The reaction of grief goes through several stages in its development. Immediately after receiving the news of the death of a loved one, the person experiences a state of shock and, although the mind understands that the loved one has died, it can not fully understand and feel it. He is quite capable of organizing funerals and performing numerous formalities, but he is at the same time stunned and acts as if mechanically. This stage of shock usually lasts from a few days to a week.
In the future, the shock is replaced by an awareness of loss - there are tears, a sense of guilt ("I was a bad daughter," "a bad wife," "little care for him" ...). A person concentrates on things and objects related to the deceased, recalling events connected with him, his words, habits, etc. Often there are visual and auditory illusions - extraneous noises, shadows on the wall are perceived as steps or outlines of the figure of the deceased, a person experiences the sensations of his presence in the house. These experiences often occur in dreams.
IMPORTANT! Occurrence of plentiful hallucinations, when a person for a long time hears the voice of the deceased, talks to him, sees him, testifies to the pathological character of the grief reaction and requires treatment.
The state of depression, unlike just a bad mood, has an external resemblance to the normal, non-pathological reaction of grief. It is familiar to most people who have experienced severe life losses, most often the death of a loved one. The reaction of grief is the answer to such dramatic events. At this stage, there is a symptomatology similar to depression - reduced mood, motor retardation, loss of appetite. Characterized by a sense of guilt for the fact that not everything was done to save the life of the deceased. Often there is a feeling of hostility towards doctors and other relatives who "have not fulfilled their duty." At the same time, the severity of these symptoms is not so severe that a person does not fulfill his household duties, could not return to work or completely avoided communication. These manifestations last an average of 2 to 4 months and should normally be resolved no later than 5-6 months. The severity of the loss weakens, the depressive symptoms go away, emotional farewell with the deceased ends, and the person fully returns to life.
Grief and depression are not exactly the same thing. If in the first case all experiences are closely related to the loss suffered and are psychologically understandable, in the second case, a low mood is often psychologically inexplicable and incomprehensible to others, especially if a person is vitally well-off. Therefore, people in a state of grief always evoke compassion and understanding among the people, while in a state of depression - a lack of understanding and even irritation.
When experiencing grief, a person as a whole does not suffer from self-esteem, his judgments in everything that does not concern loss are sound and consistent. There is respect for oneself, a sense of guilt does not acquire a comprehensive or absurd, delusional character, there are no thoughts of one's own death. There is no thought of its uselessness, a pessimistic assessment does not extend to the past, let alone the future, a person realizes that life continues. The bodily symptoms of depression ("stone on the heart", etc.) are much less pronounced, instincts are not so oppressed.
Thus, a normal, non-pathological experience of grief or just a bad mood is manifested. It does not need treatment, but requires only sympathy, help and psychological support from others. In order to cope with his grief, a person must himself do a certain mental work, which psychiatrists and psychotherapists call the elaboration of traumatic experiences (the "work of sorrow"). To do this, he must get rid of illusions and errors, clearly realize that life is finite, resurrection is impossible and separation from loved ones is waiting for each of us.
If one of your relatives is suffering grief, you should try to be near him, give him the opportunity to talk and cry. Do not give him advice "not to think about it", "to distract", "to throw everything out of your head", etc. - they are completely unnecessary and even harmful, because they prevent the reaction of injury. Constantly emphasize the temporary nature of his condition. For a while (1-2 weeks) a person needs rest and reduced load, a change in the situation will be useful. Alcohol in such cases helps poorly, because it gives only a short-term relief.
In a state of grief, people often, including on the advice of doctors, begin to take tranquilizers, "to calm down." Do not do this because the interference slows the "work of grief". In addition, with prolonged and uncontrolled use, these drugs can cause addiction and dependence. In some cases, the grief response can be painful when a person becomes more and more stuck in grief and therefore needs medical attention. This is evidenced by the following signs:
• greater than normal, its duration, when the first stage lasts more than 2 weeks, the reaction as a whole - more than 6 months. If, after 2 months after the loss, there is still a distinctive depressive symptomatology, it is necessary to assume the presence of a depressive episode - the help of a psychiatrist (psychotherapist) is required;
• greater than normal, depth of experience, when they are accompanied by complete avoidance of communication with others and inability to return to work;
• a more pronounced sense of guilt, than in the norm, right up to the delirium of self-blame, that is, when these thoughts clearly do not correspond to reality and the person does not manage to dissuade them;
• if a person expresses clear thoughts about suicide;
• the delayed nature of the grief reaction, when it does not occur immediately, but after a long time after the loss.
If you notice the appearance of any of the above signs from your close, suffering grief, then it means that you need to seek help from a psychotherapist or, in his absence, a psychiatrist. Atypical reaction to grief requires predominantly psychotherapy, when the patient is once again "carried through" through previous experiences and gets the opportunity to react to them.
In what cases are there more frequent atypical grief reactions?
• if the death of a loved one was sudden and unexpected;
• If the person did not have the opportunity to see the body of the deceased, say goodbye to him and express grief immediately after a sad event (death in case of earthquakes, floods, catastrophe of sea vessels, explosions, etc.);
• if a person has experienced a loss of parents in childhood;
• the prognosis of an atypical grief reaction worsens in case of low socioeconomic status, in the absence of social support, loneliness, and also with alcohol dependence.
The main difference between depression and just a bad mood is the perception of a real world by a person. The surviving person in most cases does not need psychiatric help. The basis for seeking help is atypicality (greater depth and length of time), as well as a suspicion of having another mental disorder that has been identified or aggravated by a mental trauma.