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.

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.”