Updated: Jan 31
Eighteen months ago I lost my life partner to cancer. We'd been friends for over 30 years. It was a huge loss. I felt resilient and ready for the fight while he was alive. But I felt broken once he'd passed. What is grief and how do we differentiate it from depression? When does grief get "complicated"? Let me tell you what we know.
Grief and depression are two of the most common and difficult emotional states to experience. Whether it's the death of a loved one, the loss of a job, or even a major life transition, grief and depression can be overwhelming and all-consuming. In this article, I'll discuss the differences between grief and depression, the symptoms of both, and how to cope with them. I'll also explore how to find hope and healing after experiencing grief and depression.
What is Grief?
To state the 'bleedin-obvious' grief is an emotional reaction to a significant loss or change. It typically involves feelings of sadness, despair, and even anger or guilt. Grief can also manifest itself in physical symptoms such as insomnia, fatigue, and changes in appetite. It is important to remember that grief is a normal, natural response to loss and that it is different for everyone.
The thing that no one prepares you for is the fear. I have never felt so afraid for so long in my life. It was overwhelming. My grief got very complicated, very quickly. I would fall in to what I came to call "grief holes" where I couldn't function properly. The grief holes were sometimes shallow (and fast to recede) and at other times seemingly bottomless (and all consuming). At those times, it felt like the ground has fallen out from underneath me. I learned to reach out to friends and family, and, as embarrassing as it sometimes felt, I learned to say exactly what I was truly feeling, to listen to the advice of people who love me and to keep them very close.
Causes of Grief and Depression
Grief and depression can be caused by a variety of factors, including the death of a loved one, the end of a relationship, job loss, or any other major life transition. Traumatic events such as war, natural disasters, and physical or sexual abuse can also cause grief and depression. In some cases, grief and depression can be the result of a combination of factors.
Grief vs Depression
Grief and depression are often confused, but they are not the same thing. Grief is an emotional response to a major loss or change, while depression is a mood disorder that can be caused by a variety of factors. Grief can lead to depression, but depression can also exist without grief. It is important to recognise the differences between the two so that you can seek the appropriate help and support.
Symptoms of Grief and Depression
The symptoms of grief and depression can vary from person to person, but there are some common signs to look out for. Grief can manifest itself in feelings of sadness, loneliness, and guilt. It can also cause physical symptoms such as fatigue, insomnia, and changes in appetite. Depression can also cause feelings of sadness, loneliness, and guilt, as well as feelings of hopelessness and worthlessness. It can also cause physical symptoms such as fatigue, insomnia, and changes in appetite.
The Grief Process
Grieving is a process, and it can take time to heal and move forward. It is important to be patient with yourself and to remember that everyone grieves differently. The grief process typically involves the following steps: acknowledging the loss; experiencing the pain; adapting to the new reality; and finding a new meaning in life. It is important to remember that grief is not linear, and you may experience different emotions at different times.
How to Cope with Grief and Depression
It can be difficult to cope with grief and depression, but there are some things you can do to help. Firstly, it is important to talk about your feelings with someone you trust. This could be a friend, family member, or even a helping professional like me. It is also important to take care of your physical health by getting enough sleep, eating a balanced diet, and exercising regularly. Finally, it is important to do activities that bring you joy, such as spending time with loved ones, listening to music, or reading a book.
Bereavement DSM 5
The DSM 5 (Diagnostic and Statistical Manual of Mental Disorders) outlines the criteria for diagnosing bereavement. Bereavement is a normal reaction to the death of a loved one and typically involves feelings of sadness and despair. It is important to note that bereavement is not the same as depression. Bereavement typically lasts a few months (but who's counting, right?), while depression can last much longer. In order for a diagnosis of depression to be made, the symptoms must last for at least two weeks and cause significant distress or impairment in functioning.
Prolonged Grief Disorder is a new category in the DSM 5. Here's the thinking of our leading global specialists in this area on what counts as prolonged grieving.
Prolonged grieving is the death of a person close to the bereaved at least 12 months previously. Since the death, there has been a grief response characterised by intense yearning/longing for the deceased person or a preoccupation with thoughts or memories of the deceased person. This response has been present to a clinically significant degree nearly every day for at least the last month.
As a result of the death, at least 3 of the following symptoms have been experienced to a clinically significant degree, nearly every day, for at least the last month:
Identity disruption (e.g., feeling as though part of oneself has died)
Marked sense of disbelief about the death
Avoidance of reminders that the person is dead
Intense emotional pain (e.g., anger, bitterness, sorrow) related to the death
Difficulty moving on with life (e.g., problems engaging with friends, pursuing interests, planning for the future)
Emotional numbness
Feeling that life is meaningless
Intense loneliness (i.e., feeling alone or detached from others)
The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The duration of the bereavement reaction clearly exceeds expected social, cultural or religious norms for the individual’s culture and context.
The symptoms are not better explained by another mental disorder.
Grief and Trauma
Grief and trauma can be closely linked. Trauma is the emotional response to a traumatic event, such as the death of a loved one, physical or sexual abuse, or a natural disaster. Trauma can lead to feelings of shock, fear, guilt, and despair. It is important to seek professional help if you are experiencing trauma, as it can be very difficult to cope with on your own.
People with attachment and bonding complications will usually find grieving harder. For example, those who are sensitive to abandonment may grieve longer and find it very frightening to be without a partner or friend who was deeply loved.
Finding Hope After Grief
Finding hope after grief can seem impossible, but it is possible. It is important to remember that healing takes time and that it is ok to feel sad and scared. It is also important to take care of your physical and mental health by getting enough sleep, eating a balanced diet, and exercising regularly. Finally, it is important to reach out to friends and family for support and to talk to a therapist if needed.
For me, this experience has been deeply humbling. As a counsellor, I have helped lots of people who experienced grief. But I had no idea what it was like to lose someone so close until I had the experience myself. This helps me remember to stay "right sized" (as Brenè Brown says) - and to never assume I truly understand what someone else is experiencing in their inner world. It has helped me grow in compassion for others.
I have started to feel a natural buoyancy inside me once again. I've noticed myself feeling happy, hopeful and resilient once more. The sorrow still comes - even eighteen months later. But it's broken up by new life, new experiences and new people. I wish my partner was here to see it too - and he isn't. But he was a master of fun and happiness. He would want me to be happy now and to be successful.
If you're from the UK then you can find some great NHS guidance on available help for grief in the link.
If you're from New Zealand the Mental Health Association is to place to start.
If you're from Australia then Beyond Blue is a great place to start for help.
If you're from Canada there are many good grief helplines to start with.
And if you're from the US, The American Counselling Association is a good place to start.
Conclusion
Grief and depression can be overwhelming and difficult to cope with, but it is possible to find hope and healing. It is important to remember that grief and depression are normal reactions to major life changes, and that everyone grieves differently. It is also important to take care of your physical and mental health and to reach out for help if needed. With the right support and self-care, it is possible to find hope after grief and depression.
