Is It Mourning or Is It Depression?

Over the years, I´ve interacted with hundreds and hundreds of individuals who have been terminated, downsized and outsourced.   Some of these folks have been dislodged for just cause, some because of management malice or mismanagement; some with severance pay and some with a half-day notice.   The process of layoffs seems to be especially volatile in the new economy -- here today, gone tomorrow - Information Technology (IT) world.  

For most folks, when the dislocation from a job and a career is sudden, unexpected and/or unwanted, there´s a period of shock, fear or rage, as well as sadness or helplessness.   And when unemployment drags on from weeks to months and a feeling of self-doubt and despair spirals unabated...are we talking:   a) grief process, b) situational depression or, as we´ve seen, c) prolonged stress effecting biochemical and mood disorder consequences?

It´s a vital and confusing question because:   1) grief and depression have complex overlap along with marked differences as bio-psychosocial states of experience and action and 2) depression needs to be differentiated between situational or exogenous, that is, external and environmental forces (like losing a job) and the clinical, the internal or endogenous (that is genetic, family history and biochemical factors or predisposition).

Let´s begin the conceptual differentiation through word association.   What comes to mind when you read the word, "depression?":   emptiness, exhaustion, darkness, heaviness, black hole, mood disorder, food disorder, sleeplessness, agitation, mania, paralysis, helpless, hopeless, endless, suicide...Prozac!!   Perhaps not so extreme.   How about melancholy, inertia, apathy, sorrow, sadness, joyless, loneliness, pessimism, deprivation, abandonment, bereft, bereavement...grief.  

Quite a depression spectrum -- depression to grief but also grief to depression.   What is cause, what is effect?   Is this a chicken and egg issue?   It´s clearly not black or white; many shades and intensities of grayness and darkness.

Drawing on the above-mentioned experience, let´s see if a scenario involving an unemployed individual can shed light on some of the diagnostic conundrums.   Clearly, the unexpected and/or unwanted termination of a job so often triggers a profound sense of disruption and loss.   Very quickly the person is thrust into a grief process and, initially, the person literally may not know what has hit him or her.   So to clarify the many levels of confusion - from conceptual to emotional - let me outline the stages of grief.   Clearly, what follows is an ideal type as grief stage engagement rarely marches in precisely aligned and sequential steps.   The bereaved may bypass a phase or rapidly morph from one stage to another.   A person may waver -- two stages forward, one stage back, or vice versa.   Anniversary losses, such as a death or divorce dates, can easily trigger a feeling of regression, of being thrown back to the vicious beginnings or the whirlpoolish depths of a grief (or depression) cycle.   Fortunately, much of the time the regression is temporary and the person with sufficient support and stamina will continue his or her hard-fought, "Rocky" evolution and personal growth through "Good Grief!"

Stages of Grief

1.   Shock and Denial or "It Can´t Happen Here!"   It´s no big surprise when given a days notice that an employee may experience a state of shock.   There´s such total confusion and disbelief that a person often goes numb; the mind-body system has to shut down.   Sometimes shock follows the downplaying or denial of bad news.   For example, in the early ´90s, there was talk of significant restructuring in the US Postal Service.   A number of employees took the early attitude:   "We´re always dealing with change here...No big deal."  Alas, these folks didn´t count on Carvin Marvin Runyon becoming the Postmaster General.   Talk about a shocker...Within a year 50,000 employees were restructured out of the service!

2.   Fear, Panic and Shame or "Oh God, What Do I Do Now?"   Once the shock wears off, you are no longer numb, there are some predictable next steps, such as profound anxiety and vulnerability:   how will I survive this loss of income, identity, my daily routine, my social standing, etc.?   There´s a mounting sense of being out of control, which for many also evokes feelings of shame and inadequacy.   And lack of control, not surprisingly, can stir up childhood memories of the same, being or feeling tormented, rejected or humiliated by family, peers, teachers, etc.

I vividly recall the lamentation of a postal supervisor on a management fast-track, quickly derailed by reorganization:   "I once had a career path.   Then this boulder fell from the sky and crushed it!   Is it only a career path that´s been crushed?   How about the human psyche and spirit?   Has it too been burnt up or burned out?

