Major Depression or “It’s Just Grief” — How do I know?
It is not uncommon for people to question whether they or someone they know is depressed after the death of a loved one. Grief is a natural response to loss. It might be the loss of a loved one, relationship, pregnancy, pet, job or way of life. The more significant the loss, the more intense the grief will probably be. Symptoms of grief feel continuous for a long time, and they get harder to cope with over time, rather than gradually easier. The grieving process is natural and unique to each individual. While grieving, you may experience several bad days in the early stages of bad moments as you begin to heal. Eventually, it passes. In contrast, clinical depression is not intermittent and does not go away. It is ongoing, persistent, and never changing. Depression is accompanied by a feeling of hopelessness and a lack of interest, lack of motivation, or enthusiasm in all activities. Someone
experiencing clinical depression will continually question “Why go on? What’s the use?”
Grief and depression can co-exist. For some people, the death of a loved one, losing a job, or being a victim of a physical assault or a major disaster can lead to depression. When grief and depression co-occur, the grief is more severe and lasts longer than grief without depression. Distinguishing between grief and depression is important and can assist you or those you love in getting the help, support, or treatment they need.
Depression or Grief–How do I know?
Depression is one of the stages of grief and is usually the longest and one of the most difficult stages. If other people are telling you things such as “you seem to be holding up so well” when you know you aren’t, you may wonder what makes them think that or wonder if you are suffering more than normal grief. Depression and grief share similar symptoms but they also have major differences in important ways. Each is a distinct experience. Grief can sometimes trigger a major depressive episode which is common with other stressful experiences as well. Both grief and depression share some common features such as:
- Intense sadness and withdrawal from usual activities
- Insomnia
- Poor appetite
- Weight loss
- Anger and irritability
Grief and depression differ in the following way:
| Grief | Major Depression |
| There is an identifiable loss | A specific loss may not be identified |
| Deep sadness over the loss experienced | Deep sadness filled with hopelessness about nothing in particular |
| A person’s focus is on the loss | A person’s focus is on themselves |
| Fluctuating ability to feel pleasure | Inability to feel pleasure |
| Fluctuating physical symptoms | Prolonged and marked functional impairment |
| Painful feelings come in waves | Pervasive and persistent throughout all situations |
| Painful feelings are often intermixed with positive memories of the deceased | Mood and/or interest (pleasure) are decreased for most of the two weeks |
| Self-esteem is usually maintained | Feelings of worthlessness and self-loathing are common |
| Excessive focus on the episode of grief or avoidance of it altogether | Morbid preoccupation with worthlessness |
| The closeness of others is usually comforting | Persistent isolation from others and self |
| Hallucinations such as a sensation of hearing or seeing things related to the loss | Hallucinations such as a sensation of hearing or seeing things not related to anything in specific; feeling sensations as if you’re being touched when you aren’t; smelling or tasting things that have no source |
| Thoughts of death may surface when thinking of or fantasizing about “joining” the deceased loved one | Thoughts are focused on ending one’s life due to feeling worthless or undeserving of living or being unable to cope with the pain of depression |
- If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 or MOCARS at 800-356-5395 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.
- If you find that you or a loved one identifies with several of the items in the depression column, it is important to consult with a physician or mental health provider. If you are grieving but it seems to continue for too long, it’s necessary to seek help. If there is any doubt, it is best to seek help.
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