Monday, April 26, 2010
Grief Versus Depression
Grief is itself a medicine. ~ William Cowper
I recently made a visit to the doctor's office for a routine checkup on my thyroid levels. No worries, this blog is not getting too personal, that is as much of the details you will get on the medical side of things. But, I had an interesting conversation with the new doctor that I was seeing for the first time. It was about Grief versus Depression.
About a month after Stephen died, I had to go to the doctor for my thyroid check. I felt about 100 years old, my heart ached, I had dark circles beneath my eyes, and life was simply harder than I ever imagined possible. Even with my daily gratitude, I could not change the fact that I missed my son terribly, and was in a deep and inconsolable grief. It was my first visit to this physician, as my family doctor had recently moved.
Sitting up on the examining table, the nurse came in to check me in for the appointment, assess my vital signs and find out the reason for my visit. I was brief in my answers, wanting to get this over with and get the heck out of there. But, she noticed my blood pressure was elevated from the last recording on my chart.
"Your blood pressure is up. Is there anything going on in your life that is stressful right now?" she asked.
And, as if I was a dam on a raging river, I burst out crying, exclaiming that my son had died. I rambled some of the details of his passing through my tears, and grabbed a tissue.
And then, the visit took a turn. The nurse abruptly stood up, looking very uncomfortable with my tears, and said, "Well, I'm going to leave, because I'm not much good to you right now."
Yep, she just left me. Sitting on a paper sheet in a clinic examining room, to cry alone as I stared at a medical poster about the digestive system. Being a nurse myself, I immediately thought back to my school days regarding empathetic communication and surmised that she had missed those classes. Her discomfort was obvious.
But that was not the end of it. The doctor arrived in the room, and was visibly uncomfortable, averting her eyes away from my tear filled ones. She skirted around Stephen's death, never actually addressing it directly, or offering a simple condolence. If I had not been in so much pain, in need of some simple comfort, I think I would have started to laugh. Because I felt like I was part of the filming of the "before" video for, "How Medical Professionals Communicate With the Bereaved."
And then she said it.
"Let's talk about Paxil and Prozac."
Not once in my visit did I ever say I was feeling depressed. In fact, I did not even express anything about my grief, because she didn't ask. I was simply requesting a blood level and prescription renewal for my thyroid medication.
But, in her mind, based on what the nurse told her about me as they stood quietly outside the door, I needed to be medicated. Perhaps it was my tears, sparked by the fact that I, for one of the first times, had to say aloud that my son had died.
My reaction? I gave her my eyebrow, which said more than words ever could, and I told her I was grieving, not depressed and there was a big difference.
Now, Let's back up a little. What's the difference between grief and depression? The dictionary definitions defines them as:
Grief: Grief is a multi-faceted response to loss, particularly to the loss of someone or something to which we have formed a bond. Although conventionally focused on the emotional response to loss, it also has physical, cognitive, behavioral, social, and philosophical dimensions. Reaction to a major life loss; deep and poignant distress caused by or as if by bereavement.
Depression: a state of feeling sad : (2) : a psychoneurotic or psychotic disorder marked especially by sadness, inactivity, difficulty in thinking and concentration, a significant increase or decrease in appetite and time spent sleeping, feelings of dejection and hopelessness, and sometimes suicidal tendencies c (1) : a lowering of vitality or functional activity.
You can see that some of the definitions and descriptors in the depression definition sound like the feelings that one experiences on their grief journey. And honestly, in some cases, people do in fact become depressed because of grief. It can happen, and it is understandable.
But I am here to tell you that there is a big difference between the two.
Grief is a natural response to loss. Grief is a journey. Grief is something that you need to do in order to heal your broken heart. Grief is not something that needs to be medicated because a physician doesn't know what to say and wants to find solutions for you. However pure the doctor's intentions were, she didn't understand an important fact. Medicating grief does not make it go away. It simply dulls it, so it can sit and wait beneath the surface to be faced at a later date.
The reason I rant about all of this? Because my new physician (sorry, could not go back to see this gal anymore) talked about my grief as one of the first things on her list after reviewing my chart. I loved her direct approach, asking me how I was doing. She said that my chart indicated I was having a delayed grief response during my last visit. I explained that was not accurate, and that on my last visit to the doctor's office, my son had only died a month before. She quickly made note of this, and apologised for the assumption. She asked about how I was coping, and listened, nodding approval at our choice to go to grief counselling, and journal. Not once did she ask me about depression. Instead, she assessed me as a professional, and understood that I was doing just fine.
Two doctors. Two different approaches.
If you are grieving, remember that it is a journey, and it is a natural response to losing someone or something you loved. Remember that there is a difference between grief and depression, and speak up if you feel like your grief is being misdiagnosed. Remember that there is no pill that can take away the pain of loss. If there was, everyone would be taking it. The only cure for the pains of loss is time, and it is individual for everyone. Of course, if you experience some of the more marked symptoms of depression listed above or online, you should always consult your family physician.
If you are a medical professional, take some time this week to evaluate your approach to the bereaved when they show up in your office. Do you talk to them, or do you write the pain away? Do you bolt for the door, or do you comfort?
Even for the trained professional, grief can be an uncomfortable reality. Think about your approach and understand that in your quest to heal, that grief is not something to be fixed, but rather it is something to be experienced.
Have a great one,