I lost my mom in January and a good older friend in March. In both cases they were on a respirator and I was part of the decision-making process to discontinue life support. I have a hard time getting up in the mornings, and when I get off work at 1pm I just want to sleep. I have no desire to have sex, which is something that has never happened to me before. Is this normal, or could a physical condition cause my tiredness? I feel so depressed all the time. If I'm not sleeping, I just want to sit. Should I consider grief counseling?

C.

My condolences to you on the losses of your mother and your friend. I can certainly understand how being involved in the decision to discontinue life support in both situations could increase your emotional burden.

I can't say for certain what's going on with you, of course, without talking with you personally. But fatigue, hypersomnia (sleeping more than usual) and decreased interest in sex are possible symptoms of depression, as well as of some medical conditions such as hypothyroidism. And, of course, many people experience similar phenomena when overwhelmed by or recovering from significant losses.

Should you consider grief counseling? That's up to you ... but yes, it might help to have some extra support and a place to process what's going on with you. Other possibilities are to use journaling, artwork, music or other means of creative expression to identify and express feelings about your recent losses and anything else that's a focus of your life right now. I'd also recommend allowing yourself (as much as possible) the time and space and energy you need to grieve your loved ones and honor your relationship with them.

If you want to know for sure whether a physical condition could be contributing to your fatigue, see your physician for a medical assessment. If your physician considers you to be depressed, he or she might recommend medication in addition to -- or, occasionally, instead of -- counseling. Some mental health professionals, however, frown on the practice of diagnosing grieving people as depressed and prescribing medication. They feel such labeling and prescribing implies the grieving person is "sick" and that there's something inappropriate about their emotional and behavioral response to loss. If you have concerns or questions about taking medication your physician may prescribe, discuss the issues with your physician and your counselor.