Grief and depression can feel very similar at times and even be similar in symptoms, but the deeper underlying workings of the two are very different. One of the reasons I think it’s important to distinguish between the two experiences is that while grief is a natural and productive emotional response to loss, depression tends to be a condition that requires treatment. And if there is a history of depression or a tendency towards depression, a loss and the natural grief response can trigger a depressive episode. So it can get complicated.
What is grief?
Grief is a natural emotional process that occurs in response to significant loss. It is healthy and very adaptive to grieve. Grieving allows for processing a loss, for moving through it, and for reintegrating one’s life. You can’t move forward without going through a process of grief. Things only become stuck when people don’t allow themselves to grieve and instead suppress those very natural feelings (or in cases of complicated grief, which will be covered in another post). The feelings themselves can be varied and include sadness, anger, outrage, and fear. They can even include very painful feelings typically associated with depression such as despair, hopelessness, and feeling the desire to die. In this way, grief on the surface can look like depression.
People who are grieving, like those who are depressed, may have difficulty functioning. They may have trouble getting out of bed, or cannot get motivated to go to work or take care of themselves or their families, or can barely get the groceries or have no appetite to eat. Sleeping a lot or being unable to sleep are common in both grieving and depressed individuals.
But grief dissipates when the feelings are allowed to flow through and there is room for integration of the loss. Crying often leads to some relief, even if there is another wave of grief around the corner. There is movement that allows for new life to eventually flow in when grief is not suppressed. Again, the exception to this may be when there is complicated grief. In normal grief, however, space opens up to breathe again and to recreate life.
Depression, on the other hand?
As you can see, depressive symptoms can look like grief and there can be a decrease in functioning in both experiences. But I consider depression a more serious condition that is not the natural state of things. Although many people experience depression in their lives, depression is never a natural or adaptive response to life. Depression doesn’t usually just resolve when allowed to run its course. If we take a deeper look at depression beneath the symptoms, what we might find is it is a habitual way of relating to oneself and the world that is not adaptive. Depression isn’t just about the loss of something or someone external; it is often rooted in a painful belief about the self as bad or inadequate. People who struggle with depression often feel less than or unworthy. This is usually not the case in grief, even when there are feelings of guilt or regret about what could have been done differently.
Another core habitual issue involved with depression is a maladaptive tendency to turn anger towards oneself in the form of self-criticism and self-judgment rather than allowing anger to appropriately flow outwards into the world. Self-esteem is affected and criticism is leveled against oneself.
When should I consider treatment?
Because depression constricts the flow of life energy and negatively affects the capacity to live and function well, it is always a good idea to seek treatment for depression. Life can improve dramatically with therapy for depression. Individual and group therapy, especially in combination, are effective in treating chronic depression.
Grief does not always require treatment. Most people move through grief very well with the support of family and friends, even a very difficult loss. It is like a wound that heals without medical attention. It is when that wound becomes infected or there are complications that treatment is needed. Complicated grief is such an instance when treatment is highly recommended. If anything impedes you from moving through a loss and allowing the natural process of grief to occur, perhaps because you have learned to suppress strong feelings or you struggle with maladaptive thoughts, seeking help to work through your grief is important so you can move forward and heal well.