Why is loss of grief so painful

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Sadness or depression?

Grief after the death of a loved one is often associated with complaints and restrictions that are also typical of a depressive illness, e.g. depression, listlessness, loss of interest, insomnia, loss of appetite, joylessness.

So grief and depression seem to be confusingly similar. However, it is extremely important to carefully differentiate between grief and depression so that people with normal grief reactions are not mistakenly diagnosed as having depression, and so that grieving sufferers who are suffering from depression are not denied the necessary help.

Certain aspects in the experience and behavior of those affected can be used as distinguishing features. The four most important are briefly outlined here:

1. Emotional vibrational ability or emotional freeze:
Both grief and depression are associated with emotional distress. Nevertheless, differences can be made out in terms of quality and the longevity of the negative mood. Many bereaved relatives report that the grief comes in waves, but also subsides again. And with all the pain, the ability to experience moments of positive emotions and to find solace in certain activities is usually retained.

People with depression, on the other hand, are characterized by suffering from a persistent negative mood, which is described as dejection, but also as emotional numbness, or as a feeling of callousness and desolation. It can be particularly agonizing for people in a depressed state that they notice the efforts of others to cheer them up and yet there is no change in their mood.

2. Ability to regulate or at the mercy of:
In mourning, the experience of emotional suffering can be combined with a feeling of affirmative devotion to pain. However, intentionality does not have to relate only to the affirmation of painful sensations. Avoiding them is often also conscious coping behavior so that mourners can take `` time out '' from pain or face their everyday obligations. The ability to at least partially regulate one's own emotions, i.e., depending on the situation, to alternate between affirmative admission and conscious avoidance of painful feelings, is an essential characteristic of normal grief.

In depression, those affected feel largely at the mercy of a negative mood. You will be drawn in and experience the mood as beyond your control, despite your own attempts at regulation.

3. Intense thinking or pessimistic brooding:
Unsurprisingly, the death of a loved one dominates the mind of the bereaved. Recurring thoughts revolve around the circumstances of death and the deceased. Imposing memories of the deceased, worried thoughts about the future without him, are also considered to be the hallmarks of normal grief. Difficulty concentrating and thinking erratically are just as normal.

For depressive brooding, however, a certain form of intense thought activity is typical: This is pessimistic brooding, i.e. thought processes that are constantly negative, pessimistic and derogatory about oneself, one's own Feelings and problems, as well as their causes and consequences, circle.

4.Intact self-esteem or self-devaluation:
A very important difference between grief and depression relates to the self-esteem of those affected: the bereaved may experience their identity shaken, but their self-esteem is not damaged to the extent that it is for humans who suffer from depression. Sigmund Freud already worked out this difference very clearly:

"With mourning the world has become poor and empty, with melancholy it is the self. The patient portrays his ego to us as worthless, incapable of performance and morally reprehensible, he reproaches himself, insults himself and expects Expulsion and punishment. He humbles himself in front of each other, regrets each of his own for being bound to his so unworthy person. He does not have the judgment of a change that has occurred to him, but stretches his own Self-criticism of the past; he claims to have never been better "(Freud, 1917, p. 3).

For bereaved relatives and their relatives, knowledge of such distinguishing features can be helpful in order to classify their own experience or their own observations more precisely or to be able to describe them more precisely to third parties.

Sadness        depression
Emotional ability to vibrate        Emotional paralysis
Experience of consolationExperience of desolation
Experience of intentionalityExperience of being at the mercy
Intense thinkingpessimistic brooding
Intact self-esteemSelf-doubt and self-devaluation
partially restricted
Future perspective and hope
generalized lack of perspective and hopelessness
Relationship experienceExperience of being completely cut off
Night death experiencesMad life
Death wish as "after death"Death wish as liberation from suffering

Read more on the topic: "Grief or Depression?"

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Complicated grief
Grief in the DSM-5 and ICD-11 diagnostic systems
>> Sadness or depression?
Between depression and grief: depression