John T. Stallworth, J.D., Ph.D.
David S. Litton, Ph.D.
Carol Pierce-Davis, Ph.D.
Rebecca Redwood, LMSW-ACP
Theodore Carlos, M.A., LPC
Whitney Humphrey, M.A., LMFT-A
Dona Stallworth, Ph.D.
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Dealing with Depression

Give sorrow words: the grief, that does not speak, whispers the overwrought heart, and bids it speak
Shakespeare

Loss

Everyone has experienced the loss of something or someone...

Everyone has been through difficult changes ...

At some point in life everyone experiences the death of someone they love


Loss is a universal human experience. Each era, each race, each culture � and ultimately each human � is challenged to come to terms with the grief which accompanies loss. Individuals experience personal versions of its pain. They struggle to fund ways to cope, to endure, to continue with life in spite of what they feel, and despite what they have lost.


Words of wisdom and comfort, at least of a philosophical nature, abound for the times when someone is suffering. Some take the view, for instance, that loss is linked to growth � that good growth can occur in the aftermath of loss. Others remind us that loss is linked to what is good in life; one is vulnerable to grief precisely because one loves, cares or values someone or something. But these are ideas which tend to help at a later point.


This information is provided as a simplified �road map� and basic guide for a few types of grief experiences. Other writings are available to provide more personal, more extensive, more specific, or more technical information about the subject. Each in turn will suggest many other resources. In addition, individuals may seek help from counselors, mentors, or those who have been through similar painful experiences. All grief is isolating to a degree � but it need not be a solitary passage.


When Change Occurs (resulting in loss) .

Major changes in relationships, location, work, health, or belief system, for example, involve an ending and a beginning. Many times the ending involves a sense of loss. There are helpful, meaningful ways to handle this loss, to say "goodbye" to a phase in one's life, to allow closure, and thus better prepare for what is to come. This applies whether the change is intentional or unintentional, desirable or undesirable.

To cope with such major transitions, many do one of the following:

  • They deny that there is a loss. They focus on the future, on what is to come, while ignoring what is left behind.
  • They distort the past. Some glorify or idealize it, while others denigrate it. Either approach may simply be a means to lessen or avoid the pain of moving on.
  • They emotionally detach themselves. Avoiding people, becoming "numb," or finding ways to be distracted are examples of this response.

These efforts, while often successful in reducing pain or making change seem easier, can reap long-term maladaptive results. For example, those who deny, distort, or detach rarely feel resolution or satisfaction in either the ending of relationships or phases in one's life. They may experience intense grief and suffering at later, and unexpected, times. They may learn to maintain distance in future relationships as the prospect of separation is too painful to face again.

Here are some suggestions that may help you handle loss in a better manner :

  • Take time, in advance, to prepare for change. Reflect on the transition, on what it means to leave, to change.
  • Seek a larger and longer perspective. Fit the change into the overall picture of your life.
  • Describe what is or was significant about the particular time of life you are leaving to those with whom you have shared it. This includes expressing the importance or impact of those relationships.
  • Acknowledge what was good, what you now possess: the special memories, the accomplishments, the lessons learned, the growth achieved.
  • Remind yourself of the ways life can remain the same, of the continuity which can be maintained in the face of the changes.

Even when handled well, losses hurt. But acknowledging and using that pain can help you accept and remember the importance which past relationships and activities have had in your life. To make the most out of life's changes, learn to take the time to acknowledge the changes and say good-bye well.


When Relationships End (through death or separation). . .

In 1981 and 1983, over 3200 College and University students were asked to describe their most recent "major loss." Over 1/3 described the end of a friendship or a love relationship. Another third indicated the death of a loved one.

While these two kinds of loss differ, the impact of either can be devastating. When a close relationship ends, or someone important to us dies, it is common to go through a "grieving process." It can be helpful to know what that process might involve.

What can happen when you grieve?

