Depression and Grief

Are depression and grief the same thing?  There is a certain amount of confusion among people in general but also among clinicians when determining whether someone may be clinically depressed or grieving.  Although many of the symptoms are similar, it important to understand the differences because the goals of therapy are different and the way to achieve those goals, the direction of treatment is a vastly different path.   

When determining why a client is experiencing certain symptoms, it is essential that the clinician be able to assess the overall life history of the client.  Among the areas that help the clinician move forward is knowing the history of the person’s physical and mental health, personal relationships, family dynamics, history of trauma as well as a synopsis of the person’s relationship that he or she is grieving. These are just a few areas of concern that help determine what therapeutic approach will be most effective.  

 Another criteria a clinician uses to make the diagnosis is the client’s ability to perform daily tasks. According to Dr. Ronald Pies, M.D., Clinical Professor of Psychiatry, Tufts University School of Medicine, Boston, a person who is grieving is usually capable of completing ordinary daily tasks within 2 to 3 weeks of when the grieving period began. This is not usually the case in episodes of severe major depression, in which social and vocational functioning is markedly impaired for many weeks or months. Moreover, early morning awakening and pronounced weight loss are more common in major depression than in uncomplicated bereavement. Dr. Pies points out that for the person who is bereaved their inner world is one of loss and sadness but it is markedly different from that of a depressed person. In depression the sadness is intractable; in bereavement, the bereaved person usually experiences sadness in “waves,” triggered by a memory of the one who has died. The sadness is malleable and intermittent. Painful memories are often interspersed with positive recollections. Usually the bereaved person maintains self-esteem and an emotional connection to family and friends, whereas the severely depressed person will often isolate, feeling hopeless and worthless. There are several different therapeutic modalities commonly used to treat depression. In addition to talk therapy, your doctor may prescribe medications to help with symptoms of depression.

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Grief: A Simple Definition

Grief is the natural and normal reaction to a significant loss. 

Following a significant loss, we often refer to the period of intense sadness as “the grieving process”

Below are some points you might find helpful:  

• Grief is not linear, there is no set process. Grief often comes in waves and results in different emotional responses that ebb and flow
• Every loss, and the grief that follows is unique to the one experiencing it.
• The length of time, and the manner of grieving is personal, just like the loss itself.
• The only person who intimately knows the intricacies and depth of a lost relationship is the person doing the grieving.
• There is no definitive timeline for how long grief should last.
• However, it may be beneficial to consult a clinician if it feels like grief is not abating, after a period of time.
• There can be extenuating circumstances that complicate the grieving process, situations that may benefit from counseling.

Our grief is not always for the reason we think. There are times that a current loss situation will cause us to recall memories that trigger emotions from a past loss that hasn’t been fully resolved. Grief is personal, but it doesn’t have to be about a person, nor is it limited to a death. Loss can come in many different forms. 

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