3.   Rage and/or Helplessness or "How Dare They!" or "Oh No, How Could They!"   Do you think our once fast-tracked supervisor is feeling abandoned and betrayed?   Most likely.   Often people in this phase swing between rage and profound sadness.   Both states can be induced by deep underlying vulnerability or helplessness.   You´ve been wounded, feel exposed and just want to lash out.   Or you turn the rage inward in depression and self-condemnation.   Now it´s crawling under the covers escapism, or going through the motions of living or, even, straining as hard as you can to reign victorious over your basic unworthiness; to battle a fear of failure and lurking dread of being sucked into that compelling black hole of helplessness.  

Consider this:   in The Random House Dictionary:   The Unabridged Edition, the first six definitions of the word "failure" describe it as an act or an instance.   It´s not until the seventh and last definition that "failure" takes a personal direction.   So losing a job or being confronted with other losses and separations are often more events or individual episodes than a judgment upon you.

Also, please consider, that individuals predisposed to a depressive mindset are likely to over attribute self-responsibility, that is, to blame themselves for "negative" events.   These folks minimize the impact of external factors or environmental stressors.   Which is why the next phase, while often maddening, is also essential for moving through the grief process.

4.   Guilt and Ambivalence or "Damned If You Do or If You Don´t!"   The feelings and old voices of guilt (not living up to an important other´s expectations or standards) and shame (violating or compromising an internalized core value or essential part of your self-identity, integrity and esteem) can become louder and more incessant     Self-directed rage keeps taunting you for shortcomings, unworthiness, lost dreams, etc., and can ultimately drain you.   If some energy returns or remains the battle may continue in other arenas.   First, the classic approach-avoidance conflict:   "Damned if I do, damned if I don´t; damned if I stay, damned if I leave."   Take the paltry severance or not; leave the faulty marriage or not.   And while the uncertainty is terribly frustrating, at least there´s a struggle.

Some may turn to a spiritual source for relief or rescue:   "Higher Power, just tell me what to do" or "Higher Power, I turn it over to you."   And, of course, some in desperation will proclaim newfound or "born again" allegiance if they are only saved.   Yet, in the end, with or without your HP, one must get focused and cut the entangling emotional cord.

5.   Focused Anger and Letting Go or "Turning a Lemon into Lemonade" and "Freedom´s Just Another Word..."   This phase truly reveals the complexity and potential creative energy built into the grief process.   To reach that powerful, purposeful and passionate state of focused anger one must often blend rage and sadness.   Some rage can propel us out of a shocked, paralyzed or ambivalent state.   Yet, you must also face your sadness and loss and struggle with uncertainty to temper uncontrollable aggression, to make sadder yet wiser assessments and decisions.   Remember, rage unchecked much more often leads to self-destructive behavior than it does to "Going Postal!"

If you´ve worked hard to integrate the previous stages then the reward is "focused anger":   "I really don´t like what´s happened...but how do I make the best of it?"   You´re ready to loosen - if not untie - the knot of hurt and humiliation.   And best of all, you´re getting ready to knock on (maybe even knock down) doors again.

6.   Exploration and New Identity or "Now You´re Ready to ''Just Do It!´" (even if scared).   Letting go is often unnerving. It´s not just the financial security that´s at stake.   But losing a job or a vital relationship also profoundly shakes our personal/professional identity.   We´ve invested so much time, ego, energy and/or money in this position or partner...Who am I without the job, without my mate or significant other?

However, this vulnerable yet fluid state provides unprecedented opportunities to get to know yourself, to assess your true individuality - strengths and warts - and not only as it relates to financial dependence, job skills or career paths.   Now is the time for a full-scale person-in-situation life inventory.   How healthy or toxic are seemingly vital relationships and friendships?   What about your health?   During this transitional window, do dysfunctional coping patterns -- habits of drinking, smoking, drugging, eating, lack of exercise and limited socializing or spiritual support -- need to be challenged?

Even with the most dear and painful loss or separation, the words of Albert Camus, Nobel Prize-winning author and philosopher have the crystalline ring of essential truth:  

"Once we have accepted the fact of loss we understand that the loved one [or loved position] obstructed a whole corner of the possible, pure now as a sky washed by rain."

