Grief...depression...both? Now what?

September 17, 2008 11:55 AM

How to deal with long grief leading into depression? I lost my boyfriend last year in a very sudden, very horrifying suicide. (there are links in my post about it last year if you're a trainwreck gaper like i am...) I'm in weekly therapy with a great therapist. I see a great psychiatrist monthly. I am on two antidepressants that don't seem to be doing much for me but I can't really tell, because am I depressed or am I still grieving?

I just can't seem to get past it. Not a little bit. Not even at all. I have a history of dissociating unwanted emotions, but I feel this experience has ripped me open and I can't ignore anything that causes me pain now. And I can't stop thinking about him and what happened and why did it happen and should I have known, could I have guessed, is there anything I could have done, is there anything anyone could have done, how long was he planning it, why did he do it the way he did, what was he thinking WHAT WAS HE THINKING etc etc etc. Logically I have some answers to all these questions. But emotionally....my heart just ain't buying what my brain's selling. I feel like I'm getting punched in the gut forty times a day when i think about him.
I've managed to hold on to my job through this, and even had the best quarter ever, in the three months following his death. But everything else just seems....basically impossible. My friends have been less than supportive I have to say, but I haven't made much efforts to hold on to them, either. I bought an exercise bike so i could get some sweat going even though i hate leaving my apartment when i don't have to. i haven't done dishes in more than a month, and i haven't vacuumed once since i moved in here, in november of last year. i was paying the teenager downstairs to clean for me periodically, but i can't afford that now, and she's in college anyway, and I can't have a stranger in my house. i don't do any of the things i like to do; i was keeping up with photography for awhile but even that's by the wayside for the last 2 months...
OK my questions. I've asked these of my professionals, but I want a hivemind opinion:
1) I'm depressed....but is it chemical? People who understand tell me, but it's only been a year since your boyfriend __________ (insert horrible manner of self-inflicted death here), it's understandable you're struggling.... but can it be fixed? I figure the AD's are doing something....but it doesn't feel like enough...
2) Maybe no one can answer this....but....i long to know....how can i come to accept the unacceptable? There are no answers to the questions i have surrounding this loss...but new ones keep cropping up, obsessing me for days, spurred by things i read, things i see on TV, things i dream. the death of DFW last weekend was catastrophic for me in more ways than one.
3) I have started to think towards my future, acknowledging I can't stay in this safe, comfortable, well paying job that i HATE forever...I've stayed because I just couldn't handle another change....but it can't last forever, because I'm losing my ability to "embrace the suck" that is my day to day work. (it's not my coworkers, or anything against the job, i just....it's not what i thought i'd be doing with my life, and i cant' stay here forever)....but it feels impossible to make plans to do something that requires me to be really functional and presentable human when i feel like i'm so NONFUNCTIONAL and unpresentable. i never know what's going to pop out of my mouth. i can't even FATHOM the energy it would take to clean out my car let alone my house. Let alone successfully study for the GREs...and decide what I want to do with my life.
i've been waiting for more than a year now for some light to return to my life, but despite my best efforts it's just not happening. what do i need? more therapy? a swift kick to the head? what worked for you if you were in this kind of confusing black hole?

sorry for the length, thanks in advance for any answers.

posted by Soulbee to Health & Fitness (24 answers total)

Best answer: This might just be how long it takes for you. Consider that for a bit.

On the other hand, have you spoken with your psychologist and your psychiatrist about your feelings of being "stuck" in your grief and depression?

There's no timetable, but if you feel like you're not moving forward, checking in about that with the people who are working with you to help you get through this is the best idea.

It's possible that you might need different medications, or different dosages. It's possible that you might need to take a different tack in your therapy, or add/substitute different therapeutic approaches (Cognitive Behavior Therapy in addition to psychodynamic "talk" therapy, for instance).

And it's possible that some of the grief and depression might be connected more to other, more current life issues, like you hating your job, than to your partner's suicide, but it got all snowballed into that grief and sorrow.

