The correlation between unresolved grieving and depression in adults

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1 The Correlation Between Unresolved Grieving and Depression in Adults. Name Institution Course Professor Date

2 The Correlation Between Unresolved Grieving and Depression in Adults. Literature Review Grieving a loved one is an emotional journey that affects individuals differently, often pushing them to their limits. This process, a natural response to loss, can exact a significant toll on mental well-being. The connection between unresolved grieving and depression in adults is intricate, with various factors at play. When individuals do not effectively process their grief, it can linger, manifesting as depressive symptoms. While there are ways to grieve properly, unresolved grieving can lead to depression because experiencing grief is one of life's most stressful experiences that causes individuals to experience increased pain According to Seiler et al. (2020), the intricate psychobiology of bereavement and its profound implications for health constitutes a compelling field of study. Grief, especially stemming from the loss of a spouse, is an immensely challenging life event, wielding a potent impact on mental and physical well-being. The immediate aftermath of such a loss is, in particular, an epoch characterized by elevated risks of morbidity and mortality. While this is not an uncharted terrain in research, the precise mechanisms underlying the emergence of these deleterious health consequences subsequent to bereavement remain shrouded in enigmatic complexity. Delving into the comprehensive framework outlined by Seiler et al., it becomes evident that several nuanced pathways intertwine to link bereavement with health outcomes. In this context, inflammation and immune dysregulation surface as key actors on the physiological stage, demonstrating the intricate interplay between stress, neural responses, and immune processes. The surge in inflammation-related health issues following bereavement casts a perturbing shadow, manifesting in the form of heightened cardiovascular disease susceptibility

3 and even an augmented risk of certain cancers. The conspicuous implication here is that bereavement-related immune dysregulation is a pivotal facet of this multifaceted puzzle, contributing significantly to the morbidity and mortality burden. A perspective grounded in the Social Signal Transduction Theory of Depression offers a profound vantage point for understanding the nexus between bereavement and health (Slavich et al., 2020). This theory posits that the accumulated stress experienced in early and later life can sensitize neuro-inflammatory responses to subsequent stressors, thereby exacerbating an individual's vulnerability to both mental and physical health afflictions across the lifespan. Transposing this framework onto the context of bereavement, it becomes apparent that the profound caregiving burden culminating in spousal loss may serve as a potent catalyst for the initiation of inflammatory-based health complications. It is worth noting that prior literature has ventured into the realm of bereavement's effects on immune system functioning. According to Bo et al. (2021), the profound psychological landscape of bereavement constitutes a compelling arena for the exploration of intricate emotional responses, in particular, the manifestation of Complicated Grief (CG) within the context of a Cantonese cultural background in Hong Kong. While grief following the loss of a loved one has been the subject of extensive examination, the unique perspective is its focus on the earlier stages of bereavement, a realm relatively uncharted in the existing body of research. The interplay of anxiety, CG, and depressive symptoms, as underscored by the study's findings, presents a notable confluence of psychological states within the bereaved population. It is noteworthy that the symbiotic relationship between anxiety and depressive symptoms is bidirectional, implying a mutual influence within the emotional terrain of early bereavement. The consistent and robust

