INTRODUCTION
Do you feel an intense sadness that you can’t shake and then wonder if this is just grief or if it is maybe something more long-term such as depression? Grief and depression often overