Grief vs. Depression

I recently made a visit to the doctor’s office for a routine checkup on my thyroid levels. No worries, this article is not getting too personal, that is as much of the details you will get on the medical side of things. But, I had an interesting conversation with the new doctor that I was seeing for the first time. It was about Grief versus Depression.

About a month after Stephen died, I had to go to the doctor for my thyroid check. I felt about 100 years old, my heart ached, I had dark circles beneath my eyes, and life was simply harder than I ever imagined possible. Even with my daily gratitude, I could not change the fact that I missed my son terribly, and was in a deep and inconsolable grief. It was my first visit to this physician, as my family doctor had recently moved.

Sitting up on the examining table, the nurse came in to check me in for the appointment, assess my vital signs and find out the reason for my visit. I was brief in my answers, wanting to get this over with and get the heck out of there. But, she noticed my blood pressure was elevated from the last recording on my chart.

“Your blood pressure is up. Is there anything going on in your life that is stressful right now?” she asked.

And, as if I was a dam on a raging river, I burst out crying, exclaiming that my son had died. I rambled some of the details of his passing through my tears, and grabbed a tissue.

And then, the visit took a turn. The nurse abruptly stood up, looking very uncomfortable with my tears, and said, “Well, I’m going to leave, because I’m not much good to you right now.”

Yep, she just left me. Sitting on a paper sheet in a clinic examining room, to cry alone as I stared at a medical poster about the digestive system. Being a nurse myself, I immediately thought back to my school days regarding empathetic communication and surmised that she had missed those classes. Her discomfort was obvious.

But that was not the end of it. The doctor arrived in the room, and was visibly uncomfortable, averting her eyes away from my tear filled ones. She skirted around Stephen’s death, never actually addressing it directly, or offering a simple condolence. If I had not been in so much pain, in need of some simple comfort, I think I would have started to laugh. Because I felt like I was part of the filming of the “before” video for, “How Medical Professionals Communicate With the Bereaved.”

And then she said it.

“Let’s talk about Paxil and Prozac.”

Not once in my visit did I ever say I was feeling depressed. In fact, I did not even express anything about my grief, because she didn’t ask. I was simply requesting a blood level and prescription renewal for my thyroid medication.

But, in her mind, based on what the nurse told her about me as they stood quietly outside the door, I needed to be medicated. Perhaps it was my tears, sparked by the fact that I, for one of the first times, had to say aloud that my son had died.

My reaction? I gave her my eyebrow, which said more than words ever could, and I told her I was grieving, not depressed and there was a big difference.

Now, Let’s back up a little. What’s the difference between grief and depression? The dictionary definitions defines them as:

Grief: Grief is a multi-faceted response to loss, particularly to the loss of someone or something to which we have formed a bond. Although conventionally focused on the emotional response to loss, it also has physical, cognitive, behavioral, social, and philosophical dimensions. Reaction to a major life loss; deep and poignant distress caused by or as if by bereavement.

Depression: a state of feeling sad : (2) : a psychoneurotic or psychotic disorder marked especially by sadness, inactivity, difficulty in thinking and concentration, a significant increase or decrease in appetite and time spent sleeping, feelings of dejection and hopelessness, and sometimes suicidal tendencies c (1) : a lowering of vitality or functional activity.

You can see that some of the definitions and descriptors in the depression definition sound like the feelings that one experiences on their grief journey. And honestly, in some cases, people do in fact become depressed because of grief. It can happen, and it is understandable.

But I am here to tell you that there is a big difference between the two.

Grief is a natural response to loss. Grief is a journey. Grief is something that you need to do in order to heal your broken heart. Grief is not something that needs to be medicated because a physician doesn’t know what to say and wants to find solutions for you. However pure the doctor’s intentions were, she didn’t understand an important fact. Medicating grief does not make it go away. It simply dulls it, so it can sit and wait beneath the surface to be faced at a later date.

The reason I rant about all of this? Because my new physician (sorry, could not go back to see this gal anymore) talked about my grief as one of the first things on her list after reviewing my chart. I loved her direct approach, asking me how I was doing. She said that my chart indicated I was having a delayed grief response during my last visit. I explained that was not accurate, and that on my last visit to the doctor’s office, my son had only died a month before. She quickly made note of this, and apologised for the assumption. She asked about how I was coping, and listened, nodding approval at our choice to go to grief counselling, and journal. Not once did she ask me about depression. Instead, she assessed me as a professional, and understood that I was doing just fine.

