Sometimes we experience huge changes in our lives. These events can cause intense emotional anguish, and grieving during such life changes is a normal and healthy — if painful — process. Grief can be the result of a major life change such as:
- the death of a loved one (a person or pet)
- a move to a new and unfamiliar community
- an opportunity or life goal that becomes closed to us
- a loved one contracting a life-threatening illness.
Occasionally, however, this anguish triggers a major depressive episode, although few people in mourning experience true clinical depression.
Even a serious illness can increase the risk of stress and, potentially, depression in a partner: A recent study of 518,000 couples over age 65 found that when one spouse was hospitalized for a serious illness, the other spouse had a greater risk of dying within the next year. The probable reasons: increased stress and withdrawal of social, emotional, economic, and other support.
Grieving often produces a wide range of feelings. The psychological process itself is a way for the mind to adjust, over time, to the acute sorrow of a loss. Grieving also allows us to accept the finality of the loss, to experience a full range of feelings as a result of the loss, and to adjust to our changed lives. The end of grieving does not entail forgetting; rather, it usually comes with the acceptance of our loss.
A good sign that mourning is successful is a gradual shift from sad thoughts and feelings to thoughts of positive and realistic plans for the future. As this shift occurs over time and the mourner begins to enjoy life more than feeling weighed down by it, the process of grieving moves forward.
Although grief and depression may both entail feeling sad and "blue," they are different. The sadness of grief usually comes in "waves," with varying degrees of intensity and bouts of crying, and intense feelings of sadness, guilt, anger, irritability, or loneliness.
An individual experiencing grief, however, can enjoy some of life's activities. Grief is generally temporary and resolves without specific treatment.
Depression is a more persistent and unremitting sadness and is notable for a consistent inability to enjoy pleasurable life activities.
Muted or "deadened" feelings are often a sign of depression. If such symptoms persist following a life change that produces grief, mourning may have been unsuccessful and the help of a physician or other health professional is warranted. Check for the following symptoms, especially over a prolonged period or if they arise months or even years after the loss:
- physical symptoms that mimic the illness or injury of the person who died
- overuse of alcohol, illegal drugs, or prescription drugs
- persistent depression (see page 6 for symptoms)
- chronic sleep disturbances
- thoughts of or attempts at suicide (see a health professional immediately)
- inability to carry out normal daily routines.
It is important to seek medical help for physical symptoms that arise during mourning and to address any medical or psychiatric conditions that existed before the death occurred. Some evidence suggests that acute mourning may suppress the immune system and make people more susceptible to illness.