Lesson 3 of 8 - learn grieving basics and grow a pro-grief family

Is it Depression or Incomplete Grief?

They have similar symptoms,
 but different roots

By Peter K. Gerlach, MSW
Member NSRC Experts Council

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The Web address of this two-page article is http://sfhelp.org/grief/depression.htm

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        This is one of a series of articles in Lesson 3 in the Break the Cycle! self-study course.  This Les-son educates readers on healthy grieving basics so they can finish mourning major losses (broken bonds). Typical survivors of childhood trauma (Grown Wounded Children - GWCs) never learned these basics, and risk significant problems from incomplete mourning.

        Have you or someone you care for been depressed recently? Depression is so common in Ameri-can kids and adults that treating it has become a major industry. It often occurs in GWCs.

        This article explores the important difference between "depression" and incomplete grief. Can you describe the difference? Unfinished mourning  merits a different response than true depression.

The article...

Describes common symptoms of depression and normal grief,

Suggests four common causes of these symptoms

Proposes options if you're "depressed," and...

Suggests options if you're concerned about a "depressed" person.

        This article assumes you're familiar with...

  • the intro to this nonprofit web site and the premises underlying it

  • self-study Lessons 1 thru 3

  • these Q&A items about mourning, and...

  • these brief research summaries.

        My clinical experience with hundreds of therapy clients who felt "depressed" is that they're really grieving...

  • past losses (broken bonds), including some in childhood, and/or...

  • an expected future loss like youthful vigor, kids moving away, retirement, or death (anticipatory grief).

        If you or someone you care about weren't encouraged to mourn fully as a child, depressive symp-toms may signal being stuck in the sadness phase of emotional grief. "Rageaholics" are often stuck in the anger phase.

colorbutton.gif What Is "Depression"?

        It's a catch-all term for a mind-body condition ranging in intensity and impact from brief and minor ("a blue mood") to long-term and major. The condition (vs. "illness") can promote physical, psychological, and relationship problems.

        Symptoms of depression typically include some or all of these...

Low physical energy; "fatigue."

Apathy: marked disinterest in pleasurable life activities, and/or an inability to feel normal pleasures (anhedoia).

Notably sad, glum mood.

Unusual feelings of guilt, despair (hopelessness and pessimism), and/or worthlessness.

Difficulty concentrating: mind-racing, and marked indecisiveness.

Trouble sleeping or sleeping excessively.

Possible loss of appetite and related weight loss.

Recurring thoughts of death or suicide,

Crying urges or episodes with or without a "cause," and...

Excessive or unusual irritability.

If five or more of these symptoms are clearly present every day for at least two weeks (in someone's opinion), the condition is psychiatrically labeled clinical depression. Some people label serious depres-sion a "mental illness." I propose that it's a normal human condition, not an "illness"!

         Each of these symptoms can also occur during normal three-level grieving.

        Depression can be a single episode or a recurring condition. Chronically depressed people experi-ence these symptom-clusters as normal life, so they may have little motivation to change toward some-thing they've never felt.

        Depression is a problem for the sufferer, and can cause significant anxiety (worry), guilt, and frustration in people who depend on or care about the sufferer. Three possible problems are...

  • you’re significantly depressed,

  • another person you care about is, or...

  • you both are.

All of these can stress your wholistic health and other relationships, specially if you have other concur-rent problems. Let's look at the first two situations in some detail...

colorbutton.gif Options If You Feel "Depressed"

        “Depression” and the sadness phase of normal grieving feel and look the same, emotionally and be-haviorally. I suspect that many “depressed” adults and kids are really mourning major losses. If so, the cure is not pills, but acquiring these requisites so your grief can run its natural course.

        Premise - feeling "depressed" can be a symptom of up to five underlying factors:

  • unawareness of significant false-self wounds and their effects (Lesson 1); and...

  • ignorance of healthy-grieving basics (Lesson 3); and...

  • unrecognized incomplete grief; and...

  • living in a grief-inhibiting environment; and possibly....

  • hormone and brain-chemical imbalances. The first four may promote this.

        To reduce your symptoms, try these options:

        1)  Give high priority to self-study Lessons 1 thru 3. Test your knowledge of "good grief" basics with this quiz. Ignoring this option suggests toxic false-self dominance, which is the primary problem.

        2)  If you feel suicidal, get professional help. Note that many professional therapists, clergy, and counselors aren't trained to check for incomplete grief. Option - ask whomever you hire to scan Lesson 3 and "pass" the "good grief" quiz. If they're not willing to, look elsewhere.

        If you have chronic pain and/or an incurable progressive lethal disease and have nothing to live for, explore support organizations like Compassion and Choices and Final Exit Network.

        3)  Meditate on any past or recent changes in you or your lifestyle - e.g. a disability or illness, job change, a geographic move, a shift in an important role or relationship, a financial shift, births, deaths, divorces, retirements, etc. Ask yourself "What have I lost - specifically - because of this change? Use these abstract and physical loss inventories to help answer the question. Note that anticipatory grief can start before an expected loss actually occurs.   

        Once you identify your losses (broken bonds), prioritize them. Starting with the most impactful, use this level-and-phase concept to gauge where you are in grieving each loss. If you suspect some important grieving is incomplete, consider these options.

        Option 4)  Try using parts work (Lesson 1) to identify which of your subselves have taken over your true Self and are causing your apathy, hopelessness, and discouragement. Often this will disclose one or several Inner Kids who feel locally or chronically abandoned, isolated, sad, overwhelmed, and powerless.

        If you find such subselves, identify any related Guardian subselves (e.g. Catastrophizer and Cynic/ Pessimist). Work with them all toward trusting your Manager subselves, and helping the young ones grieve and feel more secure. Then see what happens to your "depression" symptoms.