Two doctors. Two different approaches.

If you are grieving, remember that it is a journey, and it is a natural response to losing someone or something you loved. Remember that there is a difference between grief and depression, and speak up if you feel like your grief is being misdiagnosed. Remember that there is no pill that can take away the pain of loss. If there was, everyone would be taking it. The only cure for the pains of loss is time, and it is individual for everyone. Of course, if you experience some of the more marked symptoms of depression listed above or online, you should always consult your family physician.

If you are a medical professional, take some time this week to evaluate your approach to the bereaved when they show up in your office. Do you talk to them, or do you write the pain away? Do you bolt for the door, or do you comfort?

Even for the trained professional, grief can be an uncomfortable reality. Think about your approach and understand that in your quest to heal, that grief is not something to be fixed, but rather it is something to be experienced.

Kelly Buckley began writing after the sudden death of her 23 year old son, Stephen.  Since that time, she has published two books, Gratitude in Grief and Just One Little Thing, and was a contributing author for the Open to Hope Foundation’s book, Open to Hope-Inspirational Stories of Healing After Loss.  Kelly continues to write and speak about gratitude in an imperfect world, and connects with thousands of people all over the world through her gratitude community on Facebook, Just One Little Thing.  To learn more about Kelly, visit www.kellybuckley.com

Photo credit.

20 Comments:

  1. Allegra said on September 12, 2012 at 4:56 pm ... #

    So sad, but too often true. My child did not die suddenly, but I have still never been been asked about treatment for my grief. It is probably part of the reason why I am caught in the torrential cycle of grief and depression. Ironically, it has become part of my new identity. The woman I was died in the same moment that my child took her last breath…

  2. Jenny said on September 12, 2012 at 7:00 pm ... #

    Thank you for putting this in writing! I had a similar experience this week. It’s been 2 years and doctors are still offering me anti-depression drugs if I get teary when asked, “How are you doing? It’s been how long now? Do you want anything?”. I’m still healing and want to go thur my loss with eyes wide open. The pain for me is a reminder of a love that will last a lifetime and worthy of tears.
    Thank you for the reassurance!!
    By the way, I follow your Twitter…you are so inspiring.

  3. Robyn Boyd said on September 14, 2012 at 1:23 am ... #

    My son, Brandon (age 25) died 8 weeks ago… july 12 was when we informed by the police. Add insult to injury, he had actually been dead for nearly a frickn month. I finally received his cell phone and the last messages were on June 19. It was an accidental overdose, without any question. Was in no way intentional.
    most nights, I can’t stop crying. Cry myself to sleep, and sometimes have his ‘cremation’ urn (in a tasteful way) next to me while I fall asleep.

    Throughout his life, we have had many mental health professionals involved. Apparently, it didn’t work.

    I could write a novel, but I’m going now to cry myself to sleep.

    If anyone has experienced a recent loss of a child, I would love to speak with you.

    Thank you,
    Robyn

  4. Toni said on September 27, 2012 at 6:31 am ... #

    I also have a new identity. I have become this insecure, lethargic, lost, broken, tearful and grieving person. It has been a year since my 41-year old husband was taken by the most horrendous cancer, and I feel no better. I have declined antidepressants so far, but I do think that grief and depression are more linked that the above article claims. At least for some of us.
    The medical profession are opening up for a new diagnosis referred to as complicated grief or prolonged grief disturbance, not unlike PTSD.
    I can still not say out loud that he died or talk about it much without breaking down in tears. I wonder how long I will be like this, and although I am sceptical to medication I feel that more counselling and psycological treatment should be offered as an alternative.

  5. Chris said on September 28, 2012 at 10:41 pm ... #

    Unfortunately for me I think my grief has turned into depression. Sometimes I feel only grief but every once in a while depression sneaks back into my life and reminds me that I am nowhere near back to how I used to be before my dad died. I hope that someday soon I can go on without these two different states of mind being intertwined in my life.

