Help for Grief and Severe Depression
Moving beyond intense feelings of grief and severe depression after the death of a loved one will take effort. It helps to know where to turn for help if you can’t manage on your own.
By Linda Foster, MA
Medically reviewed by Cynthia Haines, MD
Grief is a normal response to the loss of a loved one. But sometimes grief causes severe depression symptoms and you'll need help to move beyond the pain of your loss.
What Is “Normal" Grief?
About 50 percent of people who lose a partner have symptoms similar to major depressive disorder for up to two months following the death of their loved one, according to Ben Brewer, PsyD, a psychotherapist in Denver, Colo., who specializes in grief and loss.
The most common symptoms of grief and major depression include changes in sleep patterns (typically insomnia), lack of appetite, fatigue, withdrawal from formerly pleasant activities, and feelings of sadness and loss. Guilt or shame are also very common, as are feelings of anger at the deceased for leaving you.
“You could also have mild hallucinatory symptoms related to the loved one, such as feeling their presence or briefly hearing their voice,” says Brewer. “These symptoms of normal grief can be very intense and often surprise people who have not previously experienced a significant loss in their lives.”
Grief can last months or years, but for most people it eventually approaches a state of faded or “attenuated” grief, during which you feel adjusted to the loss of your loved one and are able to function without much interference from grief.
When Is Grief Abnormal?
Although noticeable symptoms of grief can certainly last far beyond two months, it's unusual for symptoms similar to those of major depressive disorder associated with grief to last longer than this.
“If any of the symptoms are severe or last longer than two months, particularly if they involve suicidal thoughts or more intense hallucinations, you should seek help or emergency services immediately,” says Brewer.
For non-emergency treatment, individual or group therapy has been shown to be effective in helping people process the strong emotions of grief. Brewer also recommends consulting a physician or psychiatrist about medications that can ease symptoms of prolonged or intensive grief, another effective approach.
What Severe Depression Symptoms May MeanWhen You're Grieving
Major depression is just one of a number of mental disorders that may be associated with the death of a loved one. Others include generalized anxiety disorder and post-traumatic stress disorder (PTSD).
Emotional and psychological symptoms of generalized anxiety disorder include restlessness, difficulty sleeping, trouble concentrating, excessive anxiety, or worrying that isn't appropriate for the situation; some people also have physical symptoms, such as a racing heart, profuse sweating, digestive problems, and shortness of breath.
“If the symptoms of any of these disorders become present after the death of a loved one, seeking help from a professional is advised,” says Brewer, "particularly when symptoms are severe or last longer than two months after the death."
PTSD symptoms most commonly occur if someone witnessed the traumatic sudden death of a loved one or were themselves in danger at the time of the loved one’s death. Symptoms of PTSD include:
- Avoidance. This includes feeling detached, feeling as though you have no future, being unable to recall important events surrounding the loss of your loved one, feeling numb, lack of interest, and a reduced display of moods.
- Hypervigilance or hyperarousal. This includes symptoms of extreme awareness, being easily startled and overreacting to being startled, having difficulty focusing, feeling irritable or angry, and having difficulty sleeping.
- Reliving the event. This group of symptoms involves repeatedly reliving the event or loss, so much so that it interferes with you daily activities. Symptoms include recurring dreams of the loss, flashbacks where you relive the tragic event over and over, and physical reactions to circumstances that remind you of the loss of your loved one.
Understanding Prolonged Grief
According to Brewe, there do appear to be cases in which grief becomes chronic and debilitating without matching the symptoms of major depression disorder, generalized anxiety disorder, or PTSD. Prolonged grief that does not fit one of those diagnoses is often called protracted, complicated, or traumatic grief.
“Intense symptoms of grief in these cases often last more than 14 months and do not show significant improvement towards reduced grief," Brewer explains. "Complicated or traumatic grief is often distinguished by difficulty acknowledging the death of your loved one, or disbelief; continuing to act as though your loved one is still alive — like setting a place for them at the table; and extreme distress from grief with little hope for the future.”
Complicated or traumatic grief is often associated with feelings that life is empty or meaningless without the person who died. A person dealing with this type of grief will frequently have difficulty going about daily activities because of their symptoms.
“Anyone struggling with this type of grief should seek help from a therapist who has experience working with grief and loss, and they would also likely benefit from a consultation with a physician or psychiatrist about their grief symptoms,” Brewer says.
It is possible to get past grief and severe depression and start living again. Seek out support groups in your area — your doctor or local hospital should be able to recommend one. And consult with your doctor about a referral to a grief counselor, therapist, or psychiatrist. Though you may feel alone, there are many people available to help you.