Question from a Reader: I know I’ve heard plenty of times that it is normal for ‘grievers’ to feel despondent and wish to be with their spouse who has passed on. But, it doesn’t feel like it’s normal to me because I don’t want to live any more, although I am not going to do anything to harm myself. In fact, I am on a healthy food plan and I am doing whatever it is I need to do to live from one day to the next. I stay in for days at a stretch but I go to appointments, do errands, pay bills, because I have to, I cry during the day, get my groceries, go to family get-togethers even though I’d rather not, but I know the family wants to see me and I want to see them (before I go). But, I want to tell my primary care physician that I have these thoughts and that I’m just temporarily distracting myself with these routine daily things, I really and truly don’t want to live anymore, not without my husband who passed away four months ago. I want to tell the doc this, and I’m just waiting for God to call me. I really don’t want to go to the doc, but I think it’s time for a therapist so I’m planning on asking my PCP for a referral and doing this soon. The problem is I think if I tell my PCP this I’m afraid he might think I’m suicidal and have me committed by obligation or inform the authorities. Do you think this could happen? Has it happened to anyone that you know of? I’ve been having crying spells more lately even after the tears stopped for weeks, they’re back again. I still have panic/anxiety attacks but they have subsided somewhat. But I still can’t wait to cease to exist so I won’t feel the knowledge that my beloved is gone and I know in my heart that my life is over, while others are getting on with life and working through their grief. I just won’t be happy for the rest of my life and no one can tell me any different. I don’t want to live. I truly hope I haven’t depressed anyone or upset you, but this is how I feel. I’m ready to leave this world but I don’t want to do it via an insane asylum. Thank you so much for reading this and thanks in advance for any advice or support.
My response: From what you’re telling me, it seems pretty clear that, uncomfortable as they are, you understand that these suicidal feelings you’re having are normal. Keep in mind that whatever feelings you have in grief are not right or wrong, good or bad, and they’re not always rational – feelings just are, and for your own mental health it’s important to acknowledge them and express them. So I want to commend you for acknowledging and expressing your thoughts of suicide. Most grieving people have those very same thoughts, but like you, they are terribly afraid to share them for fear of being regarded as over-reacting or crazy, or for fear of scaring other people. The simple fact is that thoughts of suicide are not at all unusual when you are grieving. Right now you may have the pessimistic belief that things will never get any better, as if life and living are useless and pointless. It is difficult to imagine life without your beloved, and not wanting to go on without your husband is understandable. Keep in mind, however, that there is a vast difference between thinking about suicide and actually acting upon such thoughts. In grief, thoughts of suicide are usually fleeting and reflect how desperately you want the pain of loss to end.
You’ve voiced a concern about sharing your suicidal thoughts with your doctor. I don’t know your primary care physician, but I would hope that he is skilled and experienced enough to recognize the difference between normal grief and clinical depression, and that his assessment of your mental state would take into account the recent death of your husband and its effects on your current outlook. Keep in mind, too, that while medical doctors are qualified to prescribe medications, not all physicians are knowledgeable about grief and the normal mourning process, and sometimes they are too quick to reach for their prescription pad rather than to refer their patients for grief counseling.
In his classic text, Grief Counseling and Grief Therapy, grief expert J. William Worden notes,
There has been much discussion among mental health professionals about the use of medication in the management of acute, normal grief. The consensus is that medication ought to be used sparingly and focused on giving relief from anxiety or from insomnia as opposed to providing relief from depressive symptoms . . . It is usually inadvisable to give antidepressant medications to people undergoing an acute grief reaction. These antidepressants take a long time to work, they rarely relieve normal grief symptoms, and they could pave the way for an abnormal grief response, though this has yet to be proved through controlled studies. The exception would be in cases of major depressive episodes. Psychiatrist Beverly Raphael (2001) affirmed that, although our psychological understandings of bereavement have increased, there is not yet a good basis for biological intervention. Pharmacological approaches should, for the most part, only be provided where there is an established disorder for which they are indicated. I would concur with this (pp. 70-71).
I also encourage you to listen to a powerful audio program from Open to Hope, as I think it will normalize what you are feeling now, and maybe give you some hope for the future. The person being interviewed is Ron Villano, whose 17-year-old son was killed in an auto accident. He describes how he struggled to survive this traumatic loss, and so much of what he felt in the aftermath of his son’s death reminds me of what you are experiencing now. Please take 20 minutes out of your day to listen to this outstanding program. Click here: http://opentohope.co…through-change/
Finally, know that you really don’t need a physician’s referral in order to seek bereavement counseling (unless your health insurance requires it). See, for example, Finding Grief Support That Is Right For You.
© 2011 by Marty Tousley, RN, MS, FT, DCC