A 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.