A Biopsychosocial Approach to Grief, Depression, and the Role of Emotional Regulation

Abstract

According to the field of affective neuroscience, grief has been identified as one of the seven primary emotions necessary for human survival. However, maladaptive grief could cause significant impairment in an individual’s life, leading to psychopathologies such as major depressive disorder. Research on grief has shifted to a biopsychosocial approach, leaving behind outdated models—such as the Kübler-Ross theory—that have shown poor consistency. The field of psychoneuroimmunology has identified adverse life events such as social loss as being associated with major depressive disorder, and inflammatory processes in chronic health conditions. Likewise, scientists in the field of affective neuroscience have theorized that prolonged and sustained activation of the grief neurological pathway can cause a cascade of neurotransmitters that inhibits the reward-seeking system, causing symptoms of depression. The objective of this review is to highlight findings on the grief process using a biopsychosocial approach to explore grief’s impact on psychopathophysiology.

Antidepressant Effect of Intermittent Long-Term Systemic Administration of Irisin in Mice

“…Taking into account the crosstalk between the CNS and the immune cells, at the beginning of the 1990s, the “cytokine theory of depression” was formulated, proposing the involvement of proinflammatory cytokines in disease pathogenesis [ 52 ]. Indeed, accumulating evidence showed an increase in proinflammatory mediators, principally IL-6, IL-1β, interferon-γ (IFN-γ), and TNF-α in depressed individuals and in patients developing depressive symptoms after therapeutic treatments, such as IFN-α therapy for chronic hepatitis C [ 53 , 54 , 55 , 56 , 57 ]. In line with these findings, it has been reported that the serum concentration of some proinflammatory cytokines was further increased in the severe form of depression [ 58 ].…”

The grief experience during the COVID-19 pandemic across different cultures

“…This increase is not only as a result of the unprecedented number of confirmed COVID-19 cases and related deaths, but also due to social isolation, disrupted mourning practices and grieving processes experienced globally. Abnormal grief could cause significant impairment in the lives of individuals and could lead to psychopathologies such as major depressive disorder and anxiety disorder as well as poor quality of life [ 12 ].…”

Addressing nurses' prolonged grief due to the COVID-19 pandemic

“…7 Symptoms include feelings of disbelief, inescapable images, and elusive behaviors, impacting the person' s ability to function. 6 Studies suggest COVID-19 deaths are both traumatic and sudden, putting caregivers at risk for both PGD and PCBD. 10…”