Depression or Grieving? Same symptoms – different treatment

Cathy came for counselling stating that she was feeling depressed. She described feeling sad, unmotivated, sleeping excessively as well as irritable and grouchy. She wondered if she might be clinically depressed and reported that her mother had struggled with depression. During the first session as information was being gathered about her current situation and her previous experiences, it was discovered that she had recently received her final divorce papers a month ago after a 15 year marriage and last Wednesday was the 1st anniversary of her brother’s death from an automobile accident.

As these issues were explored, it became clear that Cathy’s feelings were primarily due to a natural grieving process as a result of her recent losses, rather than a clinical depression. Once Cathy became aware of how these losses had actually impacted her and worked through the process of grieving, she was able to reinvest her energy back into other areas of life. At the end of therapy she stated that it was helpful to distinguish between grieving and depression and to realize her feelings were a natural response to her losses.

Many people that feel sad and “depressed” are not necessarily experiencing a clinical depression, but are grieving a loss. Grieving is more obvious when it involves the death of someone you are close to, however, there are many other types of losses that may lead to a grief response that people may overlook (e.g., separation, children leaving home, losing a job, retirement, etc.). There are also “happy” occasions such as marriage or the birth of a child which might lead to mixed feelings and a person may experience grieving the loss of such things as their “freedom” and have fears related to responsibility and financial security.

It is important to identify if the feelings are due to grief or depression because the treatment is different. Grieving is a natural and normal human reaction to loss and everyone will experience it at some point in their lives. The feelings associated with grief (e.g., sadness, anger, numbness, etc.) should be allowed expression and not repressed, inhibited, minimized or denied. If a person is able to accept the reality of the loss, adjust to the new environment, work through the feelings of the loss and reinvest energy back into other areas of their life, the feelings of grief usually subside or are eliminated. Clinical depression is often related to maladaptive thought processes and coping styles and may require different psychological or pharmacological interventions. If you are experiencing feelings of “depression”, it may be helpful to explore if there are any recent losses, especially losses that are not that obvious. If you would like assistance in determining the difference between grief and depression and help in working through these very common experiences, contact a psychologist to begin the therapy process.

by Martin A. Phillips-Hing, Ph.D. (2004)