Grief vs. Depression: Which Is It?

Grief and depression are similar emotional responses. That said, each is also a distinct experience. Understanding the differences in grief vs. depression is important for knowing how to best treat their symptoms.

Here we discuss what grief and depression are, as well as why it can be so hard to tell them apart. We then dive into the ways that depression and grief are different before exploring some of the treatment options for each—and both are treatable.

Defining Grief and Depression

The American Psychological Association (APA) defines grief as "the anguish experienced after significant loss, usually the death of a beloved person." Grief can also occur after losing a pet, a relationship, your job, your health, or anything else important to you.

Symptoms of grief often include separation anxiety, confusion, and obsessively living in the past. In severe cases, grief can even become life-threatening, whether by reducing immunity, making us more susceptible to illness or disease, or by leading to suicidal thoughts.

Depression is defined by the APA as "extreme sadness or despair that lasts more than days." In addition to making it harder to engage in one's typical daily activities, this mental health condition can show up in the body physically via pain, weight changes (gains or losses), sleep issues, and fatigue.

Depression also sometimes leads to cognitive issues. Someone diagnosed with depression may notice that they have trouble concentrating, for instance, or they might feel worthless, guilty, think about death, or have suicidal thoughts or behaviors.

Why It's Hard to Tell Depression From Grief

There are quite a few similarities between grief and depression. This can make it difficult to distinguish between the two.

One similarity is their cause. Grief is a result of loss and trauma. Someone we love or a pet passes away and we grieve because they are no longer with us. Or we lose our job or are diagnosed with a major physical illness and experience grief when thinking of how we've lost life as we know it.

The same is true with depression. Although this condition is often a result of several factors, including genetics and environment, it can also be instigated by trauma or loss. The breakup of a relationship can lead to depression, for example, as can losing one's feelings of safety and security after being victimized. This is referred to as situational depression.

There are symptom similarities as well. Someone who is grieving can experience several of the same physical and psychological responses as someone with depression, some of which include:

• Intense sadness
• Insomnia
• Irritability or anger
• Poor appetite
• Weight loss
  

Differences in Grief vs. Depression

Amidst their many similarities, there are also some clear differences in depression vs. grief. These differences exist in terms of how each is diagnosed, in addition to how they present (the way in which their symptoms appear).

Diagnostic Differences

The Diagnostic and Statistical Manual of Mental Disorders (DSM) outlines the criteria needed for a mental illness diagnosis. In the DSM-5, the latest edition of this manual, the "bereavement exclusion" was removed from the diagnosis of major depressive disorder (MDD).

Previously, this exclusion stated that during the first two months after the death of a loved one, a person with depression symptoms generally should not be diagnosed with MDD. However, the DSM-5 recognizes that while grief and MDD are distinct, they can also coexist. What's more, just as with other stressful experiences, grief can sometimes trigger a major depressive episode.

The DSM-5 text revision (DSM-5-TR) also added a new diagnosis for people experiencing extreme grief after one year of the death of a loved one. This newly added condition is referred to as prolonged grief disorder (PGD) and is considered a trauma and stress-related disorder.

PGD is marked by intense and distressing emotional pain and yearning for the lost loved one, preoccupation with the loss, disruption in one's sense of identity, emotional numbness, and avoidance of reminders of the loss. PGD symptoms are disruptive to a person's everyday functioning and ability to reintegrate into life.

Presentation Differences

Another difference in depression vs. grief is that grief tends to decrease over time and can occur in waves that are triggered by thoughts or reminders of the trauma or loss. Conversely, depression is more pervasive and persistent.

In other words, a grieving person may feel better in certain situations, such as when friends and family are around to support them. But triggers like the birthday of a deceased loved one or going to a wedding after having finalized a divorce could cause the grief to resurface.

Depression, on the other hand, tends to be present no matter the circumstances. (An exception to this is atypical depression, in which positive events can bring about an improvement in mood. A person with atypical depression also tends to exhibit symptoms that are the opposite of those commonly experienced with grief, such as sleeping excessively, eating more, and gaining weight.)

Additionally, grief usually causes a person to feel a longing for or an urge to see their lost loved one again while depression tends to result in the opposite. Someone with depression doesn't necessarily feel the urge to do anything or see anyone.

Treatment for Depression and Grief

Depression and grief are treatable. While the specific treatments recommended can vary based on a person's unique circumstances and symptom severity, they often consist of therapy, medication, or both.

Therapy

Psychotherapy, also sometimes referred to as "talk therapy," is a treatment option for both grief and depression. It works by helping us process what we are feeling while also teaching us effective coping skills.

Interpersonal psychotherapy (IPT) is a form of therapy often used for depression but has the potential for helping to treat complicated grief as well. IPT focuses on resolving symptoms, building relationships, and getting involved in mood-boosting activities.

For people with prolonged grief disorder, grief-specific cognitive behavioral therapy may be helpful. This approach uses similar techniques as cognitive behavioral therapy (CBT), like reframing negative thoughts and learning healthy coping mechanisms. It can also help us learn how to maintain a healthy attachment to loved ones we have lost.

Complicated grief therapy (CGT) is another option found to be effective after a loss, especially for individuals not taking an antidepressant. This form of grief counseling is made up of components of both CBT and IPT. In CGT sessions, you may repeat the story of how you lost your loved one and set personal goals for yourself and your relationships.

Medication

Antidepressants are a class of medications used to treat depression. A physician or psychiatrist might also prescribe an antidepressant for individuals experiencing extreme and disruptive symptoms of grief.

Common antidepressants include:

• Selective serotonin reuptake inhibitors (SSRIs): Brand names include Celexa (citalopram), Lexapro (escitalopram), and Prozac (fluoxetine).
• Selective norepinephrine reuptake inhibitors (SNRIs): Brand name SNRIs include Effexor (venlafaxine), Cymbalta (duloxetine), and Pristiq (desvenlafaxine).
• Tricyclic antidepressants: Common brand names are Elavil (amitriptyline), Tofranil (imipramine), and Pamelor (nortriptyline).

Social Support

Social support can be another powerful tool when coping with symptoms of depression or symptoms of grief. Many mental health professionals recommend attending a support group with people who are facing or have faced similar challenges.

Whether you find a support group for depression or a support group for grief, you may benefit from sharing your experiences with others, receiving their encouragement, and listening to their stories.

Getting Help for Grief or Depression

Whether you are experiencing grief vs. depression or depression vs. grief, a physician or mental health professional can help decide the best approach for treating your particular symptoms. Talk with them openly about how you feel, the severity of your symptoms, and how much they impact your life.

It's important to remember that grief is not a sign of weakness. Likewise, reaching out for help when you experience depression symptoms is a sign of strength and can help get you on the road to better mental health.