Depression in Special Circumstances: Grief and Bereavement

Grieving is a painful process that can make people appear as if they are depressed. However, it is a psychologically necessary and natural response to any loss – real or imaged, sudden or anticipated. This loss often involves a person who was loved. But people can grieve over the loss of a pet, the loss of a limb or other body part or the loss of health and status. During the grieving process, most people experience a number of stages of grief which have been well described by experts in the field.

Not uncommonly, people can feel guilty about the death, and angry at themselves for not having done something differently to have prevented the loss. It is also common to feel hostile towards the dead person and angry that they have died. This whole period can be agonizing but it is a normal and necessary part of grieving that lasts anywhere from weeks to months, and even years.

Immediately after the death, people often feel as if they were “sleepwalking”, going through the required motions as if everything were unreal. Several weeks to months later, nature’s protective shock begins to wear off, and feelings, often accompanied by waves of physical distress, take over. Physical symptoms may include the need to sigh frequently, a choking sensation, shortness of breath, extreme fatigue and lack of physical strength.

Eventually, people stop dwelling on their loss, although the hurt may never be completely forgotten. That said, any significant loss can trigger genuine depression. If depression develops, a person may experience additional guilt feelings other than guilt about actions they might have taken to have prevented the death they mourn.

They may also have death wishes other than wishing to have died with the loved one, and be severely preoccupied with their own worthlessness or be quite incapacitated to carry out normal daily tasks. A key difference between normal grieving and abnormal depression is that a bereaved person is still able to function relatively normally and self-esteem remains intact. They also are usually able to resume most daily tasks within about two months following the loss of the loved one. Even when people have a “good reason” to be depressed, grief does not normally lead to depression.

If depressive symptoms develop following a loss, people need to seek medical attention so that the depression can be treated as it would in any other setting. Typically, a bereaved person who becomes depressed will undergo either grief-counselling therapy or bereavement therapy first.

If needed, they will be treated with an antidepressant medication as well to hasten the resolution of the depression.

Children and Grief

The impact of grief on children must not be underestimated. Almost universally, children feel responsible for a parent’s death and they need to be told again and again that they are not to blame. Moreover, adults need to explain to the child exactly what happened when a person they loved died, including what happened in the hospital if the person was ill, along with other relevant details. Children should also be allowed to talk about the dead person honestly, including any negative feelings they may have harbored towards that person, and to share in memories of the lost person with others.

Most experts also feel it is better to take children to the funeral than to “spare” them the difficulty of the event and leave them at home. By allowing children to talk freely about their loss, and to understand that children may be both very angry with a parent or a family member for having died, as well as terribly frightened about what will happen to them, children will come to terms with their grief, and the potentially serious consequences of unresolved grief later in life should be avoided.