BereavementA couple of weeks ago, I was talking to one of the women on my Meals-on-Wheels route, Joan, and she told me that her doctor had put her on anti-depressants because she was depressed. She tried them for a day, and didn’t like the way they made her feel, and stopped taking them. I know that one day wasn’t enough time to determine whether they would work or not, and she’s not likely to find out. The thing is, the reason that she’s depressed? Her son died. He fell on the icy steps this winter, and broke his neck. She is understandably devastated. But she gets out of bed every day, she feeds and cares for herself and her dog, Sassy. She goes to get a massage when she can afford it, and takes care of getting her hair done. She doesn’t seem to be down in the depths of depression to me. She seems desperately and appropriately sad about the loss of her son. This is the second time she’s buried a son, and she’s a widow, so she’s had enough of death for awhile. I only get a brief glimpse of her life, a few minutes once a week, so I can’t say if she’s in need of medication or other care for her bereavement, or if time is the best aid for her.

I know for me, when my mom died, I ached. I cried. I hurt. I was confused as hell and couldn’t figure out how to live in a world without my mom. But while I was trying to navigate that, it never occurred to me to kill myself. It never occurred to me to not get out of bed, to not eat, to not try my best. If that had been Maya, or Ted, I might have felt differently. I don’t want to say that I love my mother less. But a parent is different than a spouse or a child. As ugly a fact as it is, your parents are supposed to die before you do. That doesn’t help much, and I felt robbed of the future I wanted with my mom for at least the next 15 years, but it would surely have been worse to lose my husband or child.

I was listening to Morning Edition yesterday, and there was a segment on the pain of bereavement, and how, up until recently, it has been the exception when diagnosing major depression. Loss of appetite, physical pain, inability to get out of bed or care for ones self, these are all signs of major depression, and can result in such a diagnosis, and perhaps in your psychiatrist wanting to medicate you. Unless you have recently lost someone important to you. If you have recently lost a parent, a child, a spouse, or other loved one, these symptoms have been considered normal, perhaps even necessary to the healing process.

The question, then, is whether that extreme pain is necessary. Do we need to fight our way through that horrible time in order to come to terms with our loss?  Personally, I feel like it was.  Losing my mom was the worst thing I have ever endured, the worst thing that has ever happened to me.  I feel that grieving her, and my loss, so deeply was part of loving her so deeply. That first year was an extremely difficult time, a time I hope to never have to repeat. But it was honest and true, and it was how I felt. I loved my mother very much, and she should not have died, and I miss her terribly. To have tried to cover-up or deny those feelings would have felt wrong to me.

But what if I were feeling suicidal? What if I had honest feelings of killing myself, or started harming myself in some way? What if I had somehow become dangerous to Ted, Maya, or Genevieve? Perhaps then, it is time to intervene. The difficulty, I suspect, is in figuring out when someone is truly in need of help, and what kind of help is appropriate.  There are support groups for the newly bereaved. I considered going, but I spent enough time crying, and didn’t think I could handle sitting in a room with others in the same boat. There is one-on-one therapy, which actually I was going to to help me cope with her illness and my inability to help her, but I stopped after she died, because again, I couldn’t bear the idea of sitting in a room and paying someone to watch me sob. My therapist asked me all of the important questions, and told me that my feelings were normal and that everyone grieves differently, so don’t worry if I felt more (or less) than others described to me. Or, just different. And there are drugs. Watching my mom struggle with the antidepressants they had her on has soured me on them, perhaps forever. I know quite a few people who take them, with varying degrees of success. Some do very well. Some search for the right medication, the right dosage. Some do well in how they behave, but do not like the way they feel on them.  Like Joan.  Me? I’d be very hard pressed to try anything that might make me as confused and frightened as my mother was.

I suspect that removing the bereavement exemption for major depression is probably a good idea.  The way that insurance companies work, it might well help a doctor to get a patient the support that they need once they have a diagnosis. But for the majority of us, those of us who are able to cope with our pain and somehow come through the other side of that dark tunnel of grief, I think maybe it’s better to try it without the medication at least.  Best not to try drugs too quickly, if they’re not needed.

The segment was interesting. You can listen to it here.  The comments on the print version were interesting as well.  Some said we medicate too damn fast in this country and it’s getting dangerous.  Others said that we should not judge those who need medication for treatment.  You would not, for example, have surgery without anesthesia.  Sometimes, the pain is too much, be it physical or mental.

10 thoughts on “Bereavement

  1. I think the trend toward thinking of discomfort as a disease is dangerous, if not to the individual then to humanity. We grieve for our parents as they grieved for theirs and as they would have grieved for us. Numbing ourselves to the pain of harsh reality through the use of medication denies the reality, and if we deny it then I don’t see how one could successfully move on. Our feelings – for lack of a better word – aren’t usually symptoms; they are part of our human response to life.

