Lesson 3 of 7 - learn how to grieve well
	Is it Depression or Incomplete Grief? They have similar symptoms,  but different roots By Peter K. Gerlach, MSW Member NSRC Experts Council

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The Web address of this article is https://sfhelp.org/grief/depression.htm

Updated  01-30-2015

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      This is one of a series of articles comprising Lesson-3 in the Break the Cycle! self-improvement course. This lesson aims to educate readers to healthy grieving basics so they can spot and complete unfinished mourning and evolve pro-grief relationships and families.

      This brief YouTube video clip summarizes what you'll read below. The video mentions eight lessons in this self-improvement Web site. I've simplified that to seven.

The article assumes you're familiar with...

the intro to this web site and the premises underlying it  online self-improvement Lesson 1 Q&A items and good-grief basics, and... these brief Lesson-3 research summaries.

      Have you or someone you care for been depressed recently? Depression is so common in American kids and adults that treating it has become a major industry. It often occurs in survivors of early-childhood abandonment, neglect, and abuse ("trauma")..

      My clinical experience with hundreds of therapy clients who felt "depressed" is that typical "well educated" people - including mental health and medical professionals - don't know much about the healing process of grief, and can't differentiate between it and "depression."

      One result is they waste money on "anti-depression" medication which hinders grief and leaves losses unacknowledged and unmourned. This ignorance contributes to the toxic [wounds + unawareness] cycle that is steadily weakening our society.

      This article explores the important difference between "depression" and healthy grief. It...

• Describes common symptoms of depression and normal grief,

• Suggests four common causes of these symptoms; and...

• Proposes options if (a) you're "depressed," and (b) if you're concerned about a "depressed" person.

What Is "Depression"?

      It's a catch-all term for a mind-body condition ranging in intensity and impact from brief and minor ("a blue mood") to long-term and major. The condition (vs. "illness") can promote physical, psychological, and relationship problems.

      Some clinical opinions propose that loss, grief, and/or depression may have its roots in prebirth traumatization of a baby or its mother. For more detail, read this after you're done here. 

      Symptoms of depression typically include some or all of these...

• Low physical energy; "fatigue."

• Apathy: marked disinterest in pleasurable life activities, and/or an inability to feel normal pleasures (anhedonia).

• Notably sad, glum mood.

• Unusual feelings of guilt, despair (hopelessness and pessimism), and/or worthlessness.

• Difficulty concentrating: mind-racing, and marked indecisiveness.

• Trouble sleeping or sleeping excessively.

• Possible loss of appetite and related weight loss.

• Recurring thoughts of death or suicide;

• Crying episodes with or without a "cause," and...

• Excessive or unusual irritability and anger.

      If five or more of these symptoms are clearly present every day for at least two weeks (in someone's opinion), the condition is psychiatrically labeled clinical depression. Some people label serious depression a "mental illness." I propose that it's a normal human condition, not an "illness"!

         Each of these symptoms can also occur during normal three-level grieving.

      Depression can be one episode or a recurring condition. Chronically depressed people experience these symptom-clusters as normal life, so they may have little motivation to change toward something they've never felt.

      Depression is a problem for the sufferer, and can cause significant anxiety (worry), guilt, and frustration in people who depend on or care about the sufferer. Three possible problems are...

• you’re significantly depressed,

• another person you care about is, or...

• you both are.

Each of these can stress your wholistic health and other relationships, specially if you have other concurrent problems. Let's look at the first two situations in some detail...

Options If You Feel "Depressed"

      “Depression” and the sadness phase of normal grieving feel and look the same, emotionally and behaviorally. I suspect that many “depressed” adults and kids are really mourning major losses. If so, the cure is not pills, but acquiring these requisites so your grief can run its natural course.

      Premise - feeling "depressed" can be a symptom of up to five underlying factors:

• unawareness of significant psychological wounds and their effects (Lesson 1);

• ignorance of healthy-grieving basics (Lesson 3);

• unrecognized incomplete grief;

• living in a grief-inhibiting environment; and possibly....

• hormone and brain-chemical imbalances. The first four may promote this.

      To reduce your symptoms, try these options:

      1)  Give high priority to self-improvement Lessons 1 thru 3. Lesson 1 will help you identify if your dominant personality subselves are promoting personal problems like incomplete grief. For more perspective on this, read this and this after you finish here.

      2)  Test your knowledge of "good grief" basics with this quiz. Ignoring this option suggests toxic false-self dominance, which is the primary problem.

      3)  If you have suicidal thoughts, see these options, and consider professional help. Note that many professional therapists, clergy, and counselors aren't trained to check for incomplete grief. Option - ask whomever you hire to scan Lesson 3 and "pass" the "good grief" quiz. If they're not willing to, look elsewhere.

      If you have chronic pain and/or an incurable progressive lethal disease and have nothing to live for, explore support organizations like Compassion and Choices and Final Exit Network.

      4)  Meditate on any past or recent changes in you or your lifestyle - e.g. a disability or illness, job change, a geographic move, a shift in an important role or relationship, a financial shift, births, deaths, divorces, retirements, etc. Ask yourself "What have I lost - specifically - because of this change? Use these abstract and physical loss inventories to help answer the question. Note that anticipatory grief can start before an expected loss actually occurs.   

      Once you identify your losses (broken bonds), prioritize them. Starting with the most impactful, use this level-and-phase concept to gauge where you are in grieving each loss. If you suspect some important grieving is incomplete, consider these options.

