Fyodor Dostoyevsky once said, “The mystery of human existence lies not in just staying alive, but in finding something to live for.”  When we experience a loss (either a person, place, thing, or ourselves), it can feel very daunting.  It can feel like we are losing ourselves to things that are completely out of our control; things that we don’t have much say in.  This feeling of being “out of control,” can lead people to feeling a sense of loss in more ways than one; however, some things to remember are that (1) grief is uncomfortable; (2) grief is unpredictable; (3) we can all be triggered by loss, even if it’s not a direct loss; and (4) sitting with our feelings is important.  Grief is uncomfortable; unescapable; often indescribable; something that we can but should not run from and while many people feel that they should feel a certain way, living in the “would’ve”, “could’ve”, and “should’ve” thoughts can destroy us.

What is Depression?

When we feel depressed, it can change how we act, what we think, and our resiliency.  Depression has had many terms to label it for years now.  Some of these are major depressive disorder and even clinical depression.  No matter what you call it, depression is a very serious mental illness that can affect how you think, feel, act, and interact with friends, family, and other loved ones.  It presents as feelings of sadness, irritability, emptiness, loss in things we have once enjoyed, sleeping changes (either too much or too little), decreased energy, feelings of worthlessness and/or guilt, difficulty thinking, and, in some cases, thoughts of death.  While it is normal to experience brief moments of sadness, depression is something that the person often struggles with for years at a time.  Let’s think of Eeyore from Winnie the Pooh, he experiences a “down in the dumps” type of mood that is difficult for him to get out of.  According to psychiatry.org, “there are a number of things that cause depression and with proper diagnosis and treatment, the vast majority of people with depression will overcome it.”

What does it mean for our Grief to cause Depression?

We all go through difficult things from time-to-time.  Maybe your dad recently passed away.  Maybe you recently lost your job.  Maybe your partner tells you that they want to breakup.  It is normal for us all to go through feelings of sadness, grief, and bereavement, which leads some to describe themselves as being “depressed.”  It is important for us to remember that being sad is not the same as being depressed.  Bereavement is not linear.  It changes the way we are, the ways we handle things, and ways we interact (or not interact) with others in our lives.  If you are in the process of coping with a sudden, unexplainable experience in your life, expect that you will be depressed.  Expect that you may have a loss of appetite; you will possibly have trouble sleeping; you will probably feel tearful and not want to participate in life in the way that you did prior to the experience. 

Differences between Grief and Depression.

Everyone grieves differently and it is important for us to remember that.  Some people may resemble depression; however, there are very important differences between grief and depression.  Some of these differences include ability to function, support, and the length of time that we feel a certain way.  While these things may be different, it is still important for us to treat them in similar ways.  Some ways to deal with our grief and our depression, include making sure we exercise regularly, getting a good night’s sleep, finding ways to keep ourselves busy in a productive manner, and allowing people in our life to support us.

What is a Trigger for our Depression?

It is important for us to remember that stress can take a toll on anyone; however, if we already had depression, are experiencing complicated grief, or even feeling all alone in an unexpected change in our life, it is often difficult for us to bounce back easily.  Knowing when we are about to go down the rabbit hole, is an important step for us to ensure that we can handle our feelings in a productive manner.  By identifying triggers for our depression, we can learn to identify the signs before the return of our depression.  Ask yourself what is one of my triggers for depression and then devise a plan to handle that trigger.  While triggers are different for everyone, some triggers include rejection, relationship issues, job loss, retirement/empty nesting, holiday stress, substance use, hormonal changes, family troubles, loss of a loved one, and more.  Make a mental list of your triggers and find proactive ways of handling them so that you don’t go down the rabbit hole.  Make a plan to handle things early on and ensure that you know the plan may not work in the moment so be sure to alter it as you go.

What can we do to Handle our Triggers?