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4 association between these psychological states is consistent with previous empirical research that highlights the predictive power of early symptoms on later stages. The complex cross-lagged models unearth intriguing patterns of influence. Notably, anxiety at T1 emerges as a significant predictor of both depressive symptoms and CG symptoms at T2. This connection underscores the profound impact of anxiety on the emotional trajectory of the bereaved individuals in the early stages. Such findings hold implications for clinical practice, as they spotlight the imperative of addressing anxiety as a pivotal factor in shaping subsequent emotional experiences within the grieving process. Moreover, the temporal cascade reveals the role of CG symptoms at T2 in contributing to depressive symptoms at T3. This interplay underscores the dynamic nature of emotional experiences in the context of bereavement, wherein the manifestation of CG symptoms carries a ripple effect into later stages, influencing the development of depressive symptoms. This dynamic relationship unveils the emotional web that bereaved individuals navigate, shedding light on the pivotal role played by early symptoms in shaping later experiences. Djelantik et al. (2018) posits that the psychological terrain following the loss of a loved one emerges as a focal point for understanding the evolution of both Prolonged Grief Disorder (PGD) and Post-Traumatic Stress Disorder (PTSD). While bereavement often encompasses a natural trajectory of emotional healing, it is essential to recognize that in a subset of individuals, this process may diverge into protracted experiences of PGD and PTSD. This divergence is characterized by an array of symptoms, notably including the persistent yearning for the deceased in PGD and the haunting fear that typifies PTSD. An intriguing facet of this complex psychological landscape is the interplay between PGD and PTSD symptoms, a phenomenon that has garnered limited empirical investigation. The co-occurrence of symptoms from these two

5 disorders has been the subject of scrutiny, revealing subgroups within the bereaved population. Some individuals exhibit predominantly PGD symptoms, while others manifest a combination of both PGD and PTSD symptoms (Nickerson et al., 2014). However, the nuanced temporal dynamics of this interplay remain enigmatic. Is it more likely that a bereaved person would experience PGD symptoms later on in life if they initially experienced PTSD symptoms, or vice versa? Alternatively, is there a profound interrelation between these two disorders, such that their symptoms tend to manifest concurrently throughout the bereavement trajectory? The conceptual distinction between separation distress, emblematic of PGD, and traumatic distress, which characterizes PTSD, paves the way for considering the causal relationship between these disorders. The prevailing perspective posits that the presence of PTSD symptoms may impede the processing of grief, inhibiting the resolution of separation distress. This proposition is rooted in the notion that distressing memories and fears triggered by PTSD can hinder the cognitive assimilation of the loss, thereby perpetuating grief symptoms. In summary, the profound journey of grieving a loved one is a multifaceted terrain that intricately weaves emotional, psychological, and physiological threads, influencing the well- being of individuals in distinct ways. Research has shed light on the intricate mechanisms linking bereavement to health outcomes, highlighting the central role of immune dysregulation, inflammation, and the accumulated stress experienced across one's lifespan. Understanding these pathways is pivotal in addressing the toll that unresolved grief can take on mental and physical health. Additionally, investigations into the early stages of bereavement within diverse cultural contexts, as exemplified in the study on Cantonese populations in Hong Kong, illuminate the interplay of anxiety, Complicated Grief, and depressive symptoms, underscoring the significance of addressing anxiety as a key factor in shaping the emotional journey.

6 References Bo, Y. A. N., Raymond, S. K., & Amy, Y. M. (2021). The role of post-loss anxiety in the development of depressive symptoms and complicated grief symptoms: a longitudinal SEM study. Journal of Affective Disorders , 281 , 649-656. Djelantik, A. M. J., Smid, G. E., Kleber, R. J., & Boelen, P. A. (2018). Do prolonged grief disorder symptoms predict post-traumatic stress disorder symptoms following bereavement? A cross-lagged analysis. Comprehensive Psychiatry , 80 , 65-71. Nickerson, A., Liddell, B. J., Maccallum, F., Steel, Z., Silove, D., & Bryant, R. A. (2014). Posttraumatic stress disorder and prolonged grief in refugees exposed to trauma and loss. BMC psychiatry , 14 (1), 1-11. Seiler, A., Von Känel, R., & Slavich, G. M. (2020). The psychobiology of bereavement and health: A conceptual review from the perspective of social signal transduction theory of depression. Frontiers in psychiatry , 11 , 565239. Slavich, G. M., Giletta, M., Helms, S. W., Hastings, P. D., Rudolph, K. D., Nock, M. K., & Prinstein, M. J. (2020). Interpersonal life stress, inflammation, and depression in adolescence: Testing Social Signal Transduction Theory of Depression. Depression and anxiety , 37 (2), 179-193.

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