But please remember that there's no timetable. Also, a wound gets itchy as it heals, and I think the same thing is true of psychological/emotional wounds.

I am wishing you happiness, and/or serenity. Or whatever you want from life right now.
posted by Sidhedevil at 12:20 PM on September 17, 2008

Best answer: I can't answer your questions but I want to recommend seeking out Dialectical Behavioral Therapy. It was originally created to treat Borderline Personality Disorder but can be helpful for other depression/anxiety/mood disorders as well. I imagine that it would entail adding a group therapy component to your current individual therapy. It's very practical, and has four components: mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. One of the skills taught is "radical acceptance," which is pretty much exactly what it sounds like - accepting reality for what it is. I think it might be helpful for you. Best of luck - you deserve happiness and peace of mind.
posted by granted at 12:23 PM on September 17, 2008

Best answer: I was once told, "You never really get over the death of a loved one. You just muddle through." You will, with time, keep muddling through this. Some days/weeks/months/years will be better and easier than others. Just when you start to feel like you feel better, you might start feeling worse again. Stay with your therapist, ask them to re-address your meds, maybe seek out a support group. I think the hardest part is feeling like, a year plus later, you should be over it and you aren't allowed to talk about it anymore. It's important to find a space where you can express yourself, especially those times when your pain is so raw that you feel as though it just happened.

As for what you are going to do with the rest of your life, it can be paralyzing to think, "I have to quit, take the GREs, figure out what I want to do with my life..." and see the millions of tiny steps it takes to get from Here to There. And that's after you figured out where There is. Ann Lamott's writing guide "Bird by Bird" is based on the idea that you don't have to know where you are going. You just have to know what your next step is going to be. "Baby steps" sounds like such crappy advice, but sometimes it's all a person can do and... well... you are where you are.

I am so sorry for your loss and please don't feel alone. Grieving is a lifelong process. This is how you are supposed to feel.
posted by juliplease at 12:33 PM on September 17, 2008 [1 favorite]

Best answer: 1. People talk about the mind-body connection. The mind-brain connection is even tighter and more mysterious. My non-expert guess is that you couldn't possibly be this depressed without it affecting your brain chemistry. Since you know the trigger, clearly therapy to help you deal with the event is essential. Medication might also be helpful - TALK to your psychiatrist - find the right AD usually takes some trial and error, it would be nice if he could find something that would get you steady enough that you could deal with the rest of your life.

2. When my brother died, the answer that worked for me is that it is part of the "is-ness" of the universe. In other words, the universe just is the way it is. We can like it, hate it, deny it, fight it but it still going be what it is. Some questions are unanswerable but even if you answered every question in the world, he would still be dead.

And I can't stop thinking about him and what happened and why did it happen and should I have known, could I have guessed, is there anything I could have done, is there anything anyone could have done, how long was he planning it, why did he do it the way he did, what was he thinking WHAT WAS HE THINKING etc etc etc.

Those answers don't really matter - what matter is that there is a huge whole in your heart and nothing you can do now can change the fact that you have to live without him. For me, I had to trust that my brother was in God's care (whatever that means), I could no longer do anything for him, the only thing I could change or control was how I went about living without him there.

how can i come to accept the unacceptable? By realizing that he is dead whether you choose to accept it or not. The universe is. He is dead. It may feel unacceptable but it is still a fact of life - declaring it unacceptable can't undo it. You don't have to like it, but it is reality. Once you accept that this is reality, you can work on understanding what your relationship and his death means to you and how you are going to rebuild your life with his death now an undeniable part of your history. Denying reality causes misery and doesn't change reality. Admitting reality opens the door for you to begin to figure out how to live in this new world where something like this could happen to you.

I'm glad you have a good therapist. I suggest that you wait to try to change jobs until you have a little more energy for dealing with life.

