The loss of a loved one brings feelings of anger, sadness and often depression. Understanding how death and depression coexist can help to understand the emotions of a grieving person, or work through the stages of grief yourself.
Carol and William had been married only three years when William, at age 25, was diagnosed as having leukemia. During the next three years the cancer was in remission and there was a great deal to be happy about. Their two children were growing like weeds; financially they were doing quite well. Carol was happy. She was caring for William and their two children. It seemed that they were going to beat his cancer.
In William’s last year of life, their seventh year of marriage, his condition worsened dramatically and Carol watched him decline. Carol had a special bed in the living room of their home so she could minister to his every need. She cared for him intensely and lovingly. She also prayed for his death, and she was relieved when he was no longer in pain. Even so, when he died she found:
1. She felt an incredible amount of guilt because of praying for his death.
2. She felt worthless because she had no one to care for with the same intensity.
Carol was sinking into a depressed state because she was suffering from some normal, classic causes of depression: Anger Turned Inward, True Guilt, Self-Effort, and Adjustment Reactions.
Carol put herself in the position of caring for a terminally ill person. When an individual does this, she will go through various causes of depression because of the intensity of the caregiving role. You must remember, though, that depression is normal because it breaks the routine of the old patterns of behavior. This breaking away allows the survivor to grieve and move onward with life.
ANGER TURNED INWARD
This kind of anger produces feelings of worthlessness, self-reproach, and guilt. The survivor internalizes all emotions. Carol didn’t blame God, the medical profession, or William. They did everything they could. But, did she?
Could she have done more? These feelings can also be a result of the loss of control and frustration a person feels in this situation.
When Kevin was 15 years old his father died. The night before he died, they had a horrible, loud argument. They both lost control, but Kevin blamed only himself and carried this anger and frustration around with him for years. If only he had been less argumentative, more supportive toward his father, he would be here today. If only he had been able to apologize.
It was not until he realized that his father never had a chance to apologize to him that Kevin finally stopped blaming himself, and stopped being mad at himself. It was not his fault. He was not alone in this argument. There were two people involved. But, it took years for Kevin to understand this and understand that what he originally felt was a very normal reaction.
TRUE GUILT
True guilt deals with a temporary loss of faith in God. Values that were at one time helpful and comforting are now meaningless. Carol, for instance, questioned her own value system. In doing this she set up room for doubting God. However, when she prayed for William’s death, she set up a moral dilemma within herself. If she calls on God to end William’s life, she feels guilty for praying for his death; but, she still shows a belief in God. On the other hand, if she doubts God’s plan, then she must also be doubting God.
What happens when a survivor stops the life support system for the loved one? There is an incredible amount of guilt for the survivor because she is asking for the death of this person, and she is also saying that she can’t go on like this anymore. Even though the survivor knows in her heart that the quality of her loved one’s life is questionable, she feels guilty for wanting that life to end.
What about the mother who hurriedly leaves the house with her child in tow? Even though wearing seat belts is mandatory, she is just running to the corner market for milk. What could possibly happen? A stray cat darts in front of the car and the mother brakes suddenly. Her child is thrown through the front windshield and is killed instantly. If only she had taken the few extra minutes necessary to fasten her son’s seat belt, he would be alive today. How could she have been so stupid? How could she have been so thoughtless?
For religious people, questioning why something is happening to them is ultimately questioning God. Within this religious confusion lies the guilt and resulting depression. It must be satisfied before the survivor can move on.
SELF-EFFORT
This is when the caregiver/survivor takes on all the work. Carol became nurse and wife to William; mother and father to the children. If anything went wrong around the house, Carol had to deal with it. If the two children needed rides to a friend’s house, Carol had to drive them. If William needed medication, she had to administer it. Carol had to do all the jobs because she wouldn’t allow anyone else to help her. She had too much pride to lean on an outside support system, including their extended family. Even though Carol appeared busy and motivated, all the responsibilities she took on actually led to her depression.
ADJUSTMENT REACTIONS
When a spouse, parent, or child dies, there is a great deal of adjusting that involves the survivor. Carol had already begun to take on many responsibilities that William had previously performed. Even so, she could still look to him for advice and help. However, after his death she would have to adjust to doing everything without him. This would mean simple chores like filling his car with gas, to more emotional events such as taking the children, alone, to a function that he would normally have attended.
Financial, social, emotional, physical, and spiritual areas are now part of an external stress that forces the survivor into adjusting. Hopefully, the adjustment will be in the best interest of the survivor.
Jim is a young person in college when his father dies. Suddenly, the financial security is taken away. He must now pay for his own education. In this situation, one of two reactions can occur:
1. He decides he’s not going to pay for his schooling, or can’t, so failure and doom are inevitable. He sinks into a depressed state and suffers an emotional withdrawal.
2. He adjusts to the situation by finding new creative ways to make money for his education so that failure and doom are not inevitable.
It is, of course, the second outcome which we hope will occur for ourselves or anyone we know. Unfortunately, it is not always easy and sometimes additional help is beneficial.
There are three other causes of depression that should be added here. They are: False Guilt, Misplaced or Displaced Guilt, and Wrong Perspective.
False Guilt is obsessive behavior and is usually present in a compulsive personality. A person who falls under this category constantly “picks” at herself after a death. She wishes she had done more, or, is convinced that she could have done more.
Misplaced or Displaced Guilt is when a person feels guilty for something that happened years ago, and remembers it now. It is usually an insignificant event, but holds considerable importance now to the survivor.
Wrong Perspective is when a person understands as much as she can, but does not have the facts straight.
Not having the facts straight causes anxiety which in turn causes depression. Long term anxiety causes a depression mood disorder called Dysthymic Disorder.
Depression is normal in the first few months following a death. If it is longer, professional help should be sought.
EXERCISE
1. Make a list of jobs you must do now that were formerly taken care of by your loved one.
2. Which of these jobs depresses you the most? Explain why.
Canine, J. D. (1990) I Can I Will: Maximum Living Bereavement Support Group Guide. Birmingham, Michigan. Ball Publishers.
