Grieve The Losses That Come Along With Depression

It might surprise you to know that along with a diagnosis of depression, bipolar disorder, or other mental illness, a person often experiences a number of personal life losses that need to be addressed.  Most people don’t even think about it or realize that these losses are happening.  If you choose to ignore them, these losses will frequently come back in some form, unexpectedly, to haunt you and add to your misery.  If you try to suppress them, it’s a burden you carry that will require lots of emotional effort and energy.  Dealing with losses as they arise is usually the best course to take.  Losses are frequently associated with anxiety and stress, and it’s most helpful to use your coping skills in response.

What do I mean by losses?  A difference in the way you see yourself as a healthy person is one example.  If you lose self-esteem or confidence, this could lead you to feel as if you’ve also lost a particular perception of yourself, or of your standing in your community—whether that’s as a working person, a student, a homemaker, etc. Spending time feeling unwell and going to mental health treatment appointments and support groups instead of participating in other life activities that you would prefer to do can lead you to feel as if you’ve lost time from your life.

Sometimes a change in your daily routine is perceived as a loss if it means you will no longer be able to do the things you were once able to do and which you enjoyed. Some people experience a loss of personal relationships, be it friendships, family relationships, or relationships with significant others.  This is usually not because of you, but rather because the other person doesn’t understand your illness and cannot deal with it very well.

Some people experience a loss of personal finances.  This can be due to a job loss, a cut-back in work hours, or a change in jobs or school, which are often required because of the illness. Mental health care can also become quite expensive and drain your financial reserves, and that is a loss.  Try to remember that a cut-back from your courses in school or a leave of absence from school or work is just a bump in the road overall.  You may experience loss in the form of an opportunity: attending to your illness could require you to turn down opportunities you would otherwise have accepted. Depression might require a change in your home or living arrangements, which can constitute a big loss and major stressor.  You might have to give up some hobbies, a gym membership, or travel plans for financial reasons or because of your illness, and that is a loss.  Each person has their own type of losses that are unique to him or her.

These losses are often temporary blips in your life that are restored when your healthy baseline returns – they’re not necessarily permanent.  Some things may change for the better, however.  It may be that a certain friendship was not as robust as you had hoped, or a change in jobs is actually preferable. 

Some people who have depression may not think of these as losses.  Depression often impairs self-confidence and self-esteem. As a result, those affected by depression believe that they don’t deserve certain things in life, and thus, when a loss occurs, it’s what they expect for themselves.  Their lives are miserable; they feel that they are not deserving of a spouse or friendships, so losing those people is not perceived as a loss.  The person’s thought processes are so distorted that he or she doesn’t realize it’s happened.

How do you deal with these losses?  When you experience a loss, you can’t ignore it and push it to the back of your mind.  That‘s not healthy in the long run.  First, you need to acknowledge that you’ve suffered one or several of these losses.  Then you must learn to grieve these events as losses but at the same time try not to view them as catastrophic events.  Some people go through one or several of the stages of grief and loss such as denial or anger; bargaining with the powers that be that you will do “x” if only your loss would be restored; depression surrounding the loss; and finally acceptance. 

Spend a brief period of mourning your loss – that’s okay.  It’s most helpful to acknowledge the event, sit with it, and think about it for a bit, but do not dwell on or obsess over the loss.  When you are ready, come to an understanding of this loss, accept the fact that you have experienced it and then put it to rest.  This involves coming to terms with the missed opportunities and time from your life.  It involves acceptance of the fact that others have disappointed you, let you down, or were not supportive during your time of need.  Then you will be able to move on, making your life the best you can from this point forward.  Be prepared to have your loss pop up in your mind on rare occasions, but if you’ve dealt with it adequately, this should not cause major distress.

Susan J. Noonan, MD, MPH, a part-time Certified Peer Specialist at McLean Hospital, is a consultant to Massachusetts General Hospital and CliGnosis, Inc. She is the author of Managing Your Depression: What You Can Do to Feel Better, When Someone You Know Has Depression: Words to Say and Things to Do, and Take Control of Your Depression: Strategies to Help You Feel Better Now.