Depression and Grief: Knowing the Difference and Getting Help

by Stephanie Dodaro

grieving woman“I’ll never forget where I was when I got the call that my ex-boyfriend had died.” Mary Orozco said. “I was on the 42nd Street subway station platform in Manhattan, waiting for the A train. When my friend spoke the awful words, I crumpled up under a staircase and started sobbing, people still rushing above me and around me to their trains. A young man very sweetly came over and asked me if I was ok. I blubbered that I had just found out a friend had died. But I didn’t tell him that my ex-boyfriend had walked into the ocean. I didn’t tell him that my ex had also called me the night before, but I had let the call go to voice mail. The young man squeezed my arm and said he was sorry for my loss. I was very grateful for his kindness, but at that moment, no one on earth and no words could make me feel better. I scrapped my plans and took the E train to St. Patrick’s Cathedral and just sat in a pew. I was raised Catholic, but I’m not a religious person–I just didn’t know what else to do or where else to go. I sat there numb, unspeakably sad, and angry at the throngs of tourists who were allowed to come in and take pictures when some of us were in crisis. Over the next few weeks, I was a total wreck and wondered when those waves of grief and despair would stop.”

All of us will feel the loss of a loved one at some point in our lives. For those of us who are going through divorce, caring for the terminally ill, or mourning the loss of a loved one, it can sometimes feel like the deep well of loss, pain, and loneliness might never end. Grief takes many different forms for different people and for those of us with prolonged mourning, it may be difficult to tell where grieving ends and depression begins. In fact, the prolonged stress of grief can trigger depressive episodes in people prone to depression.

“As someone with major depressive disorder, my grief was similar to depression in some ways,” Mary said. “It was overwhelming and constant, like depression. I didn’t feel like talking to people and I almost felt panicky trying to wrap my mind around the fact that I would never see him again, and that he had died in such misery. Misery I knew all too well. I questioned if there was something I could have done and, in some small part, blamed myself. But, unlike when I’ve had depressive episodes, when I was grieving I didn’t feel that my self-worth was at stake. And my sadness gradually eased over time. When my depression was untreated, it only got worse.”

Depression is a serious, potentially life-threatening disease affecting 16 million Americans at some point in their lives. It’s important to understand when symptoms are the temporary grieving or a sign of major depression or anxiety.

So how can you tell if you’re experiencing grief or clinical depression? If you’re grieving, you may feel sad or isolated, have trouble sleeping, lose your appetite, and take little interest or pleasure in doing things.

When you’re depressed, your mind is constantly overstimulated with negative self-talk, which can stunt your confidence, cloud your ability to accurately weigh consequences, and make it tough to make good choices or learn from mistakes.

Those with depression can experience symptoms common to grief, as well as more self-destructive manifestations such as:
• Feeling down or hopeless
• Experiencing constant anxiety
• Having trouble falling asleep, staying asleep, or sleeping too much
• Feeling worthless, telling yourself that you’re a failure or have let yourself or your family down
• Having trouble concentrating on activities, such as reading the newspaper or watching television
• Moving or speaking so slowly that other people notice, or being so restless that you move around a lot more than usual
• Having thoughts that you would be better off dead or of hurting yourself

During a depressive episode, the cycle of negative thought reinforcement can compound your symptoms, which then worsen over time. Fortunately, depression is now a treatable disease, with a variety of remedies available. Those suffering with symptoms may not seek help because of shame, stigma, or the belief that they should be able to overcome depression on their own–often these feelings exacerbate a sense of failure and prevent people from getting the relief they need.

If you recognize some of the symptoms of depression and have experienced them for more than two weeks, please contact your health care provider. Whether you’re experiencing prolonged mourning, clinical depression, or another medical condition like thyroid disease, your health care provider can help you get the support you need. They can refer patients to psychologists for counseling sessions. If you are experiencing more debilitating or longstanding symptoms, you may also be referred to a psychiatrist, who can prescribe medications such as antidepressants or anti-anxiety drugs for short- or long-term use.

For treatment-resistant depression, patients also have non-invasive options including TMS therapy, an outpatient treatment that uses magnetic energy to stimulate and rewire brain receptors. FDA-approved in 2008, TMS is effective in twice as many patients as antidepressants, with far fewer side effects.

Certain insurance providers also offer alternative or supplementary treatments such as holistic, integrated approaches that may include also acupuncture, nutritional counseling, or light box therapy.

“At the time of my ex-boyfriend’s death, I had been taking anti-depressants for many years and had gone through a lot of therapy,” Mary said. “Treatments for depression may not all be perfect, but I’m thankful that my meds have kept me feeling level over the years and probably helped make it easier for me to process my grief over my ex.”