I'm sorry for your loss.
posted by metahawk at 12:37 PM on September 17, 2008 [6 favorites]

This is really off-the-cuff, but it sounds like with a well-paying job you might want to consider taking a real vacation sometime in the near future. Occasionally, a drastic change of scenery can provoke new perspectives on your situation back at home. Go somewhere foreign. Go for a month. If you have the strength, consider going alone and keeping a journal. A similar trip worked wonders for me when I was going through something similar, grief-wise. Experiences like these can go a long ways in helping one to get un-stuck. If you have the resources, consider it.
posted by cior at 12:41 PM on September 17, 2008

Response by poster: thanks for the answers so far.... i hear a lot "you are young, you need to get on with your life" which means just about as much as telling someone who's feet are encased in a concrete block to go for a stroll. the dichotomy of what the world out there is telling me, versus what my "professionals" tell me, and all encased in this "he did ____________ thus he wasn't just depressed he was crazy, so you must be kind of weird to have been with him for so long" sensation (ok i don't know if people really tihnk that...but it's weighed quite heavily on my mind...the weight of it is too much sometimes! how do you deal with a loss that is so far outside of most peoples' understanding, because it wasn't just a suicide but also a spectacle?
posted by Soulbee at 12:47 PM on September 17, 2008

Response by poster: i'd love to take a vacation but i used up all my vacation time (awarded in advance last year by my kind boss when I just couldn't get out of bed, and then early this year when i had my gallbladder out.) not sure that if i went somewhere i'd be able to muster the energy to leave the hotel room anyway.
posted by Soulbee at 12:49 PM on September 17, 2008

Best answer: i think that, considering the circumstances, it's entirely reasonable that you're still awash in depression and grief and grieving depression.

nthing staying with your therapist and talking about revisiting drugs and dosages. one thing your therapist can do in particular is help provide an external check on how your current state may compare to previous states.

please try to be as compassionate with yourself as you can. i think a lot of the self-cannibalizing "i'm depressed because i suck because i'm depressed because i suck because..." cycle of things is amped up by being angry at ourselves and not giving ourselves the compassion we would give to a friend or loved one going through the same thing.

you don't have to embrace the suck, but you don't have to fix the suck in one fell swoop. little bits of progress are still progress. and sometimes, when in this rough a state, even just *averaging* progress is progress -- there are steps backwards as well as steps forward.
posted by rmd1023 at 12:50 PM on September 17, 2008

i hear a lot "you are young, you need to get on with your life"

Those people are being thoughtless at best, hideously disrespectful at worst. Nobody has the right to set a timetable on someone else's grieving.
posted by Sidhedevil at 12:57 PM on September 17, 2008 [6 favorites]

Response by poster: sidhedevil, i kind of thought so too....but you'd be astounded at the range of people that said this to me, friends, family, coworkers, even my general practitioner. i hear it ALL THE TIME. glad to see i'm not crazy to hate that.
posted by Soulbee at 1:04 PM on September 17, 2008

Sorry to hear your story. I hope things start looking up soon. Have you ever heard the phrase 'Radical Acceptance'? It is used in Dialectical Behavior Therapy. There is an intro to it here. One part of Radical Acceptance stresses that life can be worth living even though there is pain. Another says that you have four choices for dealing with painful problems: 1> Solve the problem, 2> Change how you feel, 3> Accept it, or 4> Stay miserable. You are free to choose a different option. You may have to retrain yourself and choose over and over again not to be miserable, but you CAN choose another way to live. I hope you do.
posted by RussHy at 1:29 PM on September 17, 2008 [1 favorite]

Best answer: Soulbee, you could be experiencing Post Traumatic Stress Disorder. What happened to you was a big, violent event. It probably feels like rejection, although it probably wasn't intended that way. You'll never know what was in his mind, and you don't seem crazy, so if anybody makes you feel that way, politely tell them that you just don't need that sort of crap.

how can i come to accept the unacceptable? what do i need? more therapy? a swift kick to the head? what worked for you if you were in this kind of confusing black hole?

