Grief vs. Depression: Which Is It?

It's important to sort out the differences

Holding hands with a grieving friend
Peopleimages/Getty Images

Grief and depression share similar symptoms, but each is a distinct experience, and making the distinction is important for several reasons. With depression, getting a diagnosis and seeking treatment can be literally life-saving. At the same time, experiencing grief due to a significant loss is not only normal but can ultimately be very healing.

Clinical Perspectives

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) removed a "bereavement exclusion" from the diagnosis of major depressive disorder (MDD). In the DSM-IV, the "bereavement exclusion" stated that someone who was in the first few weeks after the death of a loved one should not be diagnosed with MDD. However, the DSM-V recognizes that while grief and MDD are distinct, they can also coexist, and grief can sometimes trigger a major depressive episode, just as other stressful experiences can.

Studies have shown that the extreme stress associated with grief can also trigger medical illnesses—such as heart disease, cancer, and the common cold—as well as psychiatric disorders like depression and anxiety.

Comparisons

Giving this overlap, there are times when it may be tricky to distinguish between grief and depression. A better understanding of their similarities and differences can help.

Similarities

Grief has several symptoms in common with the symptoms of major depressive disorder, including:

  • Intense sadness
  • Insomnia
  • Poor appetite
  • Weight loss

Grief can also develop into complicated grief, which, unlike uncomplicated grief, does not seem to dissipate with time and can look a lot like depression. Symptoms of complicated or chronic grief may include:

  • Intense sadness
  • Anger
  • Irritability
  • Difficulty accepting that whatever caused the grief really occurred
  • Excessive focus on the episode of grief or avoidance of it altogether

In extreme cases, someone with complicated grief may engage in self-destructive behaviors or even contemplate or attempt suicide. It is likely due to these symptoms that the DSM no longer includes the bereavement exclusion from the diagnosis of major depression.

Differences

Where grief and depression differ is that grief tends to decrease over time and occurs in waves that are triggered by thoughts or reminders of its cause. In other words, the person may feel relatively better while in certain situations, such as when friends and family are around to support them. But triggers, like a deceased loved one's birthday or going to a wedding after having finalized a divorce, could cause the feelings to resurface more strongly.

Depression, on the other hand, tends to be more persistent and pervasive. An exception to this would be atypical depression, in which positive events can bring about an improvement in mood. A person with atypical depression, however, tends to exhibit symptoms that are the opposite of those commonly experienced with grief, such as sleeping excessively, eating more, and gaining weight.

Other clues that point to a major depressive disorder instead of grief include:

  • Feelings of guilt not related to what prompted the grief
  • Thoughts of suicide—although, in grief, there can be thoughts of "joining" the deceased
  • Morbid preoccupation with worthlessness (grief does not usually erode self-confidence)
  • Sluggishness or hesitant and confused speech
  • Prolonged and marked difficulty in carrying out the activities of day-to-day living
  • Hallucinations and delusions; however, some people experiencing grief may have the sensation of seeing or hearing things

Treatment

While grief can be extremely painful, there is generally no medical indication to treat it. Some exceptions include:

  • If grief-related anxiety is so severe that it interferes with daily life, anti-anxiety medication may be helpful.
  • If the person is experiencing sleep problems, short-term use of prescription sleep aids may be helpful.

If you meet the diagnostic criteria for MDD, antidepressants may be prescribed.

In both cases, psychotherapy can be greatly beneficial in helping you process what you are feeling and learn strategies that can help you cope.

A Word From Verywell

If you are wondering if you are experiencing grief or depression, it is important to talk to your doctor and/or therapist who can help you make the distinction.

If your symptoms are related to normal grieving of a loss, they will probably improve in time. Grief is our body's way of working through difficult and traumatic experiences. Every person grieves differently and there is no right or wrong way to do it. Talk openly with a therapist or someone you trust, and remember that grief is not a sign of weakness.

Likewise, depression is an illness like any other. Reaching out for help when you experience depression symptoms is a sign of strength and can help get you on the road to effective treatment.

Was this page helpful?
View Article Sources