Grieving the loved one or the ending of a love relationship can have a variety of effects. Here are several examples:

Emotional: sadness, anger, guilt, self-reproach, insecurity, anxiety, loneliness, fatigue, helplessness, shock, relief, freedom, longing, numbness.

Physical: dry mouth, fatigue, tightness in the chest or throat, breathlessness, weakness, emptiness, hypersensitivity, sighing, crying.

Cognitive: disbelief, confusion, preoccupation, hallucinations, forgetfulness, obsessive thoughts, sensation that the one lost is somehow present.

Behavioral: disturbances in sleep and/or appetite, dreams of the lost person, social withdrawal, avoidance of reminders of the lost person, reminiscing, overactivity.

What do you do through the grieving process? Grieving is often described as a journey a passage through several stages of very different experience. The suggested stages are not exact. They can overlap. They are not necessarily sequential, nor do all who grieve experience each one. In some cases the process can last a year or longer. The stages may include:

  • A period of numbness, shock, or denial. This often allows you to keep functioning for a brief period of time, presumably until you are prepared to begin to accept the loss and the accompanying pain.
  • A period of yearning and denial of the permanence of the loss. Often this is a time of anger. It may also lead to forms of "bargaining" efforts to reverse your loss or minimize hurt.
  • A period of despair and disorganization. This indicates awareness and acceptance of reality. It also underscores the meaning or value of your loss. In a sense, you are admitting it is important to stop normal functioning and mourn.
  • A period of reorganization or reentry. This includes a return to functional behavior, recovery of humor, the ability to enjoy things or relationships again. This indicates you are coming to terms with your loss.


What can you do?

Grief is also described as a series of tasks that must be accomplished. Worden (1982) suggests the four tasks described below. He warns that each task can be avoided or short-circuited.

The first task is to accept the reality of the loss. You stop "searching" or trying to recreate the relationship or the person. You stop denying the meaning of the loss. You allow pain to surface.

The second task is to allow yourself to feel the pain of grief. In some cases this means resisting the urge to not feel, or resisting the advice that others give which suggest pain or sorrow are unnecessary or unhealthy. It may also mean that you should resist the urge to run or escape feeling pain (i.e., by traveling, eating or drinking, overworking, etc.)

The third task focuses on adjusting to an environment without the person who was lost. For instance, you learn to live alone, sleep alone, go places alone, do work that the other did, or handle frequent reminders of them. Often your self-concept and world-view must also adjust to accept the loss.

The final task involves letting go of the person, or "relocating" your feelings for that person. This first involves finding a "place" for the one lost in your emotional life. Secondly, you make emotional energy available for other engagements. Completion of this task is indicated when you are open to future but not necessarily parallel relationships.


How do you know when the mourning is essentially over? This is hard to answer, but some suggestions may help. When you can laugh or enjoy things again When you desire to love again. When you can think of the person lost with sadness and less acute pain. When the physical, emotional, mental or behavioral conditions that accompany grief cease. When you can accept the efforts of others to comfort or encourage you. When you can set aside the "why" questions.

What else should you know? Grief looks to others like depression, but it must be respected as something different. However, grief which, over time, does not ameliorate can become a form of depression which may need treatment. Finally, consider the following comments from Deits (1988):


The way out of grief is through it.

The very worst kind of grief is yours.

Grief is hard work.

Effective grief work is not done alone.



References:


1. Bob Deits, Life After Loss. Fisher Books, 1988.

2. Elisabeth Kubler-Ross, On Death and Dying. MacMillan Publishing Company, 1969.

3. Louis LaGrand (1985) College student loss and response. New Directions for Student Services, 31. 15-28.

4. Craig Vickio, (l990). The goodbye brochure: Helping students to cope with transition and loss. The Journal of Counseling and Development. 68. 575-577.

5. J. William Worden, Grief Counseling and Grief Therapy :Springer Publishing Company, 1991.


We hope this helps.

David S. Litton, Ph.D.

John Stallworth, J.D., Ph.D.

Carol Pierce-Davis, Ph.D.

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