A Mid-life Maelstrom or Father Finally Knows Best

Camus´ words remind me of an existential crisis faced by my father in his late-40s. It´s a morality and morale-ity tale about how his corporate world went from cutthroat cocoon to just cutthroat.   For over twenty years, my father had been working as a salesmen for a large manufacturer in New York City''s garment center and fashion industry.   As I mentioned, the competition was cutthroat, but still only figuratively.   And through aggressive and tenacious persistence, he had carved out a legitimate and fairly successful niche.     He had sales turf, some financial security and hard-earned pride.

Then, almost overnight, my father realizes that organized crime is infiltrating the company big time.   (Perhaps some of dad''s capacity for denial was at play.)   Now he''s going to have to report to one of these new executive slimeballs.   His whole world is at risk; cutthroat is no longer symbolic.   This isn''t just downsizing...it''s downright "frightsizing!"   Dad''s existential crisis is in high gear.   From this experience I first learned there can be a fine line between homicidal and suicidal tendencies.   Day to day, I didn''t know if he''d go to work and punch someone out or not get off the couch, immobilized by an explosive psychic cocktail of rage, fear and depression.   (Good thing he was in group therapy at the time.)

He was caught in the classic reorganizational bind:   "damned if I stay, damned if I leave."   Fortunately, my old man realized "discretion is a better part than...''A Death of a Salesman.''"   He resigned.   Economic fears had him precipitously joining another large manufacturer.   After a month, he knew it was the wrong move.   What crystallized was his need for genuine control and autonomy, and a playing field in which he could aggressively compete.   And he eventually found it as an independent sales rep for a small manufacturer.   Of course, the owner of this garment center business was a "goniff" (Yiddish for thief) in his own right, and would often drive my father up the wall.   But crazy we have practice with and can handle in my family.   It''s when people take cutthroat literally that we usually draw the line.   And in fact, my father went on to have his most successful years in business.  

As Camus understood, a whole new corner of the possible can emerge when you accept loss and take time and heart for genuine grieving and exploring.

7.   Acceptance or "The Glass is Half Empty and Half Full."   While submerging yourself in the stages of grief for a time will feel hellish, there truly is an opportunity for rebirth.   Getting out of the black box is a distinct possibility if you can ride on and ride out this acutely emotional learning roller coaster.   The grief encounter is definitely more than a learning curve.   And there´s no absolute or fixed period of time for your movement through the stages.   My blood starts percolating when I hear "well-intentioned" family members, colleagues or friends say to the grieved, "Hey, it´s been three months (or even six months) already.   Don´t you think you´re stretching out this grief thing (or unemployment status) a bit too much."   The implication, of course, is that you´re indulging in self-pity.   Or, sometimes the verbal sting comes in a seemingly more innocuous message:   "Gee, someone with your skills, talents, experience...I can´t understand why it´s taking you so long to find a job."

The most important thing we can do after experiencing a major break - whether break up or break down, social, physical or psychological - is to take time to heal.   Now some after a loss of a job or a relationship feel compelled to jump right back into the fray.   And getting back in the saddle is a cultural icon and wise strategy for a thrown cowboy or cowgirl.   However, for a major loss it´s wise to retreat and regroup, at least temporarily.   For example, those folks who are participating in the Fairfax County Government reeducation and training program are getting career counseling and job search coaching, taking job training classes (for many students, leading to computer skills certifications) as well as the Stress Doc workshops.   Perhaps most important, they realize they are not alone. Also, folks are encouraged to grieve and to gradually recover and discover:   Who am I?   What genuinely feels like me?   What works for me and my family?   What seems to kindle (or rekindle) my passion?

So remember, there´s a real difference between "feeling sorry for yourself" and "feeling your sorrow."   When you are feeling sorry for yourself you are mostly blaming others.   When you are feeling your sorrow you are demonstrating the courage to face your fears and pain.   There are poignant moments in life when we all must take time to embrace our sorrow.

As I once penned, reflecting on more than one soul shaking grief process:   "Whether the loss is a key person, a desired position or a powerful illusion each deserves the respect of a mourning.   The pit in the stomach, the clenched fists and quivering jaw, the anguished sobs prove catalytic in time.   In mystical fashion, like spring upon winter, the seeds of dissolution bear fruitful renewal."