You are processing through this painful experience and loss, even though you may not feel progress. You accept the unacceptable over time and by sorting it out. If you've read up on the stages of grief, good, if not, it's a good idea.

You need support. It can come from a therapist, grief support group, and/or friends. You need to be able to talk about it until you're done, not on anybody else's timetable. You don't need a kick, or even to "get on with your life." You are doing what you need to do. I think you probably also need to acknowledge that this was an unusually awful experience, and that it will take even more time to heal.

What has worked for me is medication to help me stay functional, therapy, good friends, and the knowledge that it will get better over time. It does, really. I'd recommend you stay at your job unless/until you have a replacement. It provides stability & structure, and probably health insurance. Good reading and music might help. Do avoid depressing books, movies & music.

I'm so sorry for your loss. My email's in my profile if it's of any use to you.
posted by theora55 at 1:30 PM on September 17, 2008 [1 favorite]

Best answer: I was young and she didn't commit suicide, it was a car accident. We wrestled for the keys before we left and I let her win. Anyway.

1) Hard to say. Follow your therapists' guidance. After a while I decided I was sick of being reliant on chemicals to keep me going, so I quit. That's not the right move for everyone, but ask yourself how long you want to keep popping pills to deal with life.

2) You can't. The unacceptable is unacceptable and if you ever accept it, it becomes acceptable. Which it shouldn't. Death is a part of life and all that bullshit, but it doesn't make our catastrophes OK. It doesn't make things right. Things will always be wrong, from the day of your loss until your last day. Something will always be off. There will always be some small hole somewhere deep inside your soul, a hole shaped just like him. For a long time that felt fucked up and unfair to me. Then one day I realized that its kind of like the picture I get to keep of her, one that nobody else has. Its my last gift from her. Its a bittersweet one, one that still makes me cry more often than not - but you know what? I wouldn't give it up for anything in the world. Even that doesn't make the unacceptable OK, but it makes it easier to deal with.

3) It will be hard for anyone to tell you what to do here. I'd say if its only been a year, take some time to keep getting back on your feet, and start with little goals. If you can't clean out the car, focus on a single drawer in the desk or something. Then move up to the whole desk. Then maybe the car. Etc.. Try to do one small thing each day.

Once you've moved further down the path, you can start thinking about the bigger things, like what do you love - that's what you should be trying to arc towards eventually, but now's not the time to figure all of that out, you still need to keep working back towards some horribly less-than-it-used-to-be form of normal.

I hope you make it to where you need to be. I've always liked the Lewis Carroll bit from Alice in Wonderland, when I think about life:

"Cheshire Puss," Alice began... "would you tell me please, which way I ought to go from here?"

"That depends on where you want to to get to," said the cat.

MeFi mail if you ever need someone to bounce things off of.
posted by allkindsoftime at 1:36 PM on September 17, 2008 [5 favorites]

Soulbee - take a look at the answers I got in this AskMe about grief.

I haven't been where you are, not even close, but when working through grief/anger/depression, what helped me the most is someone (either the MeFi folks, or my therapist) saying "It's OK to still feel like that."

You're doing everything right. Keep on being as kind to yourself as you can. I'm dealing with a couple of people close to me who are experiencing some depression, and what really helps is when they ask me for something specific, like "Could you help me clean out my car Saturday morning?" or just "Could you just sit and listen quietly and hold my hand?" I'm more than willing to do that, and more - and if your friends aren't, time to find a new support system.
posted by Liosliath at 1:36 PM on September 17, 2008

Best answer: I am truly sorry to read of your loss. One year is NOT enough time to "get over it". Any death is hard but suicides are definately the worst for the survivors. Part of what you need is time, time to grieve; as to acceptance, first you have to accept that this process will take however long it is supposed to take for you. But also a change would probably do you good. Can you change something about your life so you feel in control? Pledge yourself a walk every evening? Don't worry about cleaning your home, but make your bed every morning and clear the sink each night. Once you have control over those two parts maybe you will feel like tackling somewhere else that has been bothering you. He sounds like he was a great guy; he had a lot to offer the world. Now you can use his inspiration to rebuild yourself so you can give back to the world in his spirit.
posted by saucysault at 2:00 PM on September 17, 2008 [1 favorite]

>not sure that if i went somewhere i'd be able to muster the energy to leave the hotel room anyway.

