When your client is grieving the death of someone significant, how do you distinguish between normal deep grief and a situation where they need professional help? It is important first to understand that the majority of people navigate their way through grief without major dysfunctions. But that doesn’t mean it’s easy. Even in normal grief, many physical, emotional, and spiritual responses can seem like clinical depression. One major difference is that with normal grief, the intensity of these responses fluctuates and gradually subsides.
You may observe that sadness, longing, and other grief expressions remain for a long time, and clients may get “ambushed” even years later by triggers that remind them of the deceased. Yet the symptoms come and go at various points rather than being constant companions as grieving clients increasingly return to a normal degree of functioning in the world. Over time, they can live and once again find enjoyment in activities and with loved ones.
However, on some occasions, you may encounter clients with more profound and complicated grief that can signal depression. Warning signs of clinical depression or a client requiring professional help include:
- Chronic deep sadness
- Excessive sleeping, barely sleeping at all, or inability to get out of bed
- Rapid weight loss or gain
- Lack of any pleasure or interest in activities or relationships
- Sustained trouble focusing, concentrating, or engaging in life
- Lack of personal hygiene
- Recurring thoughts of death or suicide, especially if they develop a suicide plan
- Generalized guilt, self-loathing, and loss of self-esteem
The more of these symptoms you observe, the greater the chance that intervention is needed. Medical professionals treat clinical depression with counseling therapy, medication, or usually a combination of the two.
We recommend you prepare ahead of time by creating a list of professionals in your area who treat depression, especially as a result of grief. A good way to build your list is to ask hospices, places of worship, and hospitals for the professionals they provide, or those to whom they refer people when help is required.
If you have a Diminishing Capacity Letter, you also have permission from clients to call their powers of attorney and other trusted people who may be effective in getting help for clients because of their relationship with them. Because figuring out where to go can seem like a huge obstacle, your clients will be especially grateful if you can provide names and resources from your research.
Remember that most people will get through their grief, often aided by their already-existing support network plus available groups and counselors. Yet you provide invaluable service to your clients and their families when you are prepared for those “sometimes” cases when extra help may turn the corner or even save a life.