Complicated Bereavement or Major Depression?

Complicated bereavement vs depression

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It can be difficult, even for a seasoned professional clinician, to tell the difference between depression and complicated bereavement.

Let’s consider comparing complicated bereavement vs. depression, or major depression. A layperson’s definition of depression involves what has become a “buzz word” of sorts. We’ve come to use the term to describe everything from having the normal, occasional bout of sadness (or the “blues”) all the way to up to very serious mental illnesses, including what has been referred to as major, or clinical depression.

It is important for professionals not to overdiagnose the everyday blues, but it is at least equally important not to overlook major depression when it exists. More serious mental illnesses (as opposed to a simpler case of the blues) involve a spectrum range of severity, duration, symptoms, and clinically significant distress/impairment. For example, to be considered a clinical condition, symptoms need to have existed consistently every day for at least two weeks.

Occasional sadness is a normal part of life, and it comes and goes, as does grief and mourning, which typically involve the loss of a loved one. Complicated bereavement disorder (also known as complicated grief) however, involves a severe case of mourning a loss, which can incur a debilitating mental health condition that only gets worse over time, rather than improving.

The grieving process is natural, but unpredictable. “Normal” grievers tend to vacillate between shock, denial, depression, back to shock again, and so on. Ultimately, they are able to resolve their emotional roller coaster and come to an acceptance of the loss.

Complicated grievers, however, go through the stages of grief, without reaching any sort of resolution or acceptance. Their grief for the loss of the loved one is exacerbated by feelings of hopelessness for the future, waves of painful emotion, and intrusive thoughts and memories of the deceased that retard their ability to work through the grief naturally.

Factors such as a pre-existing mental health condition, substance abuse issues, and/or an overwhelming number of stressors, can complicate the normal grieving process,  increasing the probability of the grief becoming a case of complicated bereavement that may call for professional clinical intervention.

If you, or a friend or loved one seems to be suffering from either major depression or complicated bereavement disorder, the last thing you’ll want to do to yourself or to him or her is go into drill sergeant mode and tell yourself or the individual to “snap out of it.” Let yourself, or him or her feel, experience, and process whatever may be necessary. Listen and be supportive. Impeding the recovery process in any way will only delay the resolution. Grief and depressive feelings need to be fully processed and dealt with, and this will take time.

A professional diagnosis, by a professional who can put the right treatment plan into motion is important. The DSM-5 (American Psychiatric. Association, 2013) includes a diagnostic codes to assist with the most accurate diagnosis possible.

It’s worth noting that both major depression and complicated grief can be exacerbated by additional depressive symptoms, anxiety, post-traumatic stress disorder (PTSD), and/or substance abuse problems.   The sooner the condition can be properly diagnosed, the better, before the condition continues worsening.

A feasible combination of professional skill, therapy, counseling, and medication can help you or your loved one deal with depressive symptoms or with complicated bereavement to help with a coming to terms with the loss. Eventually, the therapeutic process can help get to a place of being engaged normally in relationships, feel hope for the future again, and back to enjoying life.

Do you suspect that you, a good friend, or a family member may be suffering from clinical depression or complicated bereavement following a loss? If you or someone you love need to talk to someone about managing a mental illness or feelings of being overwhelmed, we want to help. Consider reaching out to our expert team at Solara Mental Health at 844-600-9747.


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