Andrea Gilats was completely destroyed when she lost Tom, her 20 -year -old husband, in cancer. He wrote letters for two years. But as the months turned over for years, its overwhelming sadness did not weaken as expected. Instead, she consumed her life for almost a decade.
“I felt that the world had broken me Postoperative effectsA memoir for the experience of sadness. “I felt like a robot, as I lived day by day without relief from this intense emotional pain.” Gilats lost one -third of her body weight because she could not eat the stomach.
What he didn’t know then was that he experienced complicated sadness or which experts now call prolonged sadness disorder (PGD), a recently recognized mental health condition that affects 7 of the 10 people who have passed.
What is prolonged sadness?
We all mourn when we lose someone we love. It is one of the most universal human experiences, and for most people, sadness gradually softens over time. But for some, such as Gilats, the pain still remains and becomes weakening.
Prolonged sadness disorder or complicated sadness disorder is characterized by a severe longing for the deceased, their concern with their thoughts and significant functional damage. People with prolonged sadness can experience identity disorder, the feeling that part of themselves has died. They often feel stuck, unable to imagine how to live their lives without their loved one.
“If you met someone with prolonged sadness three, four or five years After a loved one had died and you met someone three months After a loved one died, it is very likely that you could not say the difference, ”he explained Katherine Shear, Ph.D.Professor of Psychiatry and Founding Director The Columbia University Center for prolonged sadness.
Unlike typical sadness, which of course evolves over time, prolonged sadness keeps people stuck, preventing them from adapting to their loss. “It is the persistence of sadness, intense, worrying, harm, sadness,” Shear said.
PGD was was officially added to Diagnostic and Statistical Manual of Mental Disorders In March 2022, giving ratification to millions suffering from this situation. For adults, diagnosis requires that at least a year has passed since death, while for children and adolescents, it is six months.
It is important to understand that prolonged sadness is not the same as depression, although they can happen together. Depression involves the loss of the ability to experience any positive emotions. On the contrary, people with prolonged sadness can still feel joy when talking about their deceased loved ones or the recall of positive memories – the problem is that everything focuses on the absence of this person.
“There is sadness, but for the most part, the longing and longing and alarming thoughts and memories of the person who died,” shear said. This distinction is vital because it affects treatment approaches.
Who is more at risk of complicated sadness?
Shear research has identified various risk factors that can make someone more vulnerable to prolonged sadness. Factors include a history of mental health disorders, particularly mood disorders and anxiety disorders, he said.
In addition, your relationship with the beloved who died can also play a role in whether you are experiencing prolonged sadness. “When you had a really positive relationship with the person who died and especially if he is very unique, if he is one person in the world you were really close to, this makes it really more difficult,” Shear said. Parents who lose children and spouses who lose partners are one of the most vulnerable.
The circumstances of death are also important. Sudden, unexpected deaths, especially those involving violence, trauma or young people, are more likely to lead to prolonged sadness. Investigations show that almost half Those who have gone through unnatural deaths, including accidents, suicides, homicides and disasters, may develop PGD.
Shear also determines the previous trauma as an additional risk factor for the development of prolonged grief, noting that people who had previous trauma or childhood trauma have increased risk. This connection is particularly made of examining the inequalities of injury exposure.
Research is steadily showing that black young people and adults face higher wound exposure rates and PTSDs than their white counterparts. And studies They reveal that more Spanish and non -Spanish black teenagers face mood disorders and exposure to multiple types of violence during their lifetime compared to non -Spanish whites.
These inequalities come from systematic factors, including structural racism, unjustified housing policies and the term of researchers “tribal trauma,“The mental and emotional injury caused by meetings with racial bias, discrimination and hate crimes. Covid’s pandemic further worsens these vulnerabilities, with Communities of color they are experiencing disproportionate rates of mortalitywhich can increase the risk of prolonged sadness.
Read: The Spiritual and Natural Load of Racial Wound >>
Finding a way forward
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The good news is that prolonged sadness can be treated. Shear was developed Prolonged the treatment of sadnessAn approach to help people adapt to their loss while maintaining a connection with their deceased loved one.
Treatment works in two pieces, shear explains: helping people accept the reality of loss, while recognizing that their relationship with the deceased continues in a different form and helping them reconnect with their own values and interests to rebuild a meaningful life.
This could include practical steps such as the pursuit of distant dreams (one of the patients in the shear opened the antiques shop that always wanted, while another learned how to make chocolate sculptures), creating daily self-care rituals and enhancing relationships with live family and friends. Treatment also addresses the avoidance behaviors and thought standards that keep people stuck in their sadness.
Three studies funded by the National Institute of Mental Health found many promising results: 7 of the 10 participants who received specialized sadness intervention showed significant improvement in their symptoms, compared to Interpersonal Psychotherapy (IPT) for depressionA proven form of depression speech therapy, which has shown progress in less than 1 of the 3 participants.
A study The shear found that antidepressants alone do not significantly help prolonged symptoms of sadness and are much less effective for sadness than depression. While shear stresses that more research on definitive results are required, these findings suggest that prolonged sadness requires its own separate therapeutic approach and not to borrow treatments designed for other conditions.
“Sadness is in fact a form of love,” Shear noted, citing the author CS Lewis’s insight that sadness represents the ongoing bond we have with those we have lost. The goal of prolonged sadness therapy is not to “overcome” the loss, but to learn to carry it while still living.
When to get help
For those who are wondering if they need help, shear suggested that you look for these signs:
- Feeling unable to envision life without the deceased months or years after loss
- Feeling that death happened yesterday, even when a significant time has passed
- Losing social support because others tell you to “move on” or even start to avoid you
“In my case, I had a work colleague whose husband died three months before mine, so we mourned at the same time,” Gilats recalled. “But after about two years, I noticed that it was much better, it seemed to be well adapted, it seemed to do her best of her situation and was happy when I realized that something was not right.
Nine years after her husband died, Gilats decided to focus deliberately on activities to get herself out of pain. Eventually, he found consolation in yoga and a new purpose as a yoga trainer. He then continued to become a writer and write three books.
If you are struggling with persistent, overwhelming sadness that interferes with your daily life, you know that you are not alone and that help is available. Shear suggests planning a consultation with a therapist that can help you determine if you are treated as a long -standing sadness as a great first step.
In addition, Gilats said: “Try to do some of the things you’ve always enjoyed.
Now, Gilats says she’s no longer stuck in her sadness. Her experience offers hope for those who are in her thickness.
“I still think of my husband every day and I still miss it, but now I can enjoy my memories and marriage,” he explained. “Today. I feel a deep gratitude to spend 20 wonderful years with the man I will always love.”
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