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How do you know if you have depression versus grief?

Updated: Jul 4

sad young woman with long hair sitting on the floor; depression versus grief
Grief and depression can feel the same at first, but they differ in important ways.

You may already know that depression is prevalent in the United States. According to the National Institutes of Health, major depressive disorder is 1 of the most common, with 21 million adults having had at least one major depressive episode in their lives, which is 8.4% of all the adults in the US. According to Mental Health America, 11.5% of youth experience major depression. In California, the percentage is higher, 14.83%. Many of the symptoms of depression look like grief and vice versa. How do you know if you have depression versus grief?

Unfortunately, sometimes people have difficulty distinguishing whether what they are experiencing is grief from a loss or depression. This article talks about the symptoms of depression and grief, and how to tell whether you are feeling upset from a loss or from a depressive disorder.

Overlapping symptoms of grief and depression.

When you first experience a loss, many of the emotions you have resemble depression. The principal experience of loss is sadness, but there are also cognitive (or thinking) changes that happen such as forgetfulness, disorientation, and difficulty concentrating. With grief, some of the cognitive symptoms fade away with time as you adjust to the new reality that you loved one is not coming back. However, with depression, those cognitive changes may last for a while.

Grief is a natural response to losing someone or something important to you.

When you lose someone about whom you cared, you often get strong feelings of confusion, sorrow, anger, guilt, and longing. Grief can also come from other significant life changes such as the end of a relationship, suddenly becoming disabled or seriously injured, or losing a job. When you’re grieving, you may notice that the intensity of your emotions tends to fluctuate or change. At times you might feel okay, but other times you long for the deceased and it’s awful. You might experience waves of pain or pangs of sadness triggered by reminders of the loss.

Most people who experience grief do not have the negative symptoms for a long time. Grief is a natural process that unfolds over time and varies in duration for each person. While acute grief can be intense and all-consuming, it typically diminishes gradually over months or years as you adjust to the loss and finds ways to adapt to life without the person or thing you lost.

Acute grief versus Prolonged Grief Disorder (PGD)

However, there is a new diagnosis, Prolonged Grief Disorder (PGD), that recognizes the heart-wrenching experience of the 10 to 20% of people who get stuck emotionally in the negative feelings from grief. If you have PGD, you experience an intense longing or yearning for the person you lost, you are preoccupied with the death and the circumstances surrounding the death, and paradoxically, you might also avoid reminders of the person you lost or the death.

Sometimes you refuse to acknowledge the reality of the loss because it's too intense to bear. It might be hard to want to go on living without the deceased person. For this reason, you may have a hard time adjusting to going back to everyday life. You might also have intense emotional pain, or numbness, in response to the death. This kind of grief needs therapeutic intervention, and I am experienced in providing therapy for traumatic and complicated grief.

Depression versus grief.

Depression is a mental disorder that is more global than grief and lasts longer. By contrast, clinical depression is a mental health disorder characterized by persistent feelings of sadness, emptiness, and hopelessness. Sometimes it arises when you lose someone important to you, but often it is not be tied to a specific loss. Depressive disorders can arise without an apparent trigger.

If you have depression, you usually experience a general sense of unhappiness, loss of interest or pleasure in activities you once enjoyed (called anhedonia), and your appetite and sleep become disturbed. You might also feel of worthlessness or excessive guilt, and had difficulty with concentration, memory, and decision-making.

Depression, when not connected to grief, is characterized by a persistent and pervasive low mood that lasts for at least two weeks or more. It often lingers even without a specific triggering event. Depression can last for months or even years if left untreated. When your low mood is not temporary and situational, it can become a more persistent mood state and interfere with daily functioning, relationships, and self-esteem.

Grief doesn’t usually influence your self-perception or worldview, but depression does.

If you experience grief, you usually maintain a realistic self-perception and a coherent view of the world. Although you may struggle with feelings of sadness and loss, you can still find joy and meaning in other aspects of life. People struggling with grief may have a temporary lapse in faith or search for the meaning of the loss, but usually they come to some resolution.

In contrast, depression can profoundly affect a your self-perception and worldview. If you have depression, you often have a negative self-image, feel excessive guilt or worthlessness, and may have a pessimistic outlook on life. You may struggle to experience pleasure (aka anhedonia) or find meaning in activities that once brought them joy.

Treatment approaches differ for depression and acute grief.

If you’re experiencing grief, it can feel better to get support. You don’t necessarily need clinical intervention, but individual or group counseling for grief can help you get through this difficult time. Good self-care can also help you get back into the flow of every day life. This can include self-help programs or talking to friends who understand what you’re going through.

Depression, on the other hand, usually requires professional treatment, even if it’s brief. Learning how to think differently and cope with the negative emotions is important to prevent worsening of symptoms and to help you avoid relapse. Sometimes you might need to consider psychiatric medication, but not always. Talk therapies like Cognitive Behavioral Therapy (CBT), Solution-Focused Brief Therapy, or psychodynamic therapy can be useful in addressing depression. Lifestyle changes like improving your diet and increasing cardiovascular exercise are also very important to achieving wellness.

While grief and depression are distinct experiences, it's important to note that grief can sometimes lead to or coexist with depression. If grief symptoms persist, intensify, or significantly impair daily functioning, it may be indicative of complicated grief or depression. In that case, you should be evaluated by a mental health professional for appropriate diagnosis and treatment. If you think you need help figuring out what’s going on for your mood and how to address it therapeutically, please call me at 661-233-6771.

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