Today’s topic is not an easy one for me to discuss and it’s very personal. But I feel it’s so important to raise the awareness of depression from grief that I’m more than willing to share my story.
When a loved one dies or you experience a separation beyond your control it’s universally recognized that a process of grief will ensue. But at what point does immense sadness turn into depression? Does the categorization even matter?
According to the CDC, 1 out of 10 adults in the U.S. suffer from depression. The National Institute of Mental Health website lists the following as categories of depression: major depression, persistent depressive disorder, psychotic depression, postpartum depression, seasonal affective disorder and bipolar disorder. You will not find “depression from grief” listed in this category. However, it has been a subject for much debate.
An article in 2012 from Psychology Today states: For years, the American Psychiatric Association has urged doctors not to diagnose major depression in individuals who have recently lost a loved one. In the Diagnostic and Statistical Manual of Mental Disorders (DSMMD), sometimes known as the psychiatrist’s bible for diagnosing mental illness, grief is specifically listed as an exception to the diagnosis of clinical depression. The organization is now considering dropping that exclusion, raising the question: Is grieving ever ‘pathological’?
As recently as 2013, the American Psychiatric Association (APA) did make an exception for depression related to bereavement listed under Diagnostic and Statistical Manual – fifth edition (DSM-5).
Why is recognizing depression from grief as a true disorder important?
If you’re suffering from depression it’s important you have a treatment plan in place. If it isn’t a recognized illness your insurance may not cover the treatment you seek.
Why wasn’t it listed before?
The APA believed there was a difference in depression related to bereavement from major depression, the former was believed to be short-lived and the latter stemming from a mental disorder that may need long-term treatment. They finally recognized that the symptoms are the same and the results can be just as devastating if a person does not seek the help they need.
I know because I was faced with depression in the early stages of my grief.
When my husband Larry died I did most of my heavy grieving while the kids were at school. I didn’t hide my sadness or even tears from them. But I did spare them the sight of their mother curled up like a ball and sobbing. I thought if they saw me in such despair it would’ve frightened them at their young age.
So when the holiday break from school came it meant I was with my children 24/7 for over two weeks, which didn’t allow for me to grieve in the manner I needed to. I did find some time to allow the heavy grief to come out- during my shower or early in the morning before they woke up- but it wasn’t enough of an outlet. Most of the grief I needed to release during this already difficult time stayed pent up inside of me.
To pour salt on the wound my eldest son turned ten a few days after New Year’s Day. It was a milestone birthday and I wished more than ever his dad could’ve been there to celebrate with him.
On my son’s birthday I tried my best to present a happy face, but inside all I could think about was the day he was born and how happy we all were back then. My heart ached even more as I remembered the huge grin plastered on my husband’s face. He was the epitome of a proud papa.
Instead of feeling the joy I did when he was born I started to wallow in misery and the fatigue I felt made me want to throw in the towel. I was tired of grieving, I was tired of being the only parent around to watch my children grow up, I was tired of the burden of taking care of the business…Basically I was TIRED! That began my descent into depression.
For over three weeks I cried from the minute I dropped my children off at school until right before I picked them up. I felt no joy in my life or hope for any to come. It felt as though a heavy black cloud hung over me. I couldn’t make decisions about the business. I had no idea where we would live.
We had sold our house in Illinois the same time Larry received his diagnosis and put all our belongings in storage until we could find a new home in Arizona. Unfortunately Larry died before we could make this change together. So our things remained in storage and the boys and I lived in a temporary home. It was up to me alone to decide if we stayed in Arizona or went back to Chicago.
I couldn’t eat much and my body was beyond exhausted. I felt incapable of moving forward.
Any steps I had taken the previous three months in processing my grief seemed to be wiped away and I was back to square one: the day Larry died.
I was starting to worry that I had sunk to a level I might never recover from. Finally after three weeks of not be able to stop crying ALL DAY I confessed to my grief counselor how I was feeling.
I sat across from her sharing all of this as tears streamed down my face. “What’s wrong with me?” I wailed. Honestly, I was expecting her to say anything expect what came next. She sighed and leaned toward me and spoke softly, “I think it’s time we discuss that you may be suffering from depression…”
What! I wanted to scream, but instead I suddenly stopped crying and stared back at her as though she had to be mistaken. I wasn’t depressed.
