Am I experiencing grief or depression?

A fellow caregiver asked...

What's the difference between grief and depression?

Expert Answer

Martha Clark Scala has been a psychotherapist in private practice since 1992, with offices in Palo Alto and San Francisco, California. She regularly writes about grief and loss, the necessity of self-care, and substance abuse. Her e-newsletter, "Out on a Limb," is available to subscribers through her website.

It's easy to confuse grief with depression. The reason for this is that a number of symptoms of bereavement -- the grief commonly experienced when someone close to you has died or is dying -- are the same as those reported by people who are clinically depressed.

They include the following:

  • Sadness, melancholy, or despair

  • Low energy or fatigue

  • Weepiness or persistent tears

  • Changes in appetite and sleep patterns

  • Poor concentration

  • Guilt or hopelessness

  • Unbidden happy and sad memories

Among the bereaved, these symptoms are usually mild or temporary. But these same symptoms may be more chronic or severe among those who are clinically depressed.

Clinical depression is formally defined as a mood disorder characterized by one or more major depressive episodes -- that is, at least two weeks of a depressed mood or loss of interest accompanied by at least four additional symptoms of depression, as described above.

It is important to distinguish between feeling depressed versus clinical depression. Often, people experiencing deep sadness will say something such as, "I'm so depressed." In this case, depressed could be replaced by any number of words that describe varying degrees of sadness: sad, melancholy, blue, bummed-out, brokenhearted. But this is quite different from true clinical depression.

However, if you're grieving and suffering the following additional symptoms, you're more than likely clinically depressed or in the midst of a major depressive episode:

  • Worthlessness

  • Exaggerated guilt

  • Suicidal thoughts or plans

  • Low self-esteem

  • Powerlessness

  • Helplessness

  • Exaggerated hopelessness

  • Agitation or restlessness

  • Loss of interest in pleasurable activities

  • Exaggerated fatigue

If you see yourself in this list of symptoms, consider getting professional help from a grief therapist or other psychiatric counselor. The irony is that your symptoms may make it difficult to get motivated to get support, but try your best. You're more likely to get relief from your symptoms if you pursue treatment aggressively.