Grief Trauma Or Depression?

This week's article in our series on Coping With Death and Grief discusses some painful but natural reactions to the loss of a loved one. Everyone experiences their loss in a unique way and it helps to understand why they may be experiencing certain reactions and suggestions concerning how to handle these reactions. It also helps to know they are not alone and that others have experienced the same feelings. May this bring comfort and reassurance. Please call us with any concerns or questions. The final article in this series will be published on our blog on June 27. Part of the Coping With Death and Grief Series

1. Coping With Death and Grief
2. Understanding the Grieving Process
3. Grief, Trauma or Depression?
4. Helping Loved Ones Grieve

Grief, Trauma or Depression? By, Patricia Johnson After a loved one dies, those who grieve may find it difficult to function in everyday situations. Lingering emotional turmoil, a sense of shock and social withdrawal are painful but natural reactions. Despite these expected symptoms, is it possible to become "stuck" in grief? What if the loss prompts thoughts of self-harm or even suicide? And how can trauma affect the healing process? Symptoms of grief, depression and trauma can resemble one another. In order to respond to these symptoms appropriately and move on with life, it is crucial to understand the differences. When Grief Becomes Clinical Depression It's not unusual for those who grieve to feel despondent, empty and anxious. Grief encompasses different emotions for different people, and it takes time to adjust to the loss and any accompanying changes. Sometimes, though, the depressive state doesn't diminish over time and continues to disrupt everyday life. This may be an indicator of a depressive disorder. According to the American Cancer Society, about one in five bereaved people will develop major depression. 1It is difficult to predict whose grief will or won't turn into depression following the death of a loved one. However, the following risk factors may increase the likelihood:

• History of depression
• Little previous experience with death
• No support network
• Intense depressive reactions early in the grieving process
• Prior issues with alcohol or drug abuse

It is possible to grieve without being depressed. That said, there is a difference between the sadness of grief and the unrelenting numbness of depression. Here are signs indicating that a grieving person may also be depressed:

• Shows symptoms of grief for four or more months with no sign of improvement
• Prolonged or severe inability to function at home, work and/or school
• Stays in bed all day, doing nothing
• Thinks of suicide and/or has a preoccupation with death
• Speaks and moves slowly
• Hallucinates, which may or may not relate to the deceased
• Feels worthless

If symptoms persist-and especially if suicidal thoughts occur-it is imperative to reach out to a family doctor, counselor or pastor. Those with depression will not simply "snap out of it." However, depression is highly treatable, and with competent care a healthy life can be restored. When Trauma Blocks Grief Losing a loved one in a sudden or unexpected way-a car accident, heart attack, murder or suicide-may result in a traumatic reaction that hinders the grieving process. This sense of shock can also occur when the death is expected, as in the case of a long illness. If a person is run down psychologically, suffers from anxiety or depression or has endured previous traumatic experiences, it's more difficult to handle another setback. As a result, additional grief symptoms can be unbearable. In order to cope, the traumatized individual may attempt to avoid grieving altogether. The National Center for Posttraumatic Stress Disorder highlights broad types of symptoms that differentiate trauma from grief:2

• Re-experiencing Symptoms: Mentally replays the trauma while awake or asleep
• Avoidance Symptoms: Avoids trauma-related activities, places, thoughts or feelings
• Numbing Symptoms: Loss of emotions, especially positive ones
• Arousal Symptoms: Difficulty concentrating and sleeping, and a heightened sense of being on guard

Over time, if symptoms continue to influence life at work and home, counseling is advised. In addition to support groups, treatments that are both comforting and effective are available. Grieving the loss may be painful, but it is necessary to allow healing to occur.

1. American Cancer Society: Major Depression and Complicated Grief . 3 May 2005. 5 July 2007 < http://www.cancer.org/="">. �©
2. National Center for Posttraumatic Stress Disorder: What is Posttraumatic Stress Disorder (PTSD) ? 31 May 2007. 5 July 2007. �©

Copyright © 2007 Patricia Johnson. Used with permission. All rights reserved.