Tag Archives: Death

Grief vs. Depression

Losing a loved one is a jarring and tragic experience. It brings on a period of grief and mourning filled with feelings of sadness, anxiety, guilt, and reliving of the past shared with the deceased going back years. People amid the mourning process have described such feelings as loss of appetite, nausea, tearfulness, restless sleep, guilt about not being able to prevent the death from having occurred, and deep feelings of sadness. Many have described the feelings of grief sweeping over them and then subsiding until the process starts again. 

Reliving and talking about the person who has died can come with laughter, as those grieving remember funny and warm times. However, there is now a controversy over whether grief differs from grieving?

Ultimately, the psychiatrist must use their judgment on whether the patient is grieving or having a major depressive episode. The American Psychiatric Association’s Diagnostic and Statistical Manual shows differences between grief and major depression. Let’s look at the differences and similarities in symptoms of grieving after a loss instead of Major-Depression.

Symptoms of Grief:

1. Sadness, despair, mourning

2. Fatigue or low energy

3. Tears

4. Loss of appetite

5. Poor sleep

6. Poor concentration

7. Happy and sad memories

8. Mild feelings of guilt

Gradually and after an undetermined time, these feelings remain as the individual regains equilibrium as they return to everyday life.

Many of these symptoms are similar to the feeling of people with Major-Depression. Still, significantly different symptoms are part of the profile.

Major Depression:

1. Worthlessness

2. Exaggerated guilt

3. Suicidal thoughts

4. Low self-esteem

5. Powerlessness

6. Helplessness

7. Agitation

8. Loss of interest in pleasurable activities

9. Exaggerated fatigue

In major depression, these feelings are ongoing and carry the real danger of suicide. Daily functioning at work and home is impaired, and the individual feels as if they will never climb out of these feelings.

An essential difference between grief and Major-Depression is that, in major depression, the feelings of loss of the loved one are compensated for by warm memories. One friend recently told me that his beloved childhood people are alive in him as beautiful memories.

The death of a loved one often results in feelings of emptiness. But, for those who suffer from depression, nothing, not even warm memories, compensates for the loss. Freud referred to this in his classic book, “Mourning and Melancholia,” in which he pointed out that the one who is depressed turns their energy into attacking the self rather than integrating loved ones who are now gone.

 Some people hold onto the mistaken belief that mourning last for two weeks. However, who is to say that it takes only two weeks to grieve? The time spent mourning a loved one varies according to each individual. The danger of a mistaken diagnosis is that a physician might prescribe antidepressant medication when none is needed. But, that is where the experience and expertise of the MD are essential. Ultimately, mourning runs its course and resolves itself.

 Of course, where someone has Majord-Depression and is also grieving, the grief process may be complicated by the fact of depression. It is also possible that, for some people, the death of a loved one can turn into a depression.

Diagnosing people with any mental illness is complicated and dangerous if the diagnosis is incorrect.

The reader needs to understand that psychotherapy is always available to help those individuals who are in pain. Help is available.

Contact Dr. Schwartz at dransphd@aol.com.

Please visit his website at http://www.allanschwartztherapy.net.

Pandemic, The Economy, War and Life and Death

Along with American citizens and people worldwide, I am extremely upset about the Pandemic, Ukraine, Russia, and the economy. 

 Many friends, family, and clients say that they believed the Pandemic was over. However, Russia invaded Ukraine, and anxiety rose once anxiety and worry rose again. If these events aren’t bad enough, we have been plagued by rising prices for everything from gasoline, building materials, and food, among many other essential items.

I was born in 1942, in the middle of WW 11. My grandfather’s youngest brother, Uncle Sam, served in and earned the Purple Heart in the first World War. My three uncles served in World War 2. Then, there was the war to establish the State of Israel. Next was the invasion of Israel, the Korean War, Vietnam, invasion of Iraq, Gulf War, and Afghanistan, and more minor wars were between these. And, evermore, nations are gaining nuclear weapons and missiles. In these wars, including the current war in Ukraine, all of us witness acts of destruction. The destruction includes human lives, cities, buildings, and all the things people take for granted in their daily lives.

The great psychoanalyst, Sigmund Freud, wrote about the issues surrounding war, life, and death after World War 1. 

Freud’s Theories of Life and Death Instincts

Sigmund Freud’s theory of drives developed throughout his life and work. He initially described a class of drives known as life instincts. He believed these drives handled much of our behavior.

Eventually, he believed that life instincts alone could not explain all human behavior. With his book Beyond the Pleasure Principle in 1920, Freud concluded all instincts fall into two major classes: life drives or death drives.

The Life Drive (Eros)

Sometimes referred to as sexual instincts, the life drives deal with basic survival, pleasure, and reproduction. These instincts or drives are essential for sustaining the individual’s life and the continuation of the species.

