Yearning and not depression the most common response after a loved one dies

A new study has found that after the death of a loved one from natural causes, the normal responses from most people are acceptance and yearning for the deceased.

Lead author Holly Prigerson, who is director of Dana-Farber's Center for Psycho-Oncology and Palliative Care Research, says the most common reaction to the death of a loved one from natural causes is not depression as previously thought but rather yearning or pining.

The study by researchers at Yale University School of Medicine, analyzed data collected between January 2000 and January 2003 from 233 individuals participating in the Yale Bereavement Study.

The belief that a natural psychological response to loss involves an orderly progression through distinct stages of bereavement has been widely accepted by clinicians and the general public.

But Prigerson says the focus on depression is misguided as it is yearning which dominates the psychological picture, and a feeling that a part of one is missing and that without that essential part happiness is impossible.

In models that take into account the rise and fall of psychological responses, when rescaled, disbelief decreased from an initial high at one month post- loss, yearning peaked at four months post-loss, anger peaked at five months post-loss, and depression peaked at six months post-loss.

The authors say that acceptance increased steadily through the study observation period ending at 24 months post-loss.

The researchers say the study confirms the established theory of grief stages where initial disbelief is followed by yearning, anger, depression and then acceptance.

Prigerson says the study provides a benchmark for how grief changes over time and those who help treat grief need to focus first on the yearning stage.

The report says that sudden deaths to due to trauma or other reasons possibly produce higher degrees of disbelief and anger and less acceptance.

The study concludes that all of the negative responses are in decline by about six months after a loss and where persistence of these negative emotions lasts beyond six months this suggests a more difficult than average adjustment and the need for further evaluation of the bereaved survivor and potential referral for treatment.

The study is published in the current issue of the Journal of the American Medical Association.