Grief and Mental Health – When the Two Merge
Grief is something that we all experience at one time, or another. The stages of grief – sometimes explained as 3, 5 or 7 different stages – are pretty well known and include shock, denial, anger, sadness, acceptance in some order. Most people will struggle but eventually come to some resolution with no prediction as to how long that will take.
Resolution of deep sorrow can be made much more difficult when a pre-existing mental illness is imposed. A severe loss can trigger a relapse of virtually any mental illness, even when the illness was well treated, and the patient was stable. Patients may relapse into severe depression, bipolar episodes, panic attacks or a return of obsessive compulsive behavior. If the patient was not well stabilized, the whole apple-cart can be upset.
Even the most mentally healthy person can become unstable if unable to resolve the feelings caused by pain. Grief has been known to result in clinical depression, lasting for a long period which can lead to extreme difficulties and even death in the case of suicide. The problem comes in a case where one becomes “stuck” at a certain point – usually during the agitation period.
There is a saying; “depression is anger turned inward.” The existence of anger over an extended period can cause depression.
Anger allows us to have a heightened response to a threatening situation. Anger fuels energy, giving us a false sense of power, but over time, the brain and the body run out of that same energy. This can result in fatigue, emotional lability, and symptoms of depression. In some cases, depression caused by grief may be resolved with grief counseling.
In other cases, however, depression may have become severe enough that medication may be warranted. Clinical depression is characterized by:
• Fatigue and decreased energy
• Cloudy thinking
• Feelings of guilt, worthlessness or helplessness
• Insomnia or excessive sleeping
• Loss of interest in pleasurable activities
• Body pain or digestive problems
• Persistent sad or empty feelings
• Thoughts of suicide
How different is this from grief – not much. The only difference would be in how long it lasts. Depression carries a high risk of suicide and if symptoms last longer than what would be considered “normal” – for any reason – you should seek treatment. Depression that is severe enough to interfere with normal activities for longer than four to six weeks should be treated – even if life circumstances explained it. Counseling may work – or you may need medication for a short period.
If you have some known mental disorder, stay in contact with your mental health professional. Most – and I did not say “all”, but most mental health patients find it difficult to self-assess, some find it difficult to be openly honest. The only way to ensure that an episode of grief is resolved without severe consequences of going “off track” is to allow someone else to help assess your mental state.
Whether you are or are not a mental health patient, know that grief can cause mental illness and can worsen an existing illness – even if only for a short time. It is not something to be dismissed or ignored as the risks are high.