  6. Trevor said on October 31, 2012 at 8:11 am ... #

    Can we be happy when we are not at peace inside? Does laughter and merriment alleviate deep-rooted pain? Is it shrewd to drown feelings of depression in alcohol, to abuse drugs, or to try to eliminate those feelings by adopting a promiscuous lifestyle? The answer is no. “In laughter the heart may be in pain,”

    Laughter may mask the pain, but it fails to remove it. “For everything there is an appointed time,” states the Bible. Indeed, there is “a time to weep and a time to laugh; a time to wail and a time to skip about.” (Ecclesiastes 3:1, 4)
    When depression persists, we must take steps to overcome it, seeking “skillful direction” when necessary. (Proverbs 24:6) Laughter and amusement are of some value, but their relative worth is small. Warning against improper forms of amusement and excesses in entertainment, Solomon says: “Grief is what rejoicing ends up in.”—Proverbs 14:13b.

  7. Trevor said on October 31, 2012 at 8:18 am ... #

    This is a follow up to what i just mentioned…..
    Today, human distress is even greater, and more people than ever are depressed. But should that surprise us?
    Jesus Christ foretold that during the last days, there would be “fearful sights.”—Luke 21:7-11; Matthew 24:3-14.
    When people experience prolonged anxiety, fear, grief, or other such negative emotions, they often become depressed.
    The cause of depression or extreme sadness may be the death of a loved one, a divorce, the loss of a job, or an unrelenting sickness.
    People also become depressed when they develop a sense of worthlessness, when they feel they are a failure and have let everyone down. Anyone may be devastated by a stressful situation, but when a person develops a sense of hopelessness and is unable to see any way out of a bad situation, severe depression may result.

    People in ancient times experienced similar feelings. Job suffered sickness and personal misfortune. He felt that God had abandoned him, so he expressed a loathing toward life. (Job 10:1; 29:2, 4, 5)
    Today, many have become depressed because of overtaxing themselves, trying to follow a daily routine that is beyond their mental, emotional, and physical resources. Apparently stress, coupled with negative thoughts and emotions, can affect the body and contribute to a chemical imbalance in the brain, thus producing depression.

  8. AnnieB said on January 24, 2013 at 8:19 am ... #

    I love this article. Possibly also the writer of it! Although I was never medicated for my father’s death 47 years ago, I was treated as though nothing happened. Nothing. Until I had two major things happen and ended up in therapy, and went through the grieving process 16 years later.

    In addition, I would also say grief left unattended can also mean you find yourself grieving years later, sort of picking up the pieces. Yesterday I read the newspaper articles about my father’s death for the first time, which described in detail how he died. I spent some time last night grieving* for him, for what he went through.

    I didn’t feel depressed (I have struggled with depression since his death) – I know what it feels like — I was grieving and feel better having done so.

    Wonderful article, I’m going to the website now!

    *wailing, crying, sobbing, praying for him, talking “to” him

  9. Shoe said on February 5, 2013 at 3:34 pm ... #

    What an extremely positive and inspiring article. I really am truly
    impressed with your offerings. You offer helpful stuff.
    Keep it up. Keep blogging. Really looking forward to going through your next posting.

  10. Wendy said on March 21, 2013 at 6:38 pm ... #

    My husband died 6 weeks ago. I just want the pain to end.

  11. Karen Brady RN said on August 8, 2013 at 6:01 pm ... #

    Thank you Kelly !! Far too many times people are medicated for something the NEED to go thru. If you mask the symptoms how can you get thru it !!
    So very, very sorry you had that insensitive nurse , YIKES there is someone in the wrong profession ! Good for you to find a much more “seasoned ” physician that actually HEARD you. Grief is hard , it takes time and every single person will go thru it differently if they go thru it “consciously” and not medicated.. It feels like your heart has been tore from your chest and your not sure of your next breath.. But you go on.. some how, putting one foot in front of the other and tears come and go . Its a journey we all must take consciously .

  12. Doris said on August 9, 2013 at 10:07 am ... #

    I lost my 25 yo daughter, Stephanie, to an accidental overdose in 2009. It was close to Easter, and that is still the toughest time of the year for me. I have lost friends, but I have gained some new ones who didn’t know me “before” her death.

    I’m fortunate in that my doctor understands. He knew Stephanie, and he saw some of the things we went through together. He knows that I have good days and bad days, and he took the time to talk to me about it. I am on anti-depressants, but I was already on those – for many years – before she died. The only thing I’ve added is Xanax, because I tend to have moments of extreme panic and anxiety now. I think that’s a bit of PTSD. Having the police come to your house and ask you to sit down is something that never goes away in your head.

