Tuesday, June 2, 2009

Chronic Sorrow or Depression....?

This morning, I read a piece on family caregivers in the New Brunswick, NJ, Home News Tribune. It quoted an article in the American Journal of Public Health saying that family caregivers experience depression at a rate six times higher than non-caregivers.

I wondered, as I read the newspaper piece, whether the researchers had considered chronic sorrow in their assessment of the caregivers' moods? Would such a differential diagnosis have altered their findings?

For many of my caregiving years, I countered the concerns of my family and friends with an emphatic, "But I'm not depressed!". It's true that I had no energy, but who would if their sleep was interrupted every night? And I cried whenever I found a moment of quiet, (usually in my car driving somewhere), but I also had days of intense pleasure and beauty. My weight had gone up but that was because I was eating copious carbohydrates to counter the constant tiredness and I had a foot injury that had interrupted my usual exercise program. As far as I could tell, I wasn't feeling much differently from anyone else who was caring, long term, for an ill family member.

When I finally came across the writings of American psychologist, Dr Susan Roos, (Chronic Sorrow: A Living Loss), and of the Nursing Consortium of Chronic Sorrow Research I breathed a sigh of relief. They were describing my experience exactly and they weren't calling it depression.

Chronic sorrow is neither clinical depression nor chronic grief. Rather, it is the normal, but often unrecognized or misdiagnosed set of grief responses experienced by people with chronic conditions and the people who love them. Because this chronic condition is ongoing, so is the sorrow. Susan Roos describes this endless loss as a "living loss" that persists until the person with the chronic condition has died.

At the core of chronic sorrow is the aching discrepancy between our perception of how life is and "how it should have been". This discrepancy leads to a sorrow that is profound, pervasive, and periodically very intense.

Contrary to the experience of clinical depression, though, our daily functioning is rarely affected. We maintain access to a full range of emotions and our spirals into intense sadness are intermittent in nature, often triggered by anniversary dates, missed developmental milestones or recurrences or worsening of our loved one's condition.

Because the source of our sadness is not "resolvable", neither is our grief. We can't expect ourselves to "get over it" or "just get on with our lives". Antidepressants are not the answer unless we're actually depressed. Nor is psychotherapy focused on uncovering the traumas of our childhoods. (Though this can be helpful at another time.)

What many of us find most helpful is "companioning" with empathic support and help with problem solving. Someone who will "be" with us, in our sadness and in our joy. Someone who will walk the journey with us without trying to fix the unfixable.

That is not to say that therapy is unhelpful. A skilled grief and trauma therapist who understands the difference between depression and chronic sorrow can be an excellent "companion" and a godsend. While I don't believe it is possible to "cure" chronic sorrow, it is possible to find healing in the journey - a resolution of posttraumatic stress symptoms, the development of wisdom, a refined appreciation for life, the growth of spirituality and meaning - and that healing can be our goal.


Please remember:

1. Chronic sorrow can lead to clinical depression so, if you feel unsure about your mental health, ask your medical professional to assess your mood - after reading about chronic sorrow.

2. Never stop taking antidepressants without first consulting your physician.)

* Photo by Bigstock Photos

1 comment:

Sparkles said...

As a chronic pain patient (too many things to explain) combined with bi-polar type 1 with extreme mixed moods I completely relate to this article. Although I work with therapists, psych. doctors, physical therapy and really work on a positive daily outlook, I find myself often wondering what if..... I was still able to continue with my passion as a teacher (with 12 years under my belt.) What if I could go back and get the time back from the lost days of staying in bed? What if.... I still could own and run my home (paid for for 13 years.) I am truly grateful to have now joined "forces" with my mother and we can help each other but I worry about the grief "chronic sorrow" I cause being so close in proximity to her. Thank you for a helpful look into this continuing problem that is an underlying effect of so many families and the ones they love.