a range of emotions including shock, rage, deep sadness, irritability and even anxiety.
Eventually there is peace, loving memory and acceptance. Grief is often accompanied by very real physical symptoms as well, including sheer exhaustion, lack of appetite, and sleeplessness. The “work” of grieving is the process of adjusting to the loss of a significant person in one’s life.
Every individual’s pathway is different, and although many experts have described a variety of “expected” feelings and “stages” one might experience when grieving a loved one, they agree that there is no one pathway, timeline, or order of events for adjusting to the loss of a loved one. It is, however, generally accepted that healing comes only through experiencing the sadness, pain and other emotions of loss.
What if pain and sadness seem to go beyond “normal” grief? There are significant differences between grief and clinical depression, and if you or a friend or family member are grieving, it’s important to look out for these differences and seek help if there is concern that what may have started as grief is something more. Unlike grief, clinical depression is recognized as an illness with a biological basis that can be exacerbated by psychological and social stress.
First, what are some similarities between grief and clinical depression? Both may bring feelings of deep sadness and affect mood. Both may bring lack of interest in typically pleasurable activities. Both may cause problems sleeping (either over-sleeping or insomnia) and changes in appetite, as noted above.
The main difference is that clinical depression affects mood and how we think about ourselves. It brings a generalized sense of low self-worth and hopelessness that is not typically part of grief, or if it is, that aspect doesn't last very long.
Another important difference is that clinical depression does not always include deep sadness. For some who are depressed, the feelings may be described as “tamped” down or flat, which can be evidence they have lost interest or pleasure in life generally. Finally, a person who is clinically depressed also has trouble with day-to-day functioning.
Again, all of these things may also be experienced while grieving, but the difference is that the feelings and impact don’t tend to last as long with grief. Grief softens over time, while clinical depression persists.
As a social worker who counsels individuals and families through life transitions, here are a few things to check if you or someone you love might be struggling beyond grief: 1) Notice general hopelessness and how long those feelings continue, 2) Notice whether you or a person you love seem not to be taking care of day-to-day functioning (eating, sleeping, washing, working, cleaning, etc.) in a way that is different from usual, and for how long, and 3) Reach out for help! Here are a few resources for help with depression:
The Crisis Help Line - call or text 988;
The Friendship Line - call 1-888-670-1360;
Mental Health America provides links to many different types of resources: https://mhanational.org/crisisresources.
Note that those experiencing “normal” grieving can also benefit from additional support; two helpful resources for bereavement support are Kaiser Bereavement Services and California Hospice and Palliative Care Association.
In any case, if you notice any of the above or have a question about your feelings, talk with your primary care provider and seek professional help.
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