Individuals present
symptoms which are characteristic of a Major
Depressive Episode. The bereaved individual typically regards the
depressed mood as "normal," although the person may seek professional
help for relief of associated symptoms such as insomnia. The duration
and expression of "normal" bereavement vary considerably among
different cultural groups. The diagnosis of Major
Depressive Disorder is generally not given unless the symptoms are
still present 2 months after the loss. However, the presence of certain
symptoms that are not characteristic of a "normal" grief reaction
may be helpful in differentiating bereavement from a Major
Depressive Episode. These include:
Guilt about things other than actions taken or not taken by the survivor
at the time of the death.
Thoughts of death other than the survivor feeling that he or she would
be better off dead or should have died with the deceased person.
Morbid preoccupation with worthlessness.
Marked psychomotor retardation.
Prolonged and marked functional impairment.
Hallucinatory experiences other than thinking that he or she hears the
voice of, or transiently sees the image of, the deceased person.
Associated
Features:
Symptoms
of avoidance, numbing, and increased arousal that are present before
exposure to the stressor.
Depressed Mood.
Somatic
or Sexual Dysfunction.
Guilt or Obsession.
Addiction.
Differential
Diagnosis:
Some disorders display similar or sometimes even the same symptom. The
clinician, therefore, in his diagnostic attempt has to differentiate
against the following disorders which one needs to be ruled out to establish
a precise diagnosis.
The impact of the
loss of a loved one or friend can be devastating. Individuals who experience
the loss of a relationship through either a sudden death or a death
following a longer illness may experience many different symptoms. Emotionally,
common reactions to death include sadness, anger, guilt, loneliness,
and shock. An individual may also notice physical symptoms including
fatigue, weakness, and hypersensitivity. It is also not uncommon for
an individual's sleeping and eating pattern to change during a period
of grieving.
Treatment:
Counseling and
Psychotherapy [ See
Therapy Section ]:
Therapy can help
individuals with either short or long term symptom patterns. Treatment
aids in understanding of the loss and eases the life changes as a result
of the event. Additionally, therapy can also provide support for the
individual who recently experienced the loss.
Pharmacotherapy
[ See Psychopharmacology
Section ] :
Treatment with SRIs.
These same SRI medications are also used to treat depression, obsessive-compulsive
disorder (OCD) and other anxiety conditions.
Fluoxetine Prozac.
Fluvoxamine Luvox.
Paroxetine Paxil.
Sertraline Zoloft.
Citalopram Celexa.
Clomipramine Anafranil.
