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Can Grief Turn into Depression?

By

Jennifer Larson

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Grieving after a loss is a natural process, but it's also a hard one. Grief doesn't have a timetable, either.

Five Stages of Grief

There are five generally accepted stages of grief, according to noted psychiatrist Elisabeth Kübler-Ross' research: denial, anger, bargaining, depression and acceptance. Despite these five basic stages of grief, people don't always experience the stages in the same order, nor do they spend the same amount of time in each stage. Grieving is still a very personal, individualized experience.

Some people move relatively smoothly through the five stages. In their cases, their loss triggers acute grief, which can include both physical and psychological symptoms. Eventually, those feelings begin to diminish, over the course of weeks and months. According to research in the journal Professional Psychology: Research and Practice, some research indicates that many people return to a relatively normal state by 18 months after their loss.

Meanwhile, others find themselves stalled. It may take them longer to pull themselves through to acceptance.

When Grief Becomes Chronic

While normal bereavement—as normal as bereavement can be, that is—usually progresses, some people are unable to move forward at all. Their grief becomes essentially a chronic condition—they are mired or stuck in their grief, yearning intensely for what they have lost.

Experts sometimes call this "complicated grief." It's estimated to affect 2-3% of people who are bereaved. The chances of developing complicated grief seem to be higher in people who have lost someone unexpectedly, people who've lost a child or someone else very closely related to them, and people without a good support system, as well as people who have a history of depression or other mental health issues or major stress in their lives.

The Effects of Complication Grief

According to the American Psychiatric Association, complicated grief is associated with a number of problems, including impairment in one's ability to function socially. It can have significant negative consequences on a person's physical health, too, by keeping their stress levels elevated and affecting their ability to sleep normally. People going through the early bereavement period are also at elevated risk for having a heart attack or experiencing a condition called broken heart syndrome that mimics a heart attack and is triggered by episodes of extreme stress.

In cases of complicated grief, some experts recommend counseling or therapy, while others are open to the use of antidepressant medication. A 2015 article in the New England Journal of Medicine suggests that people taking antidepressants seemed to have a better response rate to therapy.

When Grief Turns Into Depression

About one in five people who are grieving will sink into depression, which is sometimes referred to as MDD, or major depressive disorder. They feel completely hopeless. Unlike a person who is grieving, a person who is depressed doesn't experience occasional moments of optimism or happiness to break up the dark feelings.

Other symptoms of depression, not just normal grief, can include:

  • The inability to do daily tasks

  • Delusions or hallucinations

  • Slower reaction time

  • Extreme weight loss

  • Feeling worthless

  • Thoughts of suicide

If you or one of your loved ones recently experienced a great loss, and you think that the bereavement has gone beyond what's considered "normal" it may be time to talk to your healthcare provider. A mental health professional can help you find a treatment that is appropriate to you and your needs.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: May 20, 2017

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Medical References

  1. Bryant RA, et al. Treating Prolonged Grief Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2014;71(12):1332-1339. http://archpsyc.jamanetwork.com/article.aspx?articleid=1917889
  2. Coping With the Loss of a Loved One: Major depression and complicated grief. American Cancer Society. http://www.cancer.org/treatment/treatmentsandsideeffects/emotionalsideeffects/griefandloss/coping-wi...
  3. Okun B and Nowinski J. Can grief morph into depression? Harvard Health blog. http://www.health.harvard.edu/blog/can-grief-morph-into-depression-201203214511
  4. Complicated Grief. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/complicated-grief/basics/symptoms/con-20032765
  5. Grief: Coping with reminders after a loss. Mayo Clinic. http://www.mayoclinic.org/healthy-lifestyle/end-of-life/in-depth/grief/art-20045340
  6. Pies RW, et al. Distinguishing Grief, Complicated Grief, and Depression. Medscape. Dec. 26, 2014. http://www.medscape.com/viewarticle/836977
  7. Shear MK, et al. COMPLICATED GRIEF AND RELATED BEREAVEMENT ISSUES FOR DSM-5. Depress Anxiety. 2011 Feb; 28(2): 103–117. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3075805/

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