When It´s No Longer Just Grief

While many grapple productively with the ebb and flow of grief gradually, if not grudgingly, working their way through the stages for other folks it´s not uncommon to get stuck in "the big muddy" of mourning.   Mourning becomes melancholia.   How do you know the difference?   My first therapist gave me a handle; actually a heavy lid.   She likened the state of depression to a heavy lid that often covers up or tries to hold down underlying bubbling and boiling, conscious and unconscious thoughts and emotions - fear, rage, obsessive ideation, panic, helplessness, suspicions if not paranoia, etc.   So much energy is used in suppression and repression of this raw psychic tension that exhaustion and apathy often result.   Also, some of the tension can manifest as an amorphous agitation.   A number of classic depressive symptoms may appear:

1. Fatigue, sadness, heaviness and listlessness,

2. Loss of appetite (though sometimes there´s compulsive eating) or using escapist substitutes - alcohol, tobacco, drugs, etc. to numb one´s pain,

3. Difficulty concentrating and starting and completing tasks; general diminishment in role functioning,

4. Feelings of shame and worthlessness and incompetence and inadequacy,

5. Restless and interrupted sleeping,

6. Difficulty getting active and focused especially in the morning,

7. Loss of interest in activities once seen as enjoyable or meaningful,

8. Withdrawing from friends, colleagues and family members,

9. Engaging in a variety of reckless and potentially dangerous - active or passive -- undertakings, e.g., drinking and driving, drinking while taking medication, etc.,

10. Communicating directly and indirectly a desire to harm oneself (or others) that is, expressing or demonstrating suicidal or homicidal impulses, gestures and/or actions.

As for the grief process, my analogy has a mythical bent.   Unlike depression´s tendency to bottle up and stuff down emotions, for me, grief work is like removing the cover of Pandora´s Box.   As was recently illustrated, grief opens you to a whole range of harbored fears and furies - past and present.   Ultimately, grieving releases and integrates a range of emotions and energies that enables you to regain psychic equilibrium; it helps you evolve a new or renewed sense of purpose and direction.   Vital mourning is also the wellspring of passion and determination for exploring new roles and identities.

However, key components of the grief process do overlap with key depression dynamics such as deep sadness, agitation or anxiety along with helplessness and rage (often inverted).   So when is it grief and not depression?   Or, how do we know that a difficult and possibly prolonged grief process is not being weighed down by or turned into situational or (unrecognized) clinical depression.   (Remember, chronic low-grade clinical depression is difficult to recognize and acknowledge. Over the years, the individual, as if living in a constant smog environment has adapted, albeit not without disruptive mind-body consequences, to this (mostly) moderately depressive and slowly degenerative condition.   "It´s just how life is," cough, cough.)

Warning Signs

This listing also provides depression warning signs; more than just grief clouds are in the picture.

1. Sleeping on the Job.   One vulnerable group are high tech employees caught up in the mercurial, "24/7" IT work environment, especially those who literally stay at work around the clock.   Not only are these folks exhausted from the hours and demands, but too many truly don´t have a life.   Friends and family, relaxation and recreation are forever on the back burner.   And when suddenly informed that their contract is over or the project is completed and services are no longer needed...talk about an implosion.   Now exposed on the front burner is the beleaguered employee´s burnout process which has been simmering and eroding from within.   There´s no spare energy and emotional resources to withstand the termination blow.   Not to mention the sense of injustice and outrage:   "How can you make me a sacrificial lamb after all I´ve given to the company, after all I´ve sacrificed in my life for you."   (As we indicated earlier, burnout is less a sign of failure and more that you have given yourself away.)

Often the most important lesson of this burnout-depression trauma is that, "Life Is Not Fair."   Ultimately, we must learn to stand up for our psychological integrity and physical health.   If we don''t, the risk is predictable:   the line between grief and depression can be too readily burnt into oblivion.

