When does grief turn into depression?
“GRIEF IS NOT TO BE SOLVED; GRIEF IS TO BE FELT AND EXPERIENCED.”
By Jackie Menjivar
(K. Mitch Hodge / Unsplash)
Most of us have experienced grief at some point in our lives. And especially within the last few years, amid a global pandemic, it’s become a more visible part of our world. A lot of people lost loved ones, missed milestones, and had to come to terms with a tremendous amount of change and loss.
We grieve because these things matter to us. And while grief is a totally natural response, sometimes it’s hard to tell when it crosses a line into something deeper. Is there such a thing as a “normal” amount of grief? And when does grief become depression? Here are some things to think about.
What’s the difference between grief and depression?
Grief is a response to loss — whether that’s the loss of a person, thing, idea, or expectation. You can mourn the death of a loved one, the loss of a home, or a failed relationship.
Grief looks different for everyone, but there are some common responses. You might feel anger, sadness, yearning, guilt, confusion, or denial. It’s also common to have physical symptoms too, like frequent crying, loss of energy, and trouble sleeping and eating.
Sometimes a grief response can look a lot like depression. Both impact your mood, energy, motivation, and physical health. Grief can even cause feelings of hopelessness and thoughts about suicide. So how can you tell the difference between the two? Look for the source of your distress.
“Where does your sadness come from? If you can identify an answer and that answer is tied to missing somebody or something or a change in your life, to me, that goes back to situational depression or grief-related depression,” says Theresa Nguyen, licensed clinical social worker and VP of Policy and Programs at Mental Health America. “But if you say, ‘I don't know. I can't identify a life circumstance that makes me feel sad,’ that may signify clinical depression.”
Are your symptoms triggered by reminders of your loss? Do they lessen over time? Depression doesn’t have a source, and it’s a persistent condition that doesn’t come and go.
Are you able to feel pleasure sometimes (like when you’re comforted by family and friends)? Depression makes it hard to feel pleasure in any situation. If you can find those moments of relief easily, it’s more likely to be grief.
Are your thoughts focused on your loss or on yourself? Do your thoughts about suicide relate to wanting to be with your lost loved one or not wanting to live without them? People with depression often experience a sense of worthlessness, self-loathing, and insecurity with themselves, and that isn’t the case with grief.
That being said, when it comes to your mental health, labels only matter if you find them helpful. Your situation may not fit perfectly into a diagnosis, and that’s okay. You may even choose to avoid a label altogether. If you’re feeling distressed and having trouble functioning, you can address those symptoms without labeling it anything in particular. And if you do identify with a label and find it helpful to communicate your situation, go for it! There are no right or wrong answers here.
“The word 'depression' is most important for treatment purposes. If you're dealing with grief, you can get treatment for grief. You can also get treatment for clinical depression. You're just going to label it what you need and talk to your provider,” says Theresa. “All labels are personal. What label feels right for you is something that we all have to negotiate when we're managing our complex chronic diseases, especially in mental health.”
How long should grief last?
We can’t stress this enough: there is no timeline for grief. You may end up grieving in one way or another for the rest of your life. A better framing would consider how well you can integrate your grief into your daily life.
“There are a lot of cultures that are more true to the way we understand grief. Grief doesn't ever end. So much of the words that we use around grief puts an onus of shame and responsibility on the griever to move on,” says Theresa. “You experienced an enormous loss. You may never move on. But does it feel better for you? Does it feel okay? Do you feel less sad?”
You can remember and honor your loss (and, yes, even continue to feel pain around it), while moving forward with your life. It becomes a part of you that never goes away, but it’s manageable.
So what if it’s not manageable? The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders offers a diagnosis of prolonged grief disorder. According to the DSM, if your grief is still intense, all-consuming, disruptive, and persistent a year or more after your loss, you may be experiencing prolonged grief disorder.
But again, labels like this aren’t perfect or even necessary. Your recovery should focus on treating yourself as a unique human being, not a diagnosis.
Can grief trigger depression?
Kind of. The thing about depression is that it doesn’t have a particular source; it’s just a constant state of being. But a traumatic or stressful event can definitely make it flare up and become more noticeable.
“Sometimes folks haven't acknowledged their depression, or they haven't recognized it in themselves yet,” says Theresa. “Grief can trigger a depressive episode that makes you realize that you've lived with this for longer.”
Are grief and depression treated differently?
One of the most common treatment options for depression is therapy, usually in the form of cognitive behavioral therapy (CBT). CBT is also helpful for treating grief, but there are other forms of therapy that may be more specifically tailored for it, including complicated grief therapy and bereavement support groups. It’s also more common to be prescribed medication to treat depression.
“The most important thing from a treatment perspective is having enough insight. If you’re going into therapy, and part of your recovery from depression is related to your grief, then bring it up. Talk to your provider about it, and find others who can help you walk through that path,” says Theresa. “The labels just give us deeper context to understand our minds and where our sadness or anxiety comes from.”
How can I manage my grief?
Acknowledge your pain. Your instinct might be to avoid thinking about your loss because it’s too painful. But while it may hurt, letting yourself feel those hard emotions will help you come to accept what’s happened and make sure that it doesn’t just bubble up to the surface later down the line. That also means finding a way to communicate your feelings, whether that’s talking it out, journaling about it, or expressing it through art.
Find a support system. Lean on your friends and family for support, and be communicative about what exactly you need from them. The people who love you will be eager to lend a listening ear, a shoulder to cry on, or just some extra company. You can also look outside your usual circle and find a support group to connect with folks going through the same thing.
Take care of yourself. Your thoughts may be with someone else, but it’s important not to forget about yourself, too. Keep up with your physical health to help your mental health — make sure you’re getting enough sleep, water, food, movement, and sunshine.
Honor your loss. You can incorporate your loss into your life and find meaning wherever you see fit. Build a shrine for your loved one, keep a sentimental object that reminds you of them, make a donation in their honor, or continue the activities or traditions you shared together. There is still a place in your life for them, even if they aren’t around physically.
Talk to a professional. You don’t have to navigate this path alone. Talk to your mental health provider (or your regular doctor if you don’t have one) to help you find treatment options.
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“Grief is not to be solved; grief is to be felt and experienced,” says Theresa. “It's a part of life, and the avoidance of loss and grief can cause a lot of suffering.”
If you think you may be experiencing symptoms of depression, a good place to start is by taking a free, online mental health screening to learn more and find help.