Dennis B. Kottler, MD
Westlake Village, CA
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See also: Depression and Bipolar Disorders
See also: "Pathological Grief Reaction"
BEREAVEMENT, the response to the loss of a loved one, often shares many of the characteristics of a Depressive Disorder, such as sadness, insomnia, diminished appetite, and weight loss. Although bereavement is not a pathological condition in itself, a person might appropriately seek professional help to cope with some of these symptoms.
It is often difficult to differentiate between a normal bereavement (or grief) reaction and a depressive disorder, since the two conditions resemble one another and can sometimes coincide. Indications that a depressive disorder may be present include:
1 - Feelings of guilt which go beyond what actions might have been taken to prevent the death of the loved one.
2 - Feelings of worthlessness.
3 - Psychomotor retardation - Markedly slowed up movement and sometimes, speech.
4 - Hallucinations other than the experience of thinking that one hears the voice of the deceased person, or transiently sees his (her) image, or mistakes someone else for that person.
5 - Persistent and prolonged impairment in functioning.
6 - Thoughts of death, other than the passive wish of having died with, or instead of, the loved one.
7 - Suicidal thoughts or plans.
Another characteristic of bereavement is the tendency for the sadness to diminish over time, with periodic exacerbations of the sadness, for example, when reminded of the deceased. These exacerbations become less intense and less frequent.
In the case of a depressive disorder, the sadness is often more consistently present, and it may not as predictably diminish as time goes on.
However, these points of differentiation between bereavement and a depressive disorder are not absolute. When there is any doubt, professional consultation is advised.
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