2. Breakup of a Marriage.   Being confronted with an additional major trauma, for example, both losing a job and the dissolution of a key relationship, will also grease the grief to depression track.   For years research has shown that the more change-related stressors experienced in a time-limited period, the greater likelihood of some physical illness or mental disturbance.   Not just a layoff or downsizing but even positive changes such as a promotion can heighten stress:   higher performance expectations, new authority roles or collegial relations, etc.   Too much change, too fast can induce a feeling of being overwhelmed, a feeling of being out of control - "future shock."   And if these vulnerable feelings persist, the shaky/quicksand ground can quickly turn from "The Big Muddy" to having you trapped in "The Big Moody."

3.   Past Traumatic Loss Experiences.   One of the consequences of prolonged or sharply acute stress is a wearing down or the sudden snapping of our psychological defenses.   These defenses keep memories of painful events and the concomitant disturbing emotions out of everyday consciousness.   When cracks develop in your defensive armor brought on by the stress of loss or separation (such as losing a job or mate) then past associations to previous losses, abandonments, rejections get stirred.   Now a judgmental boss in the present starts more consciously reminding you of a former harsh supervisor, or perhaps a critical parent or a devaluing spouse.   Especially if these past hurts and humiliations have not been sufficiently and successfully grappled with and grieved emotionally the result, again, is a depression predisposing mourning process.

4.   Battered Employee/Spouse Syndrome.   Sometimes an employee (or spouse) who has been subjected to a pattern of verbal and emotional trauma (not to mention physical abuse) does not know how to set limits and fight back, or does not believe that leaving the abusive scene is an option.   This person is definitely vulnerable to helplessness, worthlessness and passivity.   In the work setting, when management does not believe they can force out an employee, or they don´t want to directly fire the person for fear of legal consequences...an insidious game may ensue.   The targeted individual may be subjected to subtle forms of hostility by management or by a management surrogate.     Perhaps management tolerates or ignores the baiting of the employee by colleagues. Even when the harassment seemingly isn''t blatant it can be a legal issue if management should have known about the harassment and interceded.   However, taking companies to court still can be another "holy grail" quest.   Any of the above scenarios can break down an individual´s will, spirit and health.

And when an embattled employee hangs on trying to fight the system without sufficient financial and legal resources, the result, too often, is a greater deterioration of his or her physical and mental states.   Once the proverbial backbreaking straw event occurs through trumped up dismissal, outsourcing or from the employee finally giving up the fight the endgame is predictable.   Grief is overwhelmed by "battle fatigue" or the individual collapses in a heap of depression.

5.   Illusion of Security and Age Anxiety.   In a rapidly changing, paradigmatic shifting economy - from the industrial to the informational/high technical - all folks but, ironically, many early computer trained or science degreed professionals may find themselves frighteningly out of date.   Having created a seemingly secure position, for example, evolving mainframe expertise, once laid off these professionals suddenly feel like they´ve been dropped off on the moon.   Compared to when they were last doing job exploration, the current IT field, gravity and atmosphere is so profoundly different.   It literally is a shock.   First there are the unanswered telephone calls and resumes mysteriously lost in the job listings black hole.   Then there´s the constant refrain:   "You need to upgrade your skills and certifications."

Of course, this scenario is a bit less daunting than the one for a basically middle aged computer virgin; just the thought of becoming computer literate can throw such an individual in a phobic or panic state.   And, not surprisingly, age is a significant job/career factor even for those not technophobic.   Frequently, a number of old timers in the computer field or (or post-40 year old newbies to IT) bemoan age discrimination in what´s increasingly perceived as a Gen X run world.   Once again, when psychological, educational and socioeconomic forces are conspiring against you (or are perceived as such) the boundary line quickly dissolves between grief and depression.

6.   Multiply Downsized.   A particularly at-risk individual is the member of the increasingly large horde known as the "Multiply Downsized."   This creature is often found in the engineering, aerospace and rapid startup-rapid fold IT industries, as well as in an array of government agencies.   After awhile it appears this employee´s main mission is as a statistical artifact in a restructuring process.   Of course, some folks who have survived several layoffs or downsizings develop a thick skin - "been there, done that."   Their transitional radar is finely honed and now the battle veterans know to jump ship before it crashes into the restructuring iceberg.