    Bless you, all of you. Peace, D

  13. Susan, RN said on December 11, 2013 at 1:47 pm ... #

    I am almost at the 5th anniversary (12/13/08) of my 25 year old son’s end of a year long battle with a rare stomach cancer. He left a widow, 2 small daughters….and a totally broken/hollow mother. I currently (after a bankruptcy and 2 year sabatical—actually I was totally unable to function as an RN) am currently working the past 3 years as a Qualified Mental Health RN–in a facility where we deal with the Severely Mentally Ill. Even here, working with a number of mental health professionals……I hear each year around this time (when I get depressed and a little crazy) that this extended grief is ABNORMAL. I have come from non-functioning back to a very qualified and competent professional again. It breaks my self esteem and sense of worth go completely down the tubes at these times when I do lose it a little–for even my professional co-workers to basically just want me to “get a grip”. Think I’ll just work in my own office from now on with my own individuals…..and not socialize with co-workers at all. If you haven’t been thru it…DON’t pretend to know what it is all about. :(

  14. Mark said on January 4, 2014 at 9:57 am ... #

    I have not done anything like this before so if I make some mistakes with my writing please overlook.
    I woke up this morning and I feel like I am so sad and lost. My son Stephen passed away dec 4 2012. He was 25 years old and had a blood sugar spike that was just much for his body that had been abused by drug addiction that I know of since he was 16 or 17. My son also had been treated for several mental health problems prior to his addiction since the age of a around 14. Social anxiety, OCD, depression, and schizophrenia.
    We thought the schizophrenia was not real until it finally showed up when he didn’t receive his meds when overdosed for the 3 rd time in a 4 yr. period 2 times where spent time in ICU unit on a ventilator. I’m not going to go on about his drug problem it was serious as you can see and tried everything to help him with multiple treatments for drug addicts in and out of rehab. I also felt like ever time we took him somewhere that somebody would reach him and he would be ok when he came out of treatment. I felt like I slowly watched my son die which I would tell him several times.Then when it finally happened I still was in shock that he didn’t survive his last time in ICU from the blood sugar spike. I have never felt pain like this and it has been much harder than I would have ever imagined. It has been over a yr. now and the holiday season has made feel like I have been pushed off a cliff and I can’t climb out. I’m sorry but let get back to what happened this morning. I got up early and started to just cry and I just picked my I pad and typed in Google (crying from death of my son.) and I started to read and the the story was about the death of a son named Stephen spelled the same as my son. I felt like something was telling me you need to read on as the tears just poured out. So I decided to leave this message. I have been treated for depression and it has helped somewhat but there is not a magic pill that’s going to fix this. I would welcome any comments or advice. I wanted the leave this last thing if other fathers are reading I’m 44yrs old and it’s ok to cry…
    Mark

  15. Vicki Jones said on January 5, 2014 at 4:00 pm ... #

    I came to this website because I lost my husband of 38 years 6 weeks ago. I woke up this morning and began crying and could not stop. I am so afraid that this is going to take me down. I feel at times like I am going crazy because I miss him so much. The weekends are the worst because that is when we got to spend our time together. I run an in home Day Care and he would be here but we got our quality time on the weekends.
    He had been sick off and on most of 2013 so when he went into the hospital on 19 Nov I thought it was another couple days in the hospital and he would be home. He died on 21 Nov. I wake up in the morning and realize that he is gone and I literally can not move. I just lie there afraid to move because if I do reality slaps me in the face and I have to face another day of pain. I have to force myself to get up. The only time it doesn’t paralyze me is when I know I have to get up and take care of the children in my Day Care. I am fine during the week while the kids are here.
    I truly do not know who I am without him. I have taken care of him for so many years. My whole daily routine seems strange to me. I feel so weak because I have raised 7 children and I can’t seem to pull myself up out of this. I know it has only been a short time but I do not see this getting any better. I do not want to take medication. What do I do to shut my mind off and get on living without him. I am trying to be strong for my children because I know they are hurting but how can I help them when I don’t feel I can get through this?

  16. Suzi said on January 19, 2014 at 6:02 pm ... #

    My mum died 2012 and my dad 2013. I feel so lost and numb of emotion towards my friends, kids and husband. I have suffered depression since i was young and am on medication but the grief is totally different. Its like a nightmare that i cant wake up from. I have and am pushing everyone away from me. I dont want people telling me how i should feel and to basically get over it. I can see what im doing to my kids and husband but i cant control it. Its almost like Im trying to punish myself and everyone else because my parents died. I could always talk to my mum but now i cant. I feel like i will never be the same person again.

