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.
