Stages of Grief, Loss, & Depression

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It's normal to to feel the pain of grief when you lose someone or something close to you.  But, what is the difference between normal grief and the normal depression associated with it?   The grief process is normal, but when grief takes over your life and you begin to feel dejected, debilitated, and good-for-nothing, then it might be time to talk to your doctor. What is grief?  Grief is the natural response of experiencing intense mental suffering in response to death, affliction, or loss.  This natural process is an opportunity to properly mourn a loss and then heal from it.  It is aided when you recognize grief, get support, and allow yourself time for it to work it's course.

People can feel grief from loss of a close family member, and this affects between 5% and 9% of the population each year.  But this is not the only kind of loss that can cause grief.  It can be felt from becoming separated from a loved one or from losing a job, position, or income.  Grief can occur if a pet dies or runs away and also from major changes in life such as getting a divorce, moving, retiring, or children leaving home.  While we all feel grief and loss, each of us is different in the way we deal with our feelings.  Some people deal with grief without losing sight of their daily responsibilities because they possess positive and healthy coping skills.  Other people don't have these coping skills or the support that they need, and this obstructs their grieving process.  So, how do we react to grief and loss?  There are many stages of grief and they reflect common reactions people have as they try to make sense of a loss.  A very important part of the healing process is feeling and accepting the emotions that come as a result of the loss.  What are the common stages of grief that people go through?  

1.  Denial, numbness, and shock.  The Denial stage of grief can help to protect us from experiencing the intensity of a loss.  Numbness is a normal reaction to a death or loss and shouldn't be confused with uncaring - It's the body's way of reducing the sensation of pain associated with the loss, which can be extremely intense.  It can be very useful if we have to take action, such as planning a funeral, notifying relatives, or looking at important papers.  As we move through the grief experience and slowly acknowledge its impact, the initial denial, disbelief, and numbness begins to change.

2.  Bargaining.  Re-occurring thoughts about what you might have done in the past to prevent the death or loss may emerge again and again, and some people even become consumed with thinking about specific ways things could have been done differently to save the person's life or prevent the loss.  This stage of grief needs to be dealt with and resolved or the person may live with intense feelings of guilt or anger that can interfere with the healing process.

3.  Depression.  This occurs when begin to realize and feel the true extent of the death or loss.  Common signs of depression during this stage include sleeping problems, poor appetite, fatigue, lack of energy, and crying episodes.  Also, feelings of self-pity, loneliness, isolation, emptiness, and anxiousness.  It's important to exercise physically, eat healthy foods, and sleep regularly in order to prevent the depression from becoming debilitating condition that requires treatment with antidepressants, but that may be necessary as well.

4.  Anger.  This usually happens when we feel vulnerable and weak, so anger can arise from a feeling of abandonment because of a death or loss.  Sometimes we're angry at a higher power, at the medical team who cared for a lost loved one, or toward life in general.  Anger is a natural response to loss, and it will subside with time.

5.  Acceptance.  In time, we can learn to cope with all the emotions and feelings we experienced when the death or loss occurred.  Healing can begin once the loss becomes mixed into our set of life experiences.

What can interfere with the healing process?  Throughout our lives, we may regress to some of the earlier stages of grief, such as anger or depression, because there are no rules or time limit to the grieving process, everyone's healing process is unique.  There are some things can slow down or block the healing process following a death or loss, such as avoiding or minimizing your feelings and emotions.  Also, be certain to avoid overworking on the job, and stay clear of abusing drugs, alcohol, or other substances as a way to deal with your emotional pain.

Are there strategies I can use to help resolve my grief?  Yes.  Try to recognize and accept both your positive and negative feelings.  Give yourself plenty of time to experience your thoughts and feelings.  Speak with a trusted person about the loss and express your feelings openly.  Seek out bereavement groups in which there are other people who've had similar losses and keep in mind that crying can provide a release.  Most importantly, seek out professional help if your feelings are overwhelming.

What should I do if my grief won't go away?  If your grief continues and causes you to experience a prolonged and deep depression with physical symptoms such as poor sleep, loss of appetite, weight loss, and even thoughts of suicide, you may have a condition known as complicated bereavement or depression.  Speak with your doctor as soon as possible.  Normal sadness is part of the reaction to grief and it should subside after several months.  But, sometimes a major depression can develop along with the normal feelings of depression or sadness associated with grief.  Major depression is a medical disorder that is different from normal grief and it can occur at any time, even in the immediate aftermath of a death of loss, and it requires treatment to be resolved.  

- Jeff Stein

Depression. (n.d.). Retrieved December 27, 2014, from http://www.m.webmd.com/depression/guide/depression-grief