When grief gets misdiagnosed with other mental health disorders like depression and ADHD

When grief gets misdiagnosed with other mental health disorders like depression and ADHD

There are many parallels between grief and mental health disorders such as depression and anxiety and even medical conditions like ADHD.

Better understanding

Research illustrates the frequent confusion and subsequent misdiagnosis of grief with depression and ADHD, particularly in cases where a person is suffering from complicated grief disorder.

For example, grief and depression share similar symptoms, such as:

  • Sleep disturbance
  • Loss of appetite
  • Weight loss
  • Anxiety
  • Profound malaise

However, depression and grief are markedly different experiences. Therefore, the ability to distinguish between grief and depression (and not just for educational purposes) is essential for those seeking treatment – it may even be life-saving.

Accurate diagnosis

Getting an accurate diagnosis for depression (and other mental illnesses) and receiving the proper treatment is critical to avoid further complications such as the development of self-destructive behaviors like substance abuse and suicidal thoughts.

On the other hand, grieving the loss of a loved one is a natural way to process death and ultimately help a person heal from a significant loss.

Attention deficit hyperactivity disorder

Also known as ADHD, attention deficit hyperactivity disorder is a condition that impacts peoples’ behavior.

Core feature

Some of the core features of ADHD get characterized by inattention, impulsivity, and excessive activity, all of which are not usually age-appropriate.

Most people who have ADHD also experience challenges with emotional regulation and often express difficulty waiting in queues or similar activities that involve a degree of patience.

Restlessness - one of the key symptoms of ADHD

Key ADHD symptoms

Those with ADHD may experience the following symptoms:

  • Restlessness
  • Difficulty concentrating
  • Poor impulse control
  • Learning difficulties
  • Emotional instability
  • Emotional hypersensitivity

ADHD diagnosis

ADHD symptoms may get noticed from an early age and are often more noticeable when a child’s life circumstances change, such as when they start school or move home.

The majority of ADHD cases get diagnosed between the ages of six and twelve.

Childhood history

Research suggests that most people with ADHD will notice an improvement in their ADHD symptoms as they age. However, the majority of people diagnosed with ADHD as children will continue to experience problems with ADHD throughout adulthood.

Bereavement and ADHD

Grief interventions for children with mental health issues such as ADHD may help them process the loss of a loved one more effectively.

When dealing with loss, it’s common for children to become overwhelmed and preoccupied with thoughts related to grief, such as:

  • An inability to focus
  • Overstimulation
  • Apprehension

Emotional symptoms

However, children diagnosed with ADHD are much more likely to experience more profound, ongoing manifestations of grief, all of which can exacerbate their struggles with concentration and focus and their ability to manage emotional symptoms like stress.

Overlapping symptoms of grief and ADHD

Compounded challenges often occur in bereaved children with an existing diagnosis of attention deficit hyperactivity disorder.

The symptoms of grief and ADHD frequently overlap and may get concealed by the tendency for a child to hide their true feelings.

Some of the critical symptoms of overlapping grief in children with ADHD include:

  • The constant need to move the body (restlessness)
  • Trouble eating or sleeping
  • Isolation from family and friends
  • Trouble focusing and concentrating (low attention spans)
  • Poor performance at school and learning disabilities

Clinical perspectives

Studies show the prevalence of bereaved children getting misdiagnosed with ADHD, particularly if caretakers jump to conclusions too quickly. Additionally, children with ADHD may experience a worsening of their symptoms after a significant loss.

Clinical psychologist David Anderson, Ph.D., emphasizes the importance of empathy in bereaved children with ADHD;

”We need to have empathy for the fact that ADHD may cover over what’s going on for a child in the grieving process. They may in fact, have deeper emotions.”

Helpful support

Anderson also describes the need for front-line intervention, which involves adults getting trained to look for signs and other symptoms of grief and ADHD and help children by meeting them where they are.

Mental disorders and grief

Other research demonstrates the need for caution and suggests that caregivers should refrain from making preliminary diagnoses before meeting clinicians since mental health professionals can provide medical advice.

