Understanding the Difference Between Grief and Depression

When devastating loss hits our lives, we tend to respond with deep, intense sorrow. Initially, it might feel very uncomfortable for us, because grief stirs up many complicated and painful emotions. In time, we might hear well-intentioned friends or family members say, “Maybe it’s time to move on.” So we wonder, “Is this normal to feel like this? Am I depressed?”

Periods of grief can be confusing as we’re sorting through strong reactions, unexpected behaviors, and unwanted feelings or thoughts. It’s easy to see why most of us might get grief and the clinical diagnosis of depression mixed up at times. Here are some clear indicators that you are struggling with depression or a form of pathological grief called complicated grief.

First, your response of anger, sadness, confusion, loneliness, and guilt in the immediate aftermath of loss is a normal response. It’s important to note patterns of behavior over time, which may indicate that you need further professional and/or medical help.

The DSM-V (Diagnostic and Statistical Manual of Mental Disorders – 5th Revision) is what clinical psychologists and physicians who are psychiatrists use to diagnose specific conditions that can be treated well with medication and therapy. Now classified as Major Depressive Disorder, here are the criteria for diagnosis. Keep in mind that these symptoms must be prevalent for at least two consecutive weeks:

• Suicidal ideations (e.g. thinking and tendencies);
• Excessive weight loss or weight gain (or increased/decreased appetite);
• Energy loss and fatigue;
• Feelings of worthlessness;
• Irritability;
• Poor concentration;
• Change in sleep patterns (insomnia or hypersomnia – sleeping very little or too much).

Similarly, there is a clinical condition called complicated grief that mimics some symptoms of depression. The criteria include:

• Loss occurred over 6 months ago;
• Rumination over the loss/can’t get it off of your mind;
• Feeling that life is meaningless or worthless;
• Feeling shock/numbness;
• Neglecting self-care or care of others who need you (e.g. children);
• Auditory/Visual hallucinations of the person who has died;
• Inability to accept the loss;
• Strong feelings or reactions to any memory related to the loss;
• Cannot trust others or discuss anything other than the loss.

These symptoms must be present consistently for at least one month and significantly interfere with daily life.

Normal grief is acute; it comes and goes – sometimes without warning. But a clinical diagnosis is probable if you feel stuck and as if you are unable or unwilling to move through the grief rather than avoid or deny its presence and what it can teach you about suffering and empathy for others who are suffering. When in doubt, seek professional help. Go to your doctor and have an honest conversation. Listen to your loved ones’ concern about your welfare and take them into consideration.

(Note: I am not a physician or psychologist, and this information is not intended to replace or treat any condition you have. It’s for informational purposes only.)

Adapted from my book, From Grief to Grace: The Journey from Tragedy to Triumph.

Text (c) Jeannie Ewing 2018, all rights reserved. Photo by Ben White on Unsplash