However, the almost universally vulnerable employee is the one who has left a hometown, sold the house, said good-bye to family and friends, moved alone or with family to a new section of the country for a "great opportunity"...and within six months the promised land/position has disappeared once again in the disorganizational black hole.   This hole is more than unsettling; it''s particularly dark and bleak.   In fact, the person may not have fully grieved a previous downsizing (whether as organizational outcast or survivor) and may have been on the edge of depression before the latest transitional trigger.

7.   Addictive Patterns and Depressive Propensities.   Finally, two other susceptible classes of individuals for pathological grief are people who:

a) routinely use addictive behavior - drinking, drugging, smoking, eating, cybersexing or "romantasy" obsessing," gambling, etc. - to avoid or numb painful emotions and difficult problems.   This medical illness and/or escapist defense mechanism not only can be inherently toxic (for example, when abusing substances) but it impedes the chance for developing and shaping cognitive-affective muscles.   Psychosocial maturation is retarded by a pattern of avoiding analytic, emotional and interpersonal problem-solving.

Invariably, an addiction process which may have blocked out existing depressive signs and bottled-up rage, or numbed low self-esteem, etc., is no longer able to shut out or deny the "no exit" separation trauma.   You have to deal somehow with the loss crisis.   (I suppose a deadly overdose is a tragic exception.)   Psychological defenses and addictive escapes, as well as the grief process itself, are overwhelmed.   Massive depression, psychiatric breakdown or withdrawal may quickly ensue, and

b) people with a genetic/family predisposition to clinical depression who are not receiving proper medical/psychiatric treatment.   These folks tend to be acutely sensitive to loss, emptiness and abandonment, to shame, humiliation and rejection.   A history of having difficulty directing and sustaining energy and attention, seemingly a lifetime of self-doubt, feeling like an impostor, procrastinating, not completing projects or meeting goals, running from commitments, etc., all obviously shed light on the aforementioned sensitivity and vulnerability.   Again, the boundary between grief and depression most likely has rarely been demarcated.

So for significant numbers there´s a progression from grief to depression and, finally, with enough adversity and unending stress, the possibility of further descent into overt clinical depression.   Obviously, when there is a genetic predisposition, the contributing factor to a mood disorder is not just external or environmental.   However, it´s also true that chronic stress, untreated burnout or a prolonged and morbid grief process can either:   a) bring out a latent genetic predisposition to depression or b) can adversely impact the workings of our biochemical and hormonal systems so that even as adults, without clear family history, a clinical depressive disorder can gradually build then "suddenly" emerge full blown.

Clearly, a multi-pronged bio-psychosocial intervention is necessary for confronting major loss, for tackling comprehensively situational or clinical depression.   The intervention goal is to help the wounded individual gain the emotional stamina to embrace and evolve through the natural grief process.   Some combination of individual grief counseling, support group, couple counseling or family therapy, medication, exercise, relaxation or meditation, diet, assertiveness training and career counseling or retraining may well be needed.   My personal recovery motto is not for the faint of heart:

For the phoenix to rise from the ashes

One must know the pain

To transform the fire to burning desire!

Finally, here´s a closing strategy for confronting loss and grief as well as situational and/or clinical depression.   And the source of the inspiration shifts from the poetic to the alphabetic.   By understanding the dynamics of distress, burnout, grief and depression and by applying "Practice Safe Stress" tools and techniques every day you will, for once, be proud to have earned an "F"...actually, six of them.   May you successfully engage the path of "The Six ''F''s of Loss and Change":

1.   Shaking or breaking up life''s puzzle; letting go of a familiar past,

2.   Confronting and channeling the anxiety of an unpredictable future,

3.   Grappling with a loss of identity and integrity, with a loss of self-esteem and pride...with a loss of face,

4.   Exploring and generating new resources -- environmental, informational and psychological -- for evolving a new focus,

5.   Seeking and being open to feedback, both challenging and affirming, such as a variety of TLC -- "tough loving care" and "tender loving criticism" -- throughout the grief and rejuvenation process, and

6.   Trusting in higher power faith, from a belief in a transcendental power to the synergy and confidence instilled by participating in a vital support group or counseling/coaching relationship.

Grappling with these "Six ''F''s" can help you grow from grief and...Practice Safe Stress!

(c)   Mark Gorkin 2000

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