It is important that we begin to look for meaning.  One common understanding of “meaning” comes from Attachment theory, (See Bowlby, 1980) in that when an individual loses something that has held significance to them, they must work to re-define their role with the lost item through a process of reconstruction.  Ok, let’s imagine that our mother has passed away approximately a year ago.  Our daughter comes to us one night and informs us that she is getting married.  We are zealous with happiness for our daughter but still feel the missing part of our mother not being able to participate in such a joyous event.  We worry that our loved one not being there will bring devastation to the event.  Instead of looking at the loss here, we must begin to look at the beauty.  Our daughter is getting married.  Weddings are often very enjoyable events.  We are happy to begin helping our daughter plan her wedding.  By not looking at the sad parts, we can begin to restructure our life one piece at a time.  Our peace for this wedding would be to come up with a suitable option that not only allows our mom’s memory to have a presence at the wedding but also to remain stalwart in the idea that our daughter’s wedding day should and can be beautiful.  There are many options that one can come up with to do just this.  One idea is to have a sign on the chair, a memory table, or even a part of a wedding toast specifically about the person you are missing.

Another way that we can handle our trigger is to notice things that could possibly cause us stress.  One of which is surely that of holiday stress.  (Please see my previous article on how to handle the holidays after losing a loved one.). While the holidays can surely be a time for celebration, the stress that comes from choosing perfect outfits, sentimental presents, and attending all holiday parties, can also carry with it a sense of dread.  Remember that for this trigger, it is healthy to limit the amount of time you spend with certain people and to use mindfulness to create peace in unpeaceful situations.

What can we do every day?

There is an acronym to help you remember to help yourself with these feelings every day.  The acronym is “A-B-C-PLEASE”.  Remembering an acronym can help us remember what to do in various situations and allow us to set-the-stage in an effort to prepare ourselves for stressful situations far before we arrive.  In Dialectical Behavioral Therapy, this skill is about taking care of ourselves in the moment so that we can take care of others as well.  It allows us to set our stage.  Now, my clients know that the term “set your stage” is an important one I work with them on.  But for those who are not my client, let me explain what this means.  Setting our stage means that we recognize an upcoming stressor, plan for it, think of ways to handle it if it gets to be too much, and prepare ourselves in mind-body-spirit long before the stressor is even in front of us.  It means that we think of something (let’s say my daughter’s wedding toast) and plan for it (write it out early and practice it several times before the wedding) so that we can limit the negative emotions to it as well as the negative emotions we have tied to the negative emotions of it. 

Going back to my example, don’t get me wrong, I love my daughter but public speaking in a crowd of people I know personally has not always been my strong suit.  I easily get nervous, think I will start to get sweaty, and start to find all the reasons I am not the best suited to give the wedding toast.  If I were to stay in the moment of “I am not best suited”, I would allow myself to fail.  Instead, I set my stage.  I write out the toast early; read it over at least 100 times; and imagine myself standing in front of a crowd of people while I read the speech another 100 times.  I set my stage.  I know what I will do.  I know I will do it well.  Now, I’m not saying I won’t be vulnerable, but I am saying that I would do better than what I thought I would originally. 

This is also where the ABC-PLEASE skill comes into hand.  (A) accumulate positive emotions by doing things that are pleasant.  (B) build mastery by doing things we enjoy. (C) Cope ahead by rehearsing a plan ahead-of-time so we feel prepared.  (PL) treat physical illness.  (E-) balance your eating to avoid mood swings.  (A) avoid mood-altering substances and have mood control. (S) maintain good sleep so you can enjoy your life.  (E-) get exercise to maintain high spirits. 

We are all a lot more vulnerable to our emotions and tend to make more impulsive decisions when we don’t practice self-care; therefore, it is important for us to understand how to take care of ourselves in a way where we not only protect ourselves but also don’t make emotional decisions.  By following the ABC-PLEASE skill in DBT, we allow ourselves to be healthy and make healthy decisions for ourselves daily.  When you master the ABC skills, you will know the importance of positive experiences and the need we each have to cultivate positive experiences even after a tragic event has occurred.  Still, it is equally as important for us to take care of ourselves mentally, emotionally, and physically, especially after we’ve gone though something difficult.

To cope with our loss, it is important for us to take care of ourselves, talk with people who care about us, try not make any major decisions in our life, and find ways that we can optimize our inner feeling to positive ones.  If you feel that you have tried many things that have been brought up today, there are many trained professionals here at Fresno Family Therapy that can help.  Give us a call today!

About the Author: 

Tammie Makely, LMFT

Licensed Marriage and Family Therapist #113186

Fresno Family Therapy

Phone: (559) 795-5990

Email: info@fresnofamilytherapy.com

Fax: 1-559-468-0169

 

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