  2. When my dad died ten years ago, my mother simply avoided her grief and continues to, to this day. She left her home, she won’t listen to the radio in case it plays a song that reminds her of him, she won’t watch movies that she and my dad enjoyed or saw together, and she won’t travel anywhere because she used to travel with my father all the time. She has talked for years about “moving back over home” but she still hasn’t. She lives with my brother and his daughter. Just about every year, she tells one of us how she’s starting to get things ready to move back. I’m the only one who gently but firmly says to her, “Mom, you’re not. And you know you’re not.” She always says,”Nance, why do you say that?” And each year, I say, “Because if you were going to do it, you’d already be there.”

    I think people do need to grieve. I think feeling sadness is therapeutic. Too many people deny their feelings for a variety of reasons in American society nowadays: it’s inconvenient, it’s painful, it interferes with work, it’s unnecessary because we have drugs. Certainly if we reach the point where our feelings become dangerous or unmanageable, then we might need help and possibly medicine, but we have to remember that life is lumpy. We can’t truly know happiness if we don’t have the contrast of sadness. Loss makes us appreciate what we have. The chaos makes us grateful for the peace.

  3. Very interesting post. I tend to agree with you about getting through without medication if possible, but, as you say, in some cases medication is absolutely needed and beneficial.

  4. There are many causes for depression and I feel that is where the question of medicating lies…well that and the straight up state of the person.

    For the case of grief, I agree that we need to feel it to get through it, but sometimes you need to sleep because you haven’t been able to for days or weeks as you are overcome by the grief so a sleep aid would be beneficial, or you aren’t able to function at all, or as you said, become a danger to yourself or others so then some medication might help.

    My parents don’t grieve outwardly, and therefore we didn’t learn out to either. I really struggle with it, but I am grateful to my friends and family who listen and have helped me learn my own process.

    I have been very on the fence about psych drugs (no, I was once very against them but I blame society’s taboo-tising them 🙂 ), but I feel strongly that it is a case by case and personal decision.

  5. A lot of things here! The way you write about your own experience of bereavement and of the woman who’s lost her son is quite marvellous. And bravely honest and truthful.

    Now as to the ‘current affairs’ context of your post, the main problem for me would be the seeming drive to medicalize everything. The American Psychiatric Association (I think that’s the organisation who put it together) have that enormous diagnostic volume which, practically doubling in size every year, is gradually patholigizing every mental condition out side of a dayglo, Brave New World style ‘norm’. At this point, my worry is how any mental state which isn’t within a frighteningly narrow bell-curve has been pathologized.

    Don’t get me wrong – I agree that bereavement should definitely be considered as a factor (and I’ve benefited from anti-depressants myself). But the overall trend is kind of worrying.

    • Dad Who Writes, your note made me think of a chilling article I read in The New Yorker in the past year about drugs that enhance mental functioning and boost mood/energy–drugs that will let you work for 24 hours straight and the like. Apparently these are being used more and more in certain types of workplaces, and the author of the article wondered if the day would come when if you chose not to use such drugs, you would be subject to a lot of peer pressure, or even official pressure (from your manager), or if you would realize you simply had to take the same drugs as your co-workers or risk falling behind in productivity. It was really a grim vision. (Not what J. was talking about at all, but your comment put me in mind of it.)

  6. I guess my view on drugs is that they are a last resort. If there are other non-pharmacological ways coping with depression, then I’m all for it — ’cause chemicals can really mess with you.

  7. My….talk about timing?
    I have some close friends of our family that lost a son (Darin)just last week (some kind of seizures?). He would have been 45 this Friday, and his older brother (Daryl)died 2 years ago (May 2008) at age 45 with stomach cancer. I can’t imagine what their parents are going through? They both left 14 year old sons at the time of their death, and Daryl left two daughters also.

    I also had a good friend (Johnny)who died in a helicopter crash in March of 2008, and his 18 year old precious daughter (Lindsay)committed suicide the following March of 2009 leaving behind a grieving mother as well as grieving granparents (Johnny’s parents)who are in their 80’s.

  8. I highly agree with Ted on using drugs as a last resort.
    My ex wife tried to fix me years back? Anger issues etc.
    Talked me into seeing a quack and tried some depression meds which took my anger away but left with with a feeling that I can’t say was suicidal…but it was more like a feeling of no reason to live??
    I don’t know how to explain it?
    My anger motivates me to live dang it!!!!
    Anyway…I fixed it myself…….divorce… I can get mad at something and I don’t have to worry about some cry baby thinking she needs to be married to Mr. perfect!

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