It is common that a stressful life event triggers a person’s first episode of depression. Although the death of a loved one can be one of the most stressful experiences a person goes through, not everyone experiences depression after a loss and the relationship between loss and depression is complex. When someone dies, surviving loved ones often go through a grief process that involves mourning and letting go. Although a grieving period usually includes feeling sad and may include other symptoms that look similar to depression, most experts acknowledge that grieving is a normal and expected reaction to loss, and a distinct process from depression. However, in some cases, loss of a loved one can trigger thoughts and feelings that are not part of a normal grieving process. In those cases, loss may bring about depression or other health conditions.
What Is The Difference Between Grief and Depression?
This is a complicated and sometimes controversial question to answer. Although researchers are studying this issue, it is not yet well understood. In prior versions of the Diagnostic and Statistical Manual of Mental Disorder (DSM), which is the manual used to diagnose depression and other mental health conditions in the United States, it was indicated that people should not be diagnosed with depression if they have experienced the death of a loved one within the past 8 weeks, and did not have any symptoms of depression prior to the loss. The most recent version of the DSM removes that guideline, but encourages health care providers to distinguish between normal grief and depression (APA, 2013). Some of the differences between sadness and grief include:
- In grief, sadness tends to come in waves and usually includes positive memories or emotions mixed in with the negative ones. In depression, thoughts and feelings tend to be mainly sad and negative.
- Feelings of low self-esteem and worthlessness are common in depression but not in grief.
Further complicating this question is that researchers have identified a type of grief that looks different than both normal grief and depression. This type of grief has been termed Persistent Complex Bereavement or Prolonged Grief and it occurs in about 10% of those who lose a close loved one. Prolonged Grief is different from other grief in that it is more intense, lasts longer and causes disruption to daily life that does not fade over time. In addition, a person may feel intense concern about the future and personal safety. Prolonged Grief is different from depression in that is it more personal and closely tied to a loss whereas depression is more characterized by sadness (Tay, Rees, Chen, Kareth, & Silove, 2015).
If Grieving is Normal, Do People Seek Treatment for Grief?
It can be difficult to distinguish between grief, prolonged grief and depression. Sometimes an assessment by a professional can help to sort out what is going on. If the loss has prompted depression or complicated grief, treatment may be helpful. Even in cases of normal grief, receiving supportive therapy to help make sense of the loss may be beneficial.
Tay, A. K., Rees, S., Chen, J., Kareth, M., & Silove, D. (2015). Factorial structure of complicated grief: associations with loss-related traumatic events and psychosocial impacts of mass conflict amongst West Papuan refugees. Soc Psychiatry Psychiatr Epidemiol. doi:10.1007/s00127-015-1099-x