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What Causes Grief

Dealing with loss is something that all of us must do as we grow older. Grief can be painful and traumatic, and if too much of it hits us at once, it can be overwhelming. It is a major psychological cause of depression, especially among older people, who often must face several losses at the same time.

When we talk of loss and grief, we commonly think of death of loved ones- a spouse, children, brothers and sisters, and friends. There are also many other losses that cause depression.

An early loss occurs when children leave home for marriage, college or work. Parents, especially mothers, may experience severe grief (the “empty nest syndrome”). This is most common with women who do not work outside the home and have spent so many years being responsible for the family.

Retirement also catches many people off guard. After a person has been working for more than 50 years, the job becomes his or her identity. For example, Joe may consider himself a doctor, engineer, or teacher rather than a husband, father or individual person. The change of role can be very traumatic- not only for the reduction in income that often comes with retirement, but also for the strain on a marriage that may occur if both spouses are at home all the time. A wife may feel threatened if the husband begins running the show, doing the things that she has always done. She may say “I promise to love, honor and obey but not have him under foot 24 hours a day!” Either spouse may become depressed, or sometimes outside help is needed to resolve the conflicts that can occur.

Another common loss that many people experience is the loss of a home. Some people may decided to sell their homes out of personal preference, but in many cases reduced income or deteriorating health forces the choice. Here we may be dealing with several losses at once: Loss of income (due to retirement or job changes), changes in lifestyle due to that, loss of health and loss of home- including neighbors and longtime friends.

These losses, combined with the very mixed and frightening feelings that happen when a loved one dies, can cause older people to sink into a deep depression. They may be afraid to talk about these feelings, afraid that someone might think they are going crazy. These emotions are normal, and they can be overcome.

Usually, our first reaction to the death of a loved one- or any other major loss- is shock and denial. We can’t believe it. Anger is also a common reaction. Sometimes people are angry with God for letting it happen, or angry with a loved one for dying. Sometimes they want to do some bargaining, saying, for example, “If you will do this, I will do that”, often as a way of avoiding the loss.

After dealing with all the other emotions, we come to an attitude of acceptance. Acceptance cannot come, however, until we have allowed the initial feelings of grief to come to the surface and we have dealt with them.

Different people vary greatly in their abilities to cope with loss. For some, grief can last a long time and evolve into a serious depression. For others, it passes quickly. If the depression seems to be lasting too long, a person should seek professional help. Remember, however, that a reasonable amount of grief is normal. Your feelings are valid and should not be denied.

Melinda Black is the program director of the HSCMC Mental Health Unit.