Grief and Depression

The Fundamental Differences Between Grief and Depression

For those experiencing a profound loss, it’s not at all uncommon for them to feel grief. The mental, emotional, and sometimes physical changes that happen after the death of a loved one or other loss can be attributed to normal feelings of grief. It’s also normal to wonder if those feelings of sadness have become something more insidious, like depression.

More than 6% of the US adult population experiences a bout of major clinical depression in a given year. But it’s crucial to understand how normal grief and clinical depression differ. Knowing the difference between the two can help the bereaved person get the help they need. The following article will explore the fundamental differences between grief and depression, who is most at-risk of having normal grief turn into depression, and how to effectively treat major depressive disorder.

First, it’s important to recognize the symptoms of normal grief, versus the symptoms of clinical depression. Normal grief can be characterized by the following symptoms, which can sometimes be confused for depression. Also, the way individuals cope with loss will look different for everyone.

Changes in appetite and sleep.
Avoidance of social situations.
Existential anger.
Loss of interest in work, school, or other activities.
Sadness and feelings of hopelessness.
Tearfulness.
Fatigue.
Problems concentrating.
Suicidal ideation.
Neglecting hygiene and other forms of self-care.

Depression is a clinical disorder, where the following combination of symptoms is present every day for at least two weeks. Only a trained clinician is authorized to diagnose someone with depression officially.

Changes in sleep and appetite.
Fatigue.
Anger and hopelessness.
Sadness.
Feelings of guilt and worthlessness.
Difficulty concentrating.
Sluggish, slow movements.
Irritability.
Significant impairment.
Delusions.
Suicidal thoughts, self-harm, and suicidal attempts.

How do grief and depression issues manifest?

Feelings of grief and the changes they bring are a rational response to loss, such as the death of a loved one. But in vulnerable individuals, grief that goes on for too long can start to turn into clinical depression. Loss and the despair that follows may be horrible experiences, but depression can be deadly and significantly impact a person’s functioning. It’s crucial that family members and friends of the bereaved can recognize the differences so they can get their loved one help for depression. It’s also possible that a person can experience grief and depression at the same time.

What are the significant differences between grief and depression?

Many symptoms of normal grief and depression overlap. But, there are several notable differences between grief and depression.

Grief is focused on a particular loss, whereas in clinical depression, the focus is on the self. In clinical depression, there may not even be a loss that is identifiable.
Depression is often characterized by a complete inability to feel pleasure. With grief, a person can experience fleeting joy.
When someone is grief-stricken, they have intermittent physical symptoms related to their grief. With clinical depression, physical symptoms such as sluggishness or fatigue are prolonged and lead to significant functional impairment.
Depressed patients tend to isolate themselves consistently. When someone is grief-stricken, they find comfort when close to family and friends.
People who experience grief have a wide range of emotions. Depressed people have a limited emotional range.
Depressed patients experience a lot of guilt that is generalized and vague. People who are grieving may only experience guilt related to certain aspects of the loss.
Self-loathing and low self-esteem are usually marked symptoms in clinical depression. People who are grieving have intact self-esteem.
When it comes to thoughts of death, the grieving may want to commit suicide to be reunited with a deceased loved one. Depressed patients are tempted to commit suicide as a way to cope with pain or feelings of worthlessness.

Who is most at risk of developing clinical depression because of loss and grief?

About one in five people who experience a significant loss will go on to develop major clinical depression. There are several notable risk factors for experiencing depression after a loss:

People who have experienced depression before are at high-risk of having normal grief turn into major depressive disorder.
Bereaved individuals with no support system in place risk developing clinical depression from grief and loss.
People who struggle with drug or alcohol addiction are at-risk of becoming clinically depressed from the death of a loved one.
Those who are also experiencing significant life stressors at the same time as the loss can become clinically depressed.

How can someone know if they are clinically depressed or experiencing normal feelings of grief?

If the following symptoms are present for at least two months after the loss, then it’s likely that normal grief has turned into major depression.

Constant feelings of guilt or worthlessness.
Suicidal thoughts.
Attempts at self-harm.
Significant impairment in functioning at work, home, or school.
Slowed affect.
Delusions or visions of the deceased.
Significant weight gain or loss.

In many cases, the normal grieving process can last for a long time. But when severe, depressive symptoms occur that impair a person’s functioning or put their life in danger, it’s crucial that they get help for depression.

What can someone do to cope with feelings of grief, or treat clinical depression?

There are many steps someone can take to get through the normal grieving process without having it turn into depression. Getting support from friends, loved ones, and even a trained therapist or participating in group therapy for the bereaved can be beneficial. It’s also vital that people who are grieving do not turn to alcohol or drugs to cope. Getting enough sleep, eating well, and exercising can all help alleviate some of the normal stress a person will experience during a loss.

If grief turns into clinical depression, medications like SSRIs, and SNRIs, and group and one-on-one therapy can effectively treat the symptoms of depression. Deep brain stimulation techniques and transcranial magnetic stimulation (TMS) coupled with therapy are highly effective at treating depression symptoms. A full third of TMS patients go on to experience a complete remission from symptoms after their first round of TMS treatment for depression.

Normal grief can last for months, or even years. But it’s vital that family and loved ones of the bereaved can recognize the differences between normal sadness and depression. For grief that turns into a depressive episode, there are many proven methods for treating and alleviating painful depression symptoms. For those who suspect that their grief has turned into depression, don’t hesitate to reach out to a qualified therapist for a clinical evaluation.