      Option 5)  Study Part 3 of lesson 1, and work patiently at the parts-work strategy for "Depression" with an open mind.

      6) Be aware of the terms your family adults use in thinking and speaking. Depressed and depression can be evoke anxiety in subselves who associate them with sick or ill, crazy, nuts, weak, inferior, anxiety, bad, doctors, hospitals, therapy, trouble, or other vague or specific discomforts. "I'm working to accept some major losses now" can feel better to someone's subselves than "I am (or you are) really depressed."

      7)  If subselves feel guilty that your "depression" symptoms are burdening other people "too much," confirm your right to feel how you feel. Read and apply this article on managing excessive guilts, and use these wise guidelines. "Feeling better" is your responsibility. Other people are responsible for managing their own comfort!

      8)  Become aware of whose advice you follow about assessing and treating "depression." e.g.  family elders, mentors, hero/ines, health professionals, and media authorities. It's likely they don't know what you're reading here. Finally...

Option 9)  Think twice if you're considering anti-depressant medication. "Mood control" chemicals may relieve your symptoms, but not what's causing them. If these options don't relieve your symptoms, consider hiring a qualified therapist or licensed grief counselor for a professional evaluation. "Qualified" means...

• usually guided by their true Self; plus...

• having a wholistic (mind + body + spirit + emotions) view of health; plus…

• openness to the premises in this Web site, specially about personality subselves and incomplete grief; plus…

• believing that grieving is appropriate for all significant life losses, not just someone's death; plus...

• training in, and experience at, promoting healthy three-level grieving; including this research; plus...

• up-to-date medical training on the organic causes of "depression," and "anti-depressant" medications.

Status Check

      Learn about yourself by meditating on these statements. T = true, F = false, and ? = "I'm not sure," or "It depends on (what?)":

I accept that grieving is needed for all kinds of life losses (broken bonds), not just death. (T  F ?)

I believe grief is a healthy human response which can be slowed or blocked. 
(T  F ?)

My childhood adults consistently encouraged and modeled (a) feeling and (b) expressing healthy grieving values, emotions, thoughts, and behaviors. (T  F ?)

I’m comfortable now (a) feeling and (b) expressing _sadness and _ anger privately and publicly; and (c) I’m comfortable enough being around others who feel and express shock, sadness, and anger. (T  F ?)

I can clearly describe (a) my personal and (b) my family’s grief policy - i.e. our sets of shoulds, oughts, musts, and values about feeling and expressing grief. (T  F ?)

I now live in a pro-grief home and family - i.e. one which consistently encourages everyone to mourn well. Note the difference between intentionally encouraging grief among your family members, and passively tolerating their mourning. (T  F ?)

I am now able to (a) identify and (b) grieve my losses thoroughly; or if not, (c) I'm taking effective steps to improve this. (T  F ?)

I can (a) clearly tell the difference between “depression” and incomplete grief now, and (b) I can name at least six symptoms of incomplete grief. (T  F ?)

Other adults in our family would answer "True" to the statement above. (T  F ?)

I accept that using anti-depression (mood control) medication may hinder healthy mourning.  (T  F  ?)

Now I feel a mix of calm, centered, energized, light, focused, resilient, up, grounded, relaxed, alert, aware, alive, serene, purposeful, confident, and clear, so my true Self is probably leading my other subselves (personality). (T  F ?)

      What did you just learn?

       So far, we’ve explored options if you are significantly depressed. Let’s now explore your…

Options If Someone Else Seems Depressed...

      With your Self guiding you, notice how you feel about (a) the depressed person, and (b) being around her or him. Then consider these ideas...

• use your feelings as pointers to identify what you need, relative to this person. If you need to "make them feel better," try to discern why their "depression" is affecting you.

• get clear on what you can affect and what you can't.

• ask the person what s/he needs - in general, and from you.

• avoid saying "You'll feel better soon." You have no way of knowing that. See these alternatives.

• avoid saying "I know just how you feel." Because you have a different personality and history, you probably don't.

• if the person wants solitude, respect that;

• beware offering help that isn't invited. That can feel insulting.

• if s/he is open to feedback,

  • invite the person to explore whether they're mourning past and/or recent losses. Common  responses are "Uh... I don't think so," or "I'm not sure - I've never thought about that." If they ask why you ask, propose that the sadness phase of normal grief feels like depression - and their symptoms will lift as their grief runs it's natural course. Refer them to Lesson 3 in this Website.

  • offer an overview of personality subselves. If s/he seems open to that idea, add the concepts of true Self and false self. Discuss the possibility that a false self may be causing her/his depressive feelings and/or grief. If appropriate, suggest that s/he study Lesson 1 to explore this possibility. If you're working on Lesson 1, describe your experiences.

• avoid urging the person to get anti-depressant medication - unless you and s/he are sure their condition is organic and not normal grief.

      If the person is a relative, the "depression" (and/or incomplete grief) is a family problem, not a personal one. Discuss this and related articles with other family members, including older kids. Also talk factually about how the person's "depression" symptoms are affecting you all, and what each member needs. Option: make building a pro-grief family (Lesson 3) a communal activity!

Recap

      This article encourages you to assess whether "depression" is really normal grief, for the symptoms are very similar. Unfinished grief is a primary personal and family problem . It usually causes a web of secondary problems in your home and relationships. The article offers practical options if you and/or another person feel significantly "depressed.”

      Pause and recall why you read this article. Did you get what you needed? If not, what do you need? Who's answering these questions - your wise true Self or ''someone else''?

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