While we think of life instincts regarding sexual procreation, these drives include thirst, hunger, and pain avoidance. The energy created by the life instincts is known as libido.

Freud proposed Eros was opposed by ego forces (the organized, realistic part of a person’s psyche that mediates between desires). In this latter view, he maintained that life instincts were opposed by the self-destructive death instincts, known as Thanatos.

Behaviors commonly associated with life instincts include love, cooperation, and other social actions. The life drives focus on preserving life, both the individual and the species. This drive compels people to engage in actions that sustain their own lives, such as looking after their health and safety. It also exerts itself through sexual drives, motivating people to create and nurture new life. 

Positive emotions such as love, affection, and social cooperation are also associated with life drives. These behaviors support both individual well-being and the harmonious existence of a cooperative and healthy society.

The Death Drive (Thanatos)

Freud first introduced the concept of the death drive in his essay Beyond the Pleasure Principle. He theorized that the death drive is the drive toward death and destruction, famously declaring that “the aim of all life is death.”

Freud believed that people typically channel their death drive outwards and manifest as aggression toward others. However, this drive can also be directed inwards, which can cause self-harm or suicide.

Freud based this theory on various clinical observations. For instance, Freud noted that people who experience a traumatic event would often reenact that experience. While studying soldiers returning from World War I, Freud observed they had a tendency to repeat the traumatic experiences that took them back to the combat scene.

He noted similar behavior in his 18-month-old grandson, Ernst, who played a game called Fort/Da whenever his mother was away. To deal with his anxiety, his grandson would repeatedly toss away and retrieve a wooden reel with a piece of string tied around it. Freud wondered how “repetition of this distressing experience as a game fit in with the pleasure principle?”

Freud concluded people hold an unconscious desire to die, but life instincts largely temper this wish.

According to Freud, the death drive stands in stark contrast to the drive to survive, procreate, and satisfy desires. In Freud’s view, all living organisms have an instinct” toward death.” in Freud’s view. The compulsion to repeat was “something that would seem more primitive, more elementary, more instinctual than the pleasure principle it overrides.” He further proposed that the death drive extended that compulsion.

As yet another war presents the danger of spreading into a wider conflict. Could Ukraine become the starting point of a third world war? I could not help but ask myself if Freud was correct. Does humanity have a drive towards self-destruction and extinction? What do you believe? I am available for exchanging ideas at

dransphd@aol.com

What if There’s No Such Thing as Closure?

The New York Times · by Meg Bernhard · December 15, 2021

The basis of this blog is on a New York Times article by writer Meg Bernhard, and a correspondence between myself and my dear friend. My friend is referring to the death of my wife, Pat. We were married for fifty years, and friends assured me that I would heal with time. But, on the contrary, I continue to feel a deep sense of loss. I have a lasting sense of loss of my beloved wife. Then I came across a New York Times article, “What if there is no such thing as closure?

The basis of this article is on Social Scientist Pauline Boss and her book, “Ambiguous Loss: Learning to Live With Unresolved Grief.”

Pauline Boss from the New York Times Article:

” Boss studied and provided therapy to the family members of Alzheimer’s patients, as well as the relatives of people whose bodies were not recovered after natural disasters or in the collapse of the original World Trade Center on 9/11. Theirs were losses without “conclusion,” in the traditional sense of the term, the experience of paradox — a simultaneous absence and presence — that eluded resolution. Can you mourn someone whose body is present, even if the mind isn’t? Or whose death is unconfirmed? Can you grieve a foreclosed future?

The concept, Boss maintains, is inclusive, encompassing a range of moderate to severe losses that we might not perceive as such. Moreover, it can take many forms, often quotidian: an alcoholic parent who, when intoxicated, becomes a different person; a divorced partner, with whom your relationship is ruptured but not erased; a loved one with whom you’ve lost contact through immigration; or a child you’ve given up for adoption. 

These experiences are an accumulation of heartbreaks that we cannot always recognize.”

A dialogue between my friend and me:

“Pat died. You lost her as a companion. You lost her as someone who shored you up.You lost your marriage, your married way of life. Your entire way of life changed, and continues to changein various ways, and each change is an ambiguous loss.”

“And, what I get from the article, is that it’s that way for all of us. What did I lose when Joan(his estranged wife) moved to Oklahoma? My life changed irreparably. What have you and I each lost (and each other person on the planet) with the pandemic that will never return as it was before? What have I lost since developing chronic arthritis pain impacting walking? Lost with Laura’s(his daughter) horrible illness and surgery, though gratefully, seeming to be moving towards a full recovery, but scarred by the ordeal?”

