Grief study says yearning is felt more strongly than depression
Contrary to traditional notions of grief after the death of a loved one, a new study finds that yearning is felt more powerfully than depression.
Researchers from Harvard Medical School and Yale University School of Medicine found that yearning was the strongest negative emotion after loss, they report in today's Journal of the American Medical Association.
Negative emotions associated with grief peaked within six months, meaning people with more prolonged symptoms might need more help after that point. The researchers recommended that the standard psychiatric reference, the Diagnostic and Statistical Manual of Mental Disorders, be revised to focus less on depression after the death of a loved one.
"Yearning is reacting to the loss of someone or something, and once that is gone, you miss it, you pine for it, you hunger for it, you crave it. That was the primary emotional experience after bereavement, rather than depression," Holly G. Prigerson, one of the authors, said in an interview. "This suggests that the DSM reconsider what the natural response to loss is, especially with respect to depression and yearning."
Prigerson is an associate professor of psychiatry at Harvard and director of the Center for Psycho-oncology and Palliative Care Research at Dana-Farber Cancer Institute.
Prigerson and her colleagues were testing the theory that people respond to loss by moving through disbelief, yearning, anger, depression, and acceptance, with depression being the dominant negative emotion.
They interviewed 233 people in the Yale Bereavement Study for up to two years following the death of a loved one from natural causes. People who had lost a child or loved one after a traumatic death such as a car crash or suicide were excluded from the study.
The participants, mostly widows, experienced the five stages of grief in the sequence popularized by Elisabeth Kübler-Ross's description of terminally ill patients, but yearning was the most powerful negative emotion and, on average, the worst feelings peaked within six months. Acceptance was the strongest emotion of all.
In contrast, the manual of mental disorders focuses on depressive symptoms, saying they should be expected two months after a loss, Prigerson said.
"People never get over a loss, they just get used to it," Prigerson said. "Even years after someone dies, they get pangs of grief, they need to think about the person, and they miss them with heartache," she said. "That's normal. But intense levels beyond that become problematic."
