A sense of great loss may come to replace stoicism or anger or numbness. Depression is the preparatory grief that the terminally ill patient has to undergo in order to prepare himself for his final separation from this world. But, Dr. Kubler-Ross distinguished two different kinds of depression. Reactive depression carries with it unrealistic shame or guilt that may be easily alleviated by addressing personal concerns or even organizational issues in a person's life. This kind deals with a past loss.
Preparatory depression takes into account impending losses.
It is a mode the dying person employs to prepare for the impending loss of so many people and things. This is often an expression of our own needs, our own inability to tolerate a long face over any extended period of time. This can be a useful approach when dealing with the first type of depression in terminally ill patients. This time of deep sadness, then, indicates that the person is in the throes of encountering the depth of the loss that looms on the horizon. If the grief is not blocked by the person or others, a deeper acceptance of one's death seems possible.