“When I was 11, we moved from the house and neighborhood I’d known since birth. I cried for a year. What did you lose when you moved in with your grandparents?”

“We’re “adapting” to loss all of our lives.”

The basis of this blog is on a New York Times article and a correspondence between myself and my dear friend. My friend is referring to the death of my wife, Pat. We were married for fifty years, and friends assured me that I would heal with time. But, on the contrary, I continue to feel a deep sense of loss. I have a lasting sense of loss of my beloved wife. Then I came across a New York Times article, “What if there is no such thing as closure?

The basis of this article is on Social Scientist Pauline Boss and her book, “Ambiguous Loss: Learning to Live With Unresolved Grief.”

Pauline Boss from the New York Times Article:

” Boss studied and provided therapy to the family members of Alzheimer’s patients, as well as the relatives of people whose bodies were not recovered after natural disasters or in the collapse of the original World Trade Center on 9/11. Theirs were losses without “conclusion,” in the traditional sense of the term, the experience of paradox — a simultaneous absence and presence — that eluded resolution. Can you mourn someone whose body is present, even if the mind isn’t? Or whose death is unconfirmed? Can you grieve a foreclosed future?

The concept, Boss maintains, is inclusive, encompassing a range of moderate to severe losses that we might not perceive as such. Moreover, it can take many forms, often quotidian: an alcoholic parent who, when intoxicated, becomes a different person; a divorced partner, with whom your relationship is ruptured but not erased; a loved one with whom you’ve lost contact through immigration; or a child you’ve given up for adoption. 

These experiences are an accumulation of heartbreaks that we cannot always recognize.”

A dialogue between my friend and me:

“Pat died. You lost her as a companion. You lost her as someone who shored you up.You lost your marriage, your married way of life. Your entire way of life changed, and continues to changein various ways, and each change is an ambiguous loss.”

“And, what I get from the article, is that it’s that way for all of us. What did I lose when Joan(his estranged wife) moved to Oklahoma? My life changed irreparably. What have you and I each lost (and each other person on the planet) with the pandemic that will never return as it was before? What have I lost since developing chronic arthritis pain impacting walking? Lost with Laura’s(his daughter) horrible illness and surgery, though gratefully, seeming to be moving towards a full recovery, but scarred by the ordeal?”

“When I was 11, we moved from the house and neighborhood I’d known since birth. I cried for a year. What did you lose when you moved in with your grandparents?”

“We’re “adapting” to loss all of our lives.”

The basis of this blog is on a New York Times article and a correspondence between myself and my dear friend. My friend is referring to the death of my wife, Pat. We were married for fifty years, and friends assured me that I would heal with time. But, on the contrary, I continue to feel a deep sense of loss. I have a lasting sense of loss of my beloved wife. Then I came across a New York Times article, “What if there is no such thing as closure?

The basis of this article is on Social Scientist Pauline Boss and her book, “Ambiguous Loss: Learning to Live With Unresolved Grief.”

Pauline Boss from the New York Times Article:

” Boss studied and provided therapy to the family members of Alzheimer’s patients, as well as the relatives of people whose bodies were not recovered after natural disasters or in the collapse of the original World Trade Center on 9/11. Theirs were losses without “conclusion,” in the traditional sense of the term, the experience of paradox — a simultaneous absence and presence — that eluded resolution. Can you mourn someone whose body is present, even if the mind isn’t? Or whose death is unconfirmed? Can you grieve a foreclosed future?

The concept, Boss maintains, is inclusive, encompassing a range of moderate to severe losses that we might not perceive as such. Moreover, it can take many forms, often quotidian: an alcoholic parent who, when intoxicated, becomes a different person; a divorced partner, with whom your relationship is ruptured but not erased; a loved one with whom you’ve lost contact through immigration; or a child you’ve given up for adoption. 

These experiences are an accumulation of heartbreaks that we cannot always recognize.”

A dialogue between my friend and me:

“Pat died. You lost her as a companion. You lost her as someone who shored you up.You lost your marriage, your married way of life. Your entire way of life changed, and continues to changein various ways, and each change is an ambiguous loss.”

“And, what I get from the article, is that it’s that way for all of us. What did I lose when Joan(his estranged wife) moved to Oklahoma? My life changed irreparably. What have you and I each lost (and each other person on the planet) with the pandemic that will never return as it was before? What have I lost since developing chronic arthritis pain impacting walking? Lost with Laura’s(his daughter) horrible illness and surgery, though gratefully, seeming to be moving towards a full recovery, but scarred by the ordeal?”

“When I was 11, we moved from the house and neighborhood I’d known since birth. I cried for a year. What did you lose when you moved in with your grandparents?”

“We’re “adapting” to loss all of our lives.”