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Lines blur between grief, depression

Q. I lost my job six months ago when the company downsized and I am still unemployed. I cannot sleep and am disinterested in any activities I once enjoyed. Is this grief or depression?

A. While 30 million Americans will suffer from depression at least once in their lives, a 2007 study found 1 out of every 4 people told they have depression could, in fact, be grieving. The line between grief and depression blurs and often we use the words interchangeably because some of the symptoms are similar.

Grief is an expected response to loss – and lack of employment is a loss – that may cause physical distress, like sleeplessness. However, with grief one still hopes, feels pleasure and expresses feelings, like humor and joy.

Grief comes in waves: One minute you are laughing at a joke, the next minute you may feel overwhelmed and take a nap.

Health care providers rarely prescribe medication for grief because it is best managed through supportive listening and activities such as rituals, journaling, exercise, social gatherings – whatever one finds soothing. Medication for grief can actually cause harm because it may numb the pain, delaying the healing process.

Clinical depression is a mood disorder involving feelings of profound loss, anger, frustration, sadness. One or more of these feelings can interfere with daily living.

Clinical depression tends to be linear and unrelenting. Depressed people tend to have changed routines: consistent lack of sleep or too much sleep, weight loss or gain, inability to function at all. Feelings of guilt or suicide may indicate clinical depression.

While you are unemployed, create a new routine. Each day track what you do and how you feel. After a few weeks share your daily logs with a professional counselor. Together, you can determine if you are experiencing a normal grief reaction or if you need a referral to someone who can assess you for clinical depression.

Q. My father-in-law recently died, and everyone asks me “How is your husband doing?” I am grieving his loss, too, but no one seems to ask me about my feelings. Am I selfish to feel left out?

A. Not at all. You are experiencing an acute loss, too, and you wish to be acknowledged for it. This is completely normal – and a sign of healthy grieving. But be forgiving. Most people are still awkward when talking to people who have just lost a loved one or who have experienced a personal tragedy, such as a cancer diagnosis.

In the anthology “Living With Grief,” the now-deceased grief expert Dana Cable wrote: “Much of our avoidance is rooted in our own fears associated with death and grief. We don’t really know what to say to a griever. Our question, ‘How are you?’ is asked in an attempt to evoke social conversation. We are not prepared to respond when the answer is ‘I’m not doing well.’ Many of us would not ask how someone was doing if we thought they would give us an honest answer.”

By the way, Cable had an interesting theory that mass grieving, such as happened during the death of Princess Diana in 1997, releases the personal grief pent up in individuals and families. It’s pent up because most people can’t listen to others’ honest feelings expressed when a loved one dies.

By asking about your husband, the asker is creating an emotional safety zone, perhaps unconsciously. You might not cry talking about your husband’s feelings, but you might burst into tears about your own feelings.

We learn grief etiquette person to person, so if you’re up to it emotionally, you might say something such as: “You’d need to ask my husband, and he’d welcome the question, but I can tell you how I’m doing with all this.”

And then, if it feels comfortable, do just that, tears and all.

Catherine Johnston, a health care professional from Olympia, and Rebecca Nappi, a Spokesman-Review features writer, welcome your questions about what to do in times of illness, dying, death and grief. Contact them through their EndNotes blog at blogs/endnotes.

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