I’m the one people came to when they needed someone to talk to. I’m the one who saw the glass as always half full. I’m the one who had to be strong for her children who were depending on her. I didn’t have time to be depressed!
Why would I think it couldn’t happen to me? Of course I knew depression had nothing to do with being strong. I knew- and still know- plenty of strong people who live with depression. How did I miss this? How did I ignore the signs? Simple: it was me who was depressed and isolated in my own world.
My grief counselor and I talked about various avenues and treatments in coping with depression. Since I was still functioning and capable of taking care of my children I expressed that I wanted to take the holistic route and go back to all the wellness techniques I had relied on in the past. Since I had a weekly appointment with her and she would be monitoring me on a regular basis she agreed with my current plan of action. And for me that was key: I had to force myself to take action.
I had stopped myself from making decisions out of fear. Without Larry, I feared I’d make the wrong decisions. I also had to wrestle with fear of moving forward without him. For someone who normally doesn’t make decisions based on fear, I was letting fear rule me. The only fear that was productive in that moment was my fear that if I got worse I wouldn’t be able to take care of my children. And, once again, my children saved me.
How do you know if you’re facing depression? Here are some of the symptoms to be aware of:
• Feelings of helplessness and hopelessness
• Loss of interest in daily activities
• Appetite or weight changes
• Sleep changes
• Anger or irritability
• Loss of energy
• Reckless behavior
• Thoughts of suicide
If at any time you feel like you may harm yourself or someone else, seek medical attention immediately!
Here are some steps you can take if you’re suffering from depression related to grief (please note I’m not discussing other forms of depression):
• Seek counseling from a certified and qualified counselor
• Reach out to family and friends, don’t isolate yourself
• Practice stress-reducing techniques
• Eat a nutrient-rich diet (yes, I said it again)
• Eliminate or limit alcohol (it’s a natural depressant)
• Be active, take a walk, practice yoga
• Reach out for help in areas you may be struggling
As I mentioned above I had no hope for my future and I didn’t feel capable of making decisions on my own.
Thankfully I had some people I could count on. After talking with my grief counselor about depression I decided I had to force myself to make some decisions. I reached out to my business partners (who were not aware of my depression) and asked for their guidance in helping me make some decisions regarding my business and a new home for my children and me.
I then decided we would stay in Arizona. After what my kids had been through I didn’t want to take them out of a school they were familiar with and away from the close friends they had made.
I continued to see my grief counselor regularly. This was extremely beneficial for me. As I mentioned in last week’s post, “Living with Anxiety,” I had a standing weekly appointment.
It was during this time that we joined New Song Center for Grieving Children. I can’t recommend enough that you find a quality, professionally organized group therapy program. One of the symptoms of depression is isolation and feeling alone. Attending group therapy with other adults who suffered a major loss helped me to see I wasn’t alone. We provided the support for one another that I still hold dear to my heart today. When you are at the lowest point in your life finding others who understand what you’re going through is priceless.
The depression didn’t go away over-night, but I kept up a steady routine of visiting my grief counselor, practicing stress-reducing techniques and paying attention to what I put into my body.
One of the reasons the American Psychiatric Association doesn’t classify “depression from grief” as a disorder is they felt that as you healed in grief your depression would heal as well and you wouldn’t have to worry about it anymore. Unfortunately, that’s not always the case.
As with my anxiety, I tend to walk a tightrope at times in fighting the depression from coming back, especially every fall. Come September (when Larry was in the hospital) through October 15th, the day he died, I always feel as though a thin veil of darkness hangs over my head. It’s not debilitating, it just weighs on my shoulders kind of like a reminder of the struggles I faced to get where I am today: at peace with my life and myself. Nevertheless, I’m extra cautious in what I do and what I put into my body during this time.
This is why I focus so heavily on wellness practices, specifically affirmations. I know too well how precarious the mind can be and every day I consciously strive to be as healthy as I can be in mind, body and spirit.
And if you are facing depression, I pray you will find your path in healing and find peace in your life.
PS. During this holiday season be extra kind to yourself. Take time to practice some of the wellness tools I’ve mentioned on other posts.