  17. Suzi said on January 20, 2014 at 2:17 am ... #

    Hello again, Im feeling really frustrated. I feel like my close friends dont understand me. Even though thet have lost a parent and know what it feels like, they dont seem to understand why i dont want to go out or see anyone. Am i being selfish and too caught up in my grief?? Its all still too raw, i smile to everyone but inside its killing me. Why dont they understand this. I almost feel guilty. :(

  18. Kate said on May 22, 2014 at 9:40 pm ... #

    I lost one of my best friends in a horrible car accident just about a month ago. Although this isn’t the first time I lost someone I loved, I was always able to bottle grief up each time before now. Now, I can’t help but cry or get angry at the fact that it happened. Given my past habit of swallowing death down and “getting over it” really quickly, I feel like I should’ve “gotten over it” the day after I found out. I also feel like I have no right to grieve since I feel that everyone else knew and loved him more than I did. I know it’s illogical, but that’s how I feel.

    P.S. I don’t know if any of the rest of you have had nightmares when experiencing a loss, but it’s happening to me. Is that normal?

  19. Alice said on October 6, 2014 at 6:21 am ... #

    I have been bottling up for years. I have had a lot of trauma and impossibly unhappy events in my life. My childhood was very traumatic from a very early age. I also have to live with the psychological consequences of these bad experiences on my children who I love so much and who all simply hang in by a thread, never reaching their potential and struggling with low self worth and unhappiness.

    For years I struggled to ignore how depressed I was and how overwhelming my situation was. In between these down periods I would have times of happiness too. But I was always haunted by the bad things that happened to me in my marriage from a very twisted husband and very fearful of the psychological damage this had done to my children.

    Eventually I asked the doctor if I could have medication. I was on an SSRI for 8 yrs and this gave me relief and helped me cope with new traumatic events in my personal life and family life.

    But I always knew I was not dealing with the real pain and that I was just keeping it on hold.

    It took me a yearr to come off the SSRI as I suffered withdrawals and had to go about it gradually. My aim was to get to the root of my pain on my own and face my sorrows. I’d been drinking too much for 8 yrs too at the same time as taking the SSRI. As I recovered somewhat from the medication I decided to quit drinking too. I was after all drowning my sorrows even though I didn’t seem to be an alcoholic in terms of behaviour and such.

    Lately I have a sense of really being in touch with my real feelings. I feel sad often and this sadness is about particular past and on going events. I even suddenly felt so sorry for myself as a young child and realised (really really realised) deep down how awful it had been for me as such a young child to experience such terrible events. But now I definitely do not feel the depression I felt hitherto, the depression that made me ask the doctor for medication. Now when I am sad I just sit with the sadness and accept it. I validate it and do not try to escape it. Lately this sadness has resulted in a build up of emotion that suddenly makes me cry in a very deep heartfelt way. I bottle the tears up in public and let them go when I have a chance to do so in private. The tears feel cleansing like I am at last expressing the real emotions I had kept back for an eternity, or ones I simply could no longer access because of years of locking them away. I have a sense that my former depression was from NOT grieving and that now I am not depressed because I am actually truly grieving in fits and starts. Sometimes when I have no space in my life to express the tears I feel wan and lifeless as if the stuffing has literally gone out of me. I feel ghostly and ethereal like I am all spirit and no substance. Letting out the emotional tears makes me feel more solid again.

  20. GINNY KLEIN said on April 23, 2015 at 2:14 pm ... #

    I lost my wonderful husband of 57 years, a sincere and loving wonderful guy, and the only man I’ve ever loved, from the moment we met to this moment and beyond. I cry alot, my kids are wonderfully supportive and this Saturday is the memorial for him at Lehigh University in Bethlehem. I had my camera man who does my show on psych stuff come down on Saturday and record the sentiments and talks from from Andy’s academic colleagues at Lehigh. My daughter is coming and I’m recording it for me, her, my son and our grandkids. I am so very sad. I miss Andy so much, and the house seems so empty. AS a therapist I know to feel my feelings and not store them up inside me. But it is so very painful to lose a treasure of a person who from the moment I met him I knew his character and loved him. I’m so sad

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