Depression Is Not A Requirement Of End Of Life

It’s pretty much a fact that the grief process affects everyone a little bit differently. Some residents of Manchester and elsewhere will experience a wide range of emotions when someone they know and love enters hospice care. Even the person who is receiving such care will deal with their own form of grief – after all, their loved ones may be losing someone special but they’re losing their whole world.

The team at Above and Beyond Home Health Care is familiar with the different stages of grief and has seen clients and their friends and families go through them all at different points.

For those not familiar with the terms, modern grief is generally defined as following the steps of denial, anger, bargaining, depression, and ultimately acceptance.

Earlier research suggested that people follow these in a linear sort of fashion, but more and more examinations of what grief really means have shown that the steps are more fluid and dynamic. For instance, some people may remain in one area longer than others. Or they may jump a few steps ahead and maybe go a few steps backward.

For people receiving hospice care, they may be at a different place in their stages than their family, friends, or caregivers, which can sometimes cause tension. For instance, someone could be coming to terms with their mortality, but other loved ones may still be stuck in the anger or bargaining stages.

There could even be conflict if someone is upset about losing their loved one, but that loved one is already trying to come to terms with their loss and may be more calm about it. Or vice versa.

Discussing depression

One of the stages, depression, deserves extra attention since it can come up in other ways than through the grieving process.

It is also a medical condition that not everyone knows all the details of, sometimes confusing it with anger or sadness. Both of these feelings could be symptoms of depression, but there are other symptoms as well.

Clinically, depression is a chemical disorder that impacts your life with strong emotions of sadness, lack of interest, and physical pain and exhaustion. Providers usually look for sustained periods of these feelings, such as several weeks, rather than a couple of days of the blues and then feeling better.

Because some depression is related to chemical levels, it’s also something that is difficult to “get over” no matter how positive you try to make yourself feel or well-meaning friends encourage you to buck up and feel better.

Depression can be expressed in many active and passive ways, from anger to withdrawal. People dealing with strong depression may not want to eat, sleep or participate in normal activities. They may not have the mental or physical energy to even get out of bed or leave the couch.

Science is still trying to learn precise triggers and treatment methods, but sometimes prolonged periods of stress are involved, as well as chronic pain. Major life changes can lead to depression, as can genetics.

Treatments vary by individual, but some methods that have led to positive results include medication that can rebalance some of the brain chemistry that seems disrupted. Meditation and exercise are also recommended to produce endorphins and a general good feeling.

Untreated depression can lead to a variety of negative outcomes, including weight loss, loss of strength, a weak immune system, higher rates of addictive behaviors like drinking or drug use, or even suicide.

Depression in hospice settings

It’s expected that an approaching death may lead to depression all around. However, this isn’t always the case.

As mentioned, everyone grieves differently. Some people may suffer from actual depression. Some people may receive help or find a way to not be as affected.

For instance, someone receiving hospice care may be ready for what’s ahead. They may be curious about what’s next. They may be tired and want an end to their pain or whatever is causing their terminal health condition. They may be dealing with their health challenges for years and may be happy to be done with any restrictions and happy to connect with loved ones for the last time.

Those with a strong faith tradition may even be excited to see what’s next, especially if they believe they are going somewhere better, perhaps to reunite with loved ones from their past.

So even if conditions for depression are present, that doesn’t mean it is automatically present.

Because depression is more complex than many think, it’s worth taking the time to learn more about if you’re not familiar with it, or you’re worried about a loved one or a caregiver who might be experiencing it.

October is a great time to do so: it’s National Depression Education and Awareness Month. It’s an opportunity to observe, find help for those who need it, and learn ways to deal with it from people who are receiving treatment.