ABSTRACT
Clients seeking treatment who have experienced clinical depression before facing significant loss require differential diagnosis and treatment of the former condition before focusing on the latter. Clients who maintain good strategies for managing depression, even with this history, may be responsive to an earlier focus on grief therapy. A treatment approach addressing stabilization of depression as the first treatment objective might include: Biological and safety needs addressed through stabilization of the pre-existing illness facilitate advancement into higher-level therapeutic goals. Sarah reported that the grief became more tangible with her depression better managed, resumption of activities of daily living and return to work. In therapy, Sarah began to recognize that the anger she had thought to be a symptom of depression was still present. While still grieving the loss of her father, she reported feeling better able to manage the simplicity of loss without the complications of anger and depression.