Then do something that won't let you stay in a hotel room, such as an adventure holiday where your horse riding, or mountain climbing, or hiking, or kayaking all day. Perhaps just having to concentrate on having to do something physical might help break your grief.
posted by zaphod at 2:40 PM on September 17, 2008

Best answer: If the antidepressants were helping you, you'd know after about 3-4 weeks. If you can't tell, they're not working. That's okay.... finding the right medication is often a crap shoot. The doctor makes the best possible guess, and then you move on to another drug. There are so many medications to try, and they affect everyone differently.

You're wondering if your depression is chemical. I think I know what you mean; "is it me, or is it my situation?" But really, any depression is chemical -- whether it's generic, post-partum, brought on by loss, or even by a positive change. The mental and physical effects are the same. Don't conclude that antidepressants won't help you. Even if they do help, you'll still have a lot of pain and grieving, but you'll be able to function better in your daily life and not feel such a terrible weight.

I suggest go to your psychiatrist with details about your depression symptoms and how they interfere with your work, relationships, and life in general. It might help to fill out a depression questionnaire (like this or this) and bring it to the office, along with examples of "normal" activities you're not able to do. Even good doctors can benefit from clearly-stated evidence, and the inventory you put together now will help you evaluate how you're doing later on.
posted by wryly at 3:07 PM on September 17, 2008 [1 favorite]

Best answer: Everyone heals in their own way and in their own time. You can't set goals, you can't speed it up, it just happens. The best you can do is take care of yourself as best as you can physically and emotionally, try not to burn too many bridges in this time of upheaval (it's a bad time to try and decide which friends to keep and which to lose, for example), and just try and get by. I don't believe in closure, I don't think you can ever "get over" something like this - but eventually you will become used to the pain and it won't hurt all of the time. You will probably never be the same person as you were before this happened, and it's ok to mourn your lost innocence as well as the person you lost.
posted by The Light Fantastic at 3:26 PM on September 17, 2008 [3 favorites]

i've been waiting for more than a year now for some light to return to my life, but despite my best efforts it's just not happening.

My friend's husband died back in 2002. It took her at least three years to get past the worst of it. So, no, you are not supposed to "be over it by now."

Having said that, you are definitely in a nonfunctional place at the moment.

One suggestion I have is to get a journal and start writing out it all out. I have a feeling you might need to access some anger, as well. Write that out too.

I used to get into my car and yell and cry and scream and ask God "why" at the top of my lungs while driving down the road, when I was grieving my friend. God is big enough to handle it, and it helped.

My friend's widow said that when she struggled with releasing her grief, she would rent a movie with sad scenes. Once she could start crying, she'd cut the movie off and use the time to grieve productively.
posted by konolia at 4:32 PM on September 17, 2008

Best answer: Here are some links you might want to check out:

http://members.tripod.com/lifegard/
http://library.thinkquest.org/16665/suicide.htm
http://www.survivorsofsuicide.com/wwwboard.html
http://www.suicidegrief.com/

I think the last board is particularly good. I lost my father to suicide many years ago. We were pretty much estranged at the time so it didn't have the same impact as what you have gone through, but the fact of it still continues to reverberate in my life.

Only other survivors can understand what you are going through so I would suggest reaching out to them wherever you can. There may be survivor circles meeting in your area.

What I've gotten from reading through these forums is that survivors don't ever 'get over' the event. They learn how to cope with the pain and find ways to reaffirm to their current lives.

