A Word About Clinical Depression 

When grieving people feel sad we often say that they are depressed, but the sadness from grief is not the same as the sadness of depression because grief is not an illness. Grief is the emotional, psychological, physical and spiritual pain we feel when a person close to us dies. It is a normal human reaction that must be expressed because of our love and attachment to the deceased loved one. Sadness is an expected part of grief and it is a natural response following the loss.

Depression is a treatable illness and one of several common mood disorders marked by loss of interest or pleasure in living, decreased self-esteem, shame, feelings of hopelessness and despair. Many people suffering from depression cannot imagine ever feeling better. The mood disturbance in depression is pervasive and unremitting and any positive mood fluctuation is usually minor without treatment intervention.

Shame and guilt are common in depression. When they occur in grief they often involve feelings of not having done enough for the deceased before his or her death, or regret over things said and done while the person was alive. In depression, the feelings arise from a fundamental belief that one is wicked or worthless.

Persons who have experienced previous depressions are especially at risk for becoming depressed at times of profound loss. Treating a griever’s clinical depression is a balancing act because sadness is an appropriate, natural stage of loss and clinical depression is a disorder. As difficult as they are to endure, both sadness and depression slow us down and take us to deeper places that allow for healing.  

Major depression, however, has the potential to become a medical emergency with risk for suicide. For the most part, grievers do not want to kill themselves, but the threat of suicide from anyone must be taken seriously. To read more about suicide, please click Thoughts of Suicide During Grief.

In the United States, one in ten men and one in five women will suffer from depression at some point in their lives. Grief is universal to any person who experiences loss. Depression and grief share many features: sadness, tearfulness, anger, anxiety, loneliness, social withdrawal, forgetfulness, appetite and weight changes and poor sleep. 

Grievers can also lose interest or pleasure in living, and cannot imagine ever feeling better because life is unbearable; but the mood fluctuations come in waves washing over the griever and the dark moods respond to empathy, support, and most of all, the passage of time. Even in deep raw grief, moments of happy reminiscences are possible.

Grief, although intensely painful and sad, moves us towards learning how to live without our loved one in a forever-changed world. The reactive depression of prolonged grief, however, is a destructive "stuck place" that causes us even more pain because we cannot move forward.

Friends and family often react to sadness by avoidance or becoming eternal cheerleaders because most people cannot tolerate melancholia for extended periods of time. Please remember that you need to feel your sorrow in order to heal. Seek out those few who can sit with you without telling you to cheer up or get on with your life.

Grief has no timetable and no absolutes. Grief may be universal, but we all grieve in our own way. How bad do we have to feel before we seek outside help? There are moments in all our lives when we can benefit from professional counseling but only you can decide: How sad is sad?

Learn more about the differences between grief and clinical depression at:

GriefCounselor.org 

Are You Grieving or Depressed? By Beth Erickson, Ph.D.

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