        5) Be aware of the terms your family adults use in thinking and speaking. Depressed and depres-sion can be evoke anxiety in subselves who associate them with sick or ill, crazy, nuts, weak, inferior, anxiety, bad, doctors, hospitals, therapy, trouble, or other vague or specific discomforts. "I'm working to accept some major losses now" can feel better to someone's subselves than "I am (or you are) really de-pressed."

        6)  If subselves feel guilty that your "depression" symptoms are burdening other people "too much," confirm your right to feel how you feel. Read and apply this article on managing excessive guilts, and use these wise guidelines. "Feeling better" is your responsibility. Other people are responsible for managing their own comfort!

        7)  Become aware of whose advice you follow about assessing and treating "depression." e.g.  family elders, mentors, hero/ines, health professionals, and media authorities. It's likely they don't know what you're reading here. Finally...

         Option 8)  Think twice if you're considering anti-depressant medication. "Mood control" chemicals may relieve your symptoms, but not what's causing them. If these options don't relieve your symptoms, consider hiring a qualified therapist or licensed grief counselor for a professional evaluation. "Qualified" means...

  • usually guided by their true Self; plus...

  • having a wholistic (mind + body + spirit + emotions) view of health; plus…

  • openness to the ideas in this Web site, specially about personality subselves and incomplete grief; plus…

  • believing that grieving is appropriate for all significant life losses, not just someone's death; plius...

  • training in, and experience at, promoting healthy three-level grieving; including this research; plus...

  • up-to-date medical training on the bodily aspects of "depression," and "anti-depressant" medications.

Status Check

        Learn about yourself by meditating on these statements. T = true, F = false, and ? = "I'm not sure," or "It depends on (what?)":

I accept that grieving is needed for all kinds of life losses (broken bonds), not just death.
(T  F ?)

I believe grief is a healthy human response which can be slowed or blocked.  (T  F ?)

My childhood adults consistently encouraged and modeled (a) feeling and (b) expressing healthy grieving values, emotions, thoughts, and behaviors. (T  F ?)

I’m comfortable now (a) feeling and (b) expressing _sadness and _ anger privately and pub-licly; and (c) I’m comfortable enough being around others who feel and express shock, sad-ness, and anger. (T  F ?)

I can clearly describe (a) my personal and (b) my family’s grief policy - i.e. our sets of shoulds, oughts, musts, and values about feeling and expressing grief. (T  F ?)

I now live in a pro-grief home and family - i.e. one which consistently encourages everyone to mourn well. Note the difference between intentionally encouraging grief among your fam-ily members, and passively tolerating their mourning. (T  F ?)

I am now able to (a) identify and (b) grieve my losses thoroughly; or if not, (c) I'm taking ef-fective steps to improve this. (T  F ?)

I can (a) clearly tell the difference between “depression” and incomplete grief now, and (b) I can name at least six symptoms of incomplete grief. (T  F ?)

Other adults in our family would answer "True" to the statement above. (T  F ?)

I accept that using anti-depression (mood control) medication may hinder healthy mour-ning.  (T  F  ?)

Now I feel a mix of calm, centered, energized, light, focused, resilient, up, grounded, relax-ed, alert, aware, alive, serene, purposeful, confident, and clear, so my true Self is probably leading my other subselves (personality). (T  F ?)

        What did you just learn?

         So far, we’ve explored options if you are significantly depressed. Let’s now explore your…

colorbutton.gif Options If Someone Else Seems Depressed...

        With your Self guiding you, notice how you feel about (a) the depressed person, and (b) being around her or him. Then consider these ideas...

  • use your feelings as pointers to identify what you need, relative to this person. If you need to "make them feel better," try to discern why their "depression" is affecting you.

  • get clear on what you can affect and what you can't.

  • ask the person what s/he needs - in general, and from you.

  • avoid saying "You'll feel better soon." You have no way of knowing that. See these alternatives.

  • avoid saying "I know just how you feel." Because you have a different history and personality, you probably don't.

  • if the person wants solitude, respect that;

  • beware offering help that isn't requested. That can feel insulting.

  • if s/he is open to feedback,

    • invite the person to explore whether they're mourning key losses. Common  responses are "Uh... I don't think so," or "I'm not sure - I've never thought about that." If they ask why you ask, propose that the sadness phase of normal grief feels like depression - and their symp-toms will lift as their grief runs it's natural course. Refer them to Lesson 3 in this Website.

    • offer an overview of personality subselves. If s/he seems open to that idea, add the con-cepts of true Self and false self. Discuss the possibility that a false self may be causing her/his depressive feelings and/or grief. If appropriate, suggest that s/he study Lesson 1 to explore this possibility. If you're working on Lesson 1, describe your experiences.

  • avoid urging the person to get anti-depressant medication - unless you and s/he are sure their con-dition is not normal grief.

        If the person is a relative, the "depression" (and/or incomplete grief) is a family problem, not a personal one. Discuss this and related articles with other family members, including older kids. Also talk factually about how the person's "depression" symptoms are affecting you all, and what each member needs. Option: make Lesson 3 a family-wide activity!

colorbutton.gif Recap

        This article is one of a series in Lesson 3 - learn good-grief basics and grow a "pro-grief" family. The article encourages you to assess if "depression" is really grief, for the symptoms are very similar. Unfini-shed grief is a primary personal and family problem. It usually causes a web of secondary problems in your home and relationships. The article offers practical options if you and/or another person feel signifi-cantly or chronically “depressed.”

 Continue studying Lesson 3!

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        Pause and recall why you read this article. Did you get what you needed? If not, what do you need? Who's answering these questions - your wise true Self or ''someone else''?

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Updated  August 30, 2010