-IBIS-1.5.0-
tx
mental/emotional
grief
diagnoses
definition and etiology
definition: a universal human response to loss, separation and/or disappointment. It is also called "bereavement reaction" and is the accepted standard of reactive depression.
etiology: The onset of grief usually follows episodes of significant loss and separation: death of a loved one; financial or material setbacks; marital separation or other romantic disappointment; and moving from a familiar place either voluntarily or by force. Usually the condition does not progress into clinical depression, unless the patient is extremely vulnerable (perhaps with no developed support groups to help process the loss) and the upset is marked. Those predisposed to affective disorders are at more risk during the grieving period.
signs and symptoms
The patient has a positive history of some loss, separation or disappointment.
Presents with insomnia, agitation, autonomic nervous system hyperactivity.
The eyes may be red and puffy from crying and the patient may sigh often during the interview, or may appear withdrawn.
There may be drooping of tissues and a sad expression on the face.
Vitality will be noticeably decreased.
The typical progression from onset to acceptance of an emotional upset is:
Shock
Denial
Anger
Guilt
Grief
Acceptance
lab findings:
In severe and unrelenting grief, lab values may show some decrease in immune status.
course and prognosis
Classically, after a significant loss, it is considered that working through the emotions around it normally last up to 2 years. If longer, or if the patient seems unable to function as they did before the grief (often constantly dwelling on the past), then clinical depression may be suspected.
differential diagnosis
Depression.
footnotes