A therapist working with older adults looks at how people react to loss and realizes that in the end most of us do a pretty good job of coping.
While providing crisis counseling to people who suffered significant losses in the aftermath of Hurricane Sandy, I began to wonder what the natural response is to losing someone (or something) we hold dear, especially among the older adults I work with.
First off, it’s well known that all of us face a mounting number of losses as we get older– Parents and friends pass away, careers end, bodies wear down, and our minds sometimes aren’t as sharp as they once were. How we respond to those losses varies depending on a number of factors. A socially (and clinically) accepted response to a significant loss is profound sadness. But how long that sadness lasts and how it affects the way we function on a daily basis reveals a lot. First a few quick definitions: Bereavement is the state of having suffered a loss. Grief refers to how a person deals with loss. Mourning has to do with society’s rituals surrounding the loss, such as funerals and burial rites.
The Handbook of Assessment in Clinical Gerontology edited by Peter A. Lichtenberg, cites a longitudinal study by Zisook, Paulus, Shuchter and Judd of how prevalent depressive disorders are after the loss of a loved one. The results showed that 20 percent of the participants met the criteria for major depressive disorder two months after the loss. After 13 months, that figure fell to 12 percent. After 25 months, it dropped even further to only 6 percent. At the same time, during all three periods, the study showed that nearly half the participants displayed no symptoms of depression, major or otherwise. These people coped. They may have been very sad, but they processed the loss and moved on.
How did they do it? My guess is that they had positive social supports that gave them a time to grieve and at the same time signaled them when it was proper to stop grieving. Furthermore, since having depressive symptoms or other problems prior to a traumatic loss is a prime indicator of whether or not a person will become depressed when a loss occurs, it’s safe to assume the resilient ones were not prone to rumination, negative self-talk, or delusions that God was somehow punishing them. Studies have shown that in most cases half of us will bounce back from a significant loss after about two months, about a third of us will have trouble adjusting but eventually let the loss go, and the remaining 20 percent will continue to suffer for a while. In the end, the number of people who have the most difficulty getting better is approximately equal to the number of people in the general population who are already at risk for mood disorders.
Bereavement is a normal reaction to loss. Depression is not. Statistics show that in most cases paying attention to others, maintaining a healthy lifestyle, staying mentally active and keeping a positive outlook will provide the resiliency we need when we lose someone or something we hold dear.