The quick answer to that question is that it’s not necessarily an either/or answer. It is possible to have grief and major depression at the same time. Grief and depression share many symptoms, making it even more challenging to identify which is the issue.
A psychiatrist I know has described depression as sadness without an underlying loss. That is, you are sad, down, lacking joy, etc. but you cannot point to a specific reason for it. Grief, in contrast, has a specific cause that is the loss of something or someone. For example, the loss of independence when it’s time to quit driving may be a source of grief. The end of a relationship and the death of a loved one are other common causes of grief. Grief is a normal and natural event.
As mentioned earlier, depression can be described as sadness without a loss or identifiable cause. Depression also tends to be isolating. Whereas people struggling with depression tend to withdraw from interacting with others, a person who is grieving often finds comfort in turning to friends and family for support. Another clue is to look at the focus. A grieving person will be sad about how the loss affects them, but they will also be focused on the person who died (in the case of a death); a depressed person tends to focus inwardly, on themselves. A person who is grieving is able to feel a range of emotions. For example, at a visitation, people may share funny stories about their loved one and laugh with the recollections. A depressed person’s range of emotions is often restricted and even very “flat.” A look at how the person feels about himself or herself can offer another clue. In depression, self-esteem is often low and the person often feels worthless and experiences self-loathing. In grief, a person’s self-esteem is generally unaffected.
With severe depression, suicidal thoughts are common and extremely worrisome. Thoughts of death are not uncommon with grief, as well, but they are a different quality of thought. In grief, the thoughts of death are often focused on the desire to be reunited with a deceased loved one. In depression, however, thoughts of death are focused on escaping the mental pain of depression. Please do not ignore it if you or someone you know is having suicidal thoughts, particularly thoughts involving a plan for how to kill oneself. Not all suicidal thoughts will require hospitalization, but all such thoughts need to be investigated by a mental health professional so that the thoughts that do merit hospitalization get immediate and proper treatment.
As a board-certified counselor who specializes in grief and depression, I invite you to call me at (816) 226-4678. I am happy to talk with you by phone for 15 minutes and answer questions you may have before setting up an appointment.
The national suicide prevention hotline is 1-800-273-8255. En Espanol, 1-888-628-9454. For the deaf or hearing impaired, call 1-800-799-4889. Or to chat with the national suicide prevention hotline, visit https://suicidepreventionlifeline.org/chat/
For support by text, text HOME to 741741.