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Depression - Reactive and Grief-Related Depression

Reactive and Grief-Related Depression

What is it


Reactive depression describes a condition of gloom, sadness, and other depressive symptoms that goes beyond -- in terms of intensity and duration of the feeling -- what would be expected in response to a given disappointment, loss or significant change.


When a loved one dies, a person naturally goes through a complicated process of grieving. In addition, feelings of shock, despair, and anger may follow many other experiences involving loss, such as the end of a relationship, the loss of a job, a divorce, or serious illness or accident. Even when events seem generally happy, when a child begins kindergarten or leaves home for college, for example, or during a move to another community or another job, you may find yourself feeling bereaved. Everyone has characteristic ways of responding to the expectable and unexpectable events in one's life, and a common reaction to disappointment, change, and loss is to feel blue.


Such feelings are normal; they indicate a serious problem only when they persist for a long period of time, seem extraordinarily intense given the nature of the circumstances, or when there is a continued pattern of responding to most every kind of stress with depressive reactions.


Symptoms and signs



  • Feelings of despair, helplessness and fatigue following a significant event, change or loss

  • Uncharacteristic feelings of worthlessness, guilt, irritability and uneasiness

  • Withdrawal from relationships and depressed sex drive

  • Lack of concentration, and reduced motivation

  • Change in eating and/or sleeping patterns.

  • When related to grief, vague and acute feelings of sorrow, shock, disbelief, anger, protest and despair that persist long after the actual loss.


What you can do


Frequently, feelings of depression are exacerbated when you are taken off guard. Being able to anticipate which experiences regularly evoke depressive reactions for you -- the beginning of the school year, for example, or after you have completed a complicated job assignment -- may offer some protection from the full impact of the feelings. Also, knowing that the depression will diminish when the stress fades may also soften the edge. For some people, exercise and relaxation techniques may also help.


Treatment


The best treatment for depressive disorders combines antidepressant medication and psychotherapy. Generally, your doctor will prescribe SSRIs (selective serotonin reuptake inhibitors) such as fluoxetine (prozac), sertraline (Zoloft), paroxetine (paxil), and fluvoxamine (Luvox).


Another type of medication, TCAs (tricyclic antidepressants) is also commonly prescribed. These include imipramine (Tofranil), nortriptyline (pamelor), amitriptyline (Elavil), and desipramine hydrochloride (Norpramin).


Once symptoms are relieved, psychotherapy can work to help you understand what precipitated the depression, and what resources are available to relieve some of the stresses within your life.


For alternative Treatments see depression


When to seek treatment


If you tend to react to situational problems with mild symptoms of depression, you may want to seek the emotional support and guidance of a therapist. Through psychotherapy, you can learn to manage such episodes in a more even-handed way and to cope with the day-to-day stresses in your life. Also, if the signs and symptoms become more acute or persistent, contact a therapist.


When sharp feelings of grief do not subside with time or seem to be expressing themselves in physical or emotional symptoms, call your doctor.


prognosis


Good. Reactive depression responds well to both medication and psychotherapy. During the course of treatment, an underlying predisposition towards depression may be uncovered, in which case, longer-term therapy may be recommended to address the deeper mood disorder.


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