Check out http://www.depressionisachoice.com for some different ideas on dealing with depressive thoughts.

It's sometimes difficult for friends and family to get over the stigma of suicide. If they aren't showing up for you in the crucial ways of showing support and affection, it's even more important to have other forms of connection.

Personally, I'd be looking for forms of ritual to help me deal with the event. Native American sweat lodges come to mind.

Hope this helps.
posted by diode at 5:44 PM on September 17, 2008

I am very sorry for your loss. I am also very glad to hear that you want to get better. That alone should give you hope.

Can you see your psychiatrist more than once per month? This might help some, as might group therapy. Certainly no harm in trying.

Friends are important. Explain to them very clearly that your well-being is on the line and you need their help. Get them to get you out of the house and start making some new memories. There's nothing worse than re-living old memories. "The last time I was here I was with him." Building new elements of your life - the things that will be part of the here-and-now, and things that have no connection to your boyfriend - are important.
posted by eratus at 6:05 PM on September 17, 2008

I'm so sorry for your loss. When my mother died I woke up in tears every day for more than a year - it was the first thing I thought in the morning and the last every night. Her death wasn't unexpected and she wasn't young. Losing a partner young and to suicide has to be overwhelming for a long time. Echoing everyone above I think you should be gentle with yourself and accept that it will take as long as it takes to grieve and to come to something resembling peace with his death. It's very easy to keep punishing yourself for staying down and it's a vicious circle. It's hard to alter your self talk to honor yourself and remind yourself that you're worth feeling better. I also think all the health woes you've had on top of the depression are a tough combination as well. Recovering from major illness and surgery on top of grief and depression is a LOT.

I do think it's worth revisiting the drugs. I've gone through multiple bouts of clinical depression and drugs that worked for me once didn't a second time. Trying a different med may make a lot of difference. I've been in that place of being entirely sick of being sick but feeling stuck there and I do think it's a sign of progress although it felt lousy at the time for me.

One thing that has helped me over time is being physically active, especially outdoors. I know the days are getting shorter but if you can take even a 10 minute walk at lunch time on your work days it may help. Enlisting local friends or family to regularly walk with you may help get you there. I've relied on classes and a team sport to force me to be physical when all I wanted to do was to curl up in a small dark space. Depression is partly physical so countering that aspect of it may help a little. Good luck - and feel free to contact me - info in profile.
posted by leslies at 6:40 PM on September 17, 2008

I'm so very sorry to read about your loss, Soulbee - and I agree with saucysault; a year is not enough time to 'get over it'. The first couple of years after my alcoholic father's death were excruciating, and - like you - I constantly wondered about his last minutes, what he had been doing, how he had felt etc. Almost ten years on, I still think about him every day, but the need to torture myself over his death has almost dissipated.

I've been very fortunate in that in the time since his death, I've met many, many people who have also lost a parent to alcoholism - not through groups, but just in everyday life - and that has really helped more than I ever thought it would. There are probably the same number of people of who lost a loved one to suicide - and you'll find them either by going to groups or just by co-incidence.

Again, I feel that I should echo what's been said above in that there is no timetable for getting over your loss but you will find it easier to cope with the grief as time passes.
posted by highrise at 11:37 PM on September 17, 2008

Response by poster: wow. i'm just bowled over by the kindness and information here. it feels better just to know there are people out there that have a better understanding of what i'm going through.

WCityMike -- thank you so much for the legwork. I did work with Elaine Weisman in Exeter for a little while. she was helpful in the crisis time but unfortunately those groups actually have a small limit on the number of participants, a short overall program time-length, and a huge waiting list. i registered in august after nate died and was finally accepted in march -- right when i was recovering from surgery. i've re-registered but have not been accepted a second time around yet. if i can get some get-up and go, i may look into the hampstead group. thank you so much. i will wade through your other links today. it feels really good to know people have taken this kind of time to help me.

thank you all.
posted by Soulbee at 6:59 AM on September 18, 2008