The assumption that a child is depressed or that they need ADHD medication (or any other medication) can lead to inappropriate and ineffective treatment plans.

Having the ability to distinguish between signs of mental illness and grief is therefore imperative.

Borderline Personality Disorder

Other personality disorders (or mood disorders) such as BPD (Borderline personality disorder) can often heighten the feelings of grief.

Risk factor

The scant research around borderline personality disorder, characterized by an intense fear of abandonment, may put people with a borderline personality disorder at higher risk for complicated grief due to the profound emotional reactions of being separated from loved ones’.

Borderline personality

When someone suffers from BPD or receives a BPD diagnosis, grief responses can be more intense than other peoples’ reactions. People with BPD may express their grief through self-destructive behaviors such as;

  • Drinking
  • Violence
  • A lack of impulse control

Unfortunately, these actions only make the grieving cycle a lot more distressing and painful.

The diagnostic and statistical manual

The diagnostic and statistical manual (DSM-5) fifth edition describes how many personality disorders such as borderline personality disorder, bipolar disorder, and other mental health conditions perpetuate symptoms of grief.

The DSM – 5 illustrates that while grief is an ”expectable or culturally approved response to a common stressor or loss, such as the death of a loved one, it is not a mental disorder.”

Major depression and bereavement

Major depression and bereavement

It is widely recognized within the mental health community that profound stress can trigger episodes of major depressive disorder (MDD) and bipolar disorder.

To prevent further confusion around grief and major depressive disorder, the DSM-5 excluded the first-time diagnosis of major depression for up to six months after a bereavement.

Researchers and critics have pointed out that major depression can get triggered by the death of a loved one and may even cause suicide.

Mental health professionals have said that it would be illogical and unfair to deprive depressed people of a medical diagnosis and the treatment they deserve because they are grieving.

Hence, the removal of specific content from the DSM-5 until enough time has passed to make more informed decisions surrounding mental health diagnoses.

Distinguishing grief from major depressive disorder is imperative to improve treatment outcomes. The DSM-5 has divided the symptoms of medical conditions like major depressive disorder and grief, all of which get included below:

Major depressive disorder symptoms

The symptoms associated with the major depressive disorder include:

  • Persistent depressed mood and an inability to experience joy and happiness or anticipate happiness or pleasure
  • Symptoms are persistent throughout most of the day
  • Criticism towards the self, feelings of worthlessness, and pessimistic ruminations
  • Thoughts that often get centered around ending one’s’ life because the person does not feel deserving of life due to feelings of worthlessness or an inability to cope with the feelings of depression

Symptoms of grief

Grief symptoms present in different ways and depend on the individual and other co-occurring mental illness, but typically involve:

  • Feeling empty and lost
  • Feelings that decrease in intensity over days to weeks and often occur in waves. All this includes the pangs of grief linked to reminders and thoughts about the deceased
  • Any self-derogatory ideation usually involves perceived failings about the deceased
  • Any existing beliefs around death and dying get focused on the dead and potentially ”joining them”.

The grieving patient

Taking all this into account, it is not surprising to learn how grieving patients’ can get misdiagnosed with having a specific mental illness.

Therapy sessions for people with complicated grief disorder can be beneficial, particularly trauma treatments like EMDR (eye movement desensitization reprocessing) and cognitive behavioral therapy. All this is especially true when people present with symptoms of post-traumatic stress disorder (PTSD).

In the throes of grief, it can be incredibly challenging to make sense of our feelings, and people often go to great lengths to avoid the severe negative impact bestowed by grief.

People who demonstrate avoidance behaviors suffer tenfold due to the consequences of repressing their grief – the result often being substance abuse, depression, social isolation, self-harm, and the co-occurrence of other mental disorders.

To better support grievers through the trauma of grief, people must be trauma-informed, including family, friends, communities, and mental health professionals.

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If you have suffered bereavement and want help processing your grief, the specialist team at Centres for Health and Healing are here to help. 

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