Feelings of sadness and hopelessness are really common after someone dies. These feelings are often referred to in every-day life as ‘depression’. Sometimes people who are grieving might wonder if their feelings have changed from what they think of as ‘normal’ grief, and become a sign that they might be depressed. Sometimes people also come across the term ‘complicated grief’ and wonder if what they are experiencing falls into that diagnosis. This blog post from Cruse Clinical Director Andy Langford looks at what these terms mean, and how to tell when what you are feeling means reaching out for more help might be appropriate.
What’s the difference between grief and depression?
The first thing I’d like to stress is that all these terms are just labels. There is no easy way of fitting the complicated mass of human feelings into neat categories, although many people have attempted to try over the years. Grief can be an overwhelming experience and it affects every part of our functioning, including our mental and physical health.
In medical terms clinical depression is a condition where the feelings of being sad, low and hopeless persist over weeks or months, often accompanied by anxiety. These feelings are also common in bereavement, and of course it is possible to be depressed while you are bereaved, and vice versa. You can read more about the signs of depression and options for treatment on the NHS website.
Another term sometimes associated with bereavement is complicated grief. There is no officially accepted definition of complicated grief in the UK, and people are not usually given this as a diagnosis. It generally refers to situations where many months after a bereavement a bereaved person is struggling to cope with the emotional impact of grief and deal with everyday life. It is often associated with situations where the death was very tragic, traumatic or unexpected.
Whether or not you or someone helping you feels you fit into any of these cateogories, the main thing to consider is how is the loss affecting you, and what is going to help you cope.
When should you worry?
There is a really wide range of feelings and physical experiences that are very common after someone dies. Usually these do change over time – slowly becoming more manageable, or coming and going. When we should be alerted and concerned is when we get stuck in feeling one way in particular for a long period.
So for example it’s really normal to spend time looking at photos, maybe crying, and thinking about the person who’s died. But you might then be able to sort the pictures out, and put them aside for a while, and go for a walk or get on with some work. This back and forth is normal and healthy. But if you notice that large parts of your life that would normally be stable are becoming unmanageable (for example you can’t get to work, and need to stay in bed) it might be time to reach out for help.
Alternatively, some people find they can get stuck in the practical aspects of dealing with the aftermath of someone dying. There are a wealth of practical tasks to complete. It can be understandable that some people consciously put aside their grief and get on with arranging the funeral, looking after the kids, dealing with moving house or whatever else is going on. At the time of writing this blog the UK is in a third coronavirus lockdown and it’s an even more difficult and busy time for many, with many children home learning, and major changes in work and financial situations to deal with.
So it’s a difficult but understandable choice to focus on these practical tasks. But again, if you find that you are getting stuck, it’s work considering whether you can fit in some time to be with yourself. Tme to be a little less busy, remember the person who died, and give yourself a chance to grieve.
The main message is, that whatever you are feeling, if you find that you’re heading in the direction of getting stuck, stop and check in with yourself. This ‘stuckness’ sometimes comes out in us not experiencing emotions in the way we usually would (for instance, crying). We may find that they come out in our body instead, such as through muscular issues, chest pains or a bad stomach. Or perhaps you are finding it more and more difficult to get out of bed each day. Whatever way it shows up it may be a sign it’s time to reach out to a support organisation or someone close who you can talk with.
Asking for help
We all need other people and keeping those connections with people you trust available is important. But sometimes it can be difficult to maintain connections after someone dies. It can be difficult to admit you are struggling and ask for help, and friends and family can find it difficult to know what to say, and wonder if it’s better to stay away rather than risk saying the wrong thing.
Finding the words to explain how you are feeling can be difficult. It can help to find a bit of time to think about what you want to say beforehand. If you can’t find the words or aren’t ready to share how you’re feeling it can be a good idea to let people know. Tell them it’s not that you don’t love or trust them, and just because you’re not ready to speak about it at the moment doesn’t mean you won’t need to in the future. It’s even tougher at the moment, and a lot of contact is having to be virtual, but even if you prefer talking with someone in-person, telephone or Zoom is better than nothing.
If you don’t have anyone you feel able to speak to, or you need help from someone not part of the situation, you can also reach out to Cruse, or to other organisations. You can also speak to your GP if you are concerned about depression or other ongoing mental health issues.
Helping someone else
The signs to watch out for in others are similar to those I talked about above – a change in behaviour, in particular if someone seems to becoming stuck in one way of thinking or behaving. It’s always important to remind someone that you are available, as being there to talk to is the most helpful thing you can do. If you’re not sure what to say, you can let them know that you can’t find the right words but are just there if you need them. You can also show someone you care with gestures such as providing a meal, and whilst electronic communication is great, it can sometimes feel very meaningful to send a letter or a card to provide a physical reminder to someone that you are thinking about them.
If someone admits that they need extra help, and just talking is not enough, you could offer to help them find out how to get further support, whether that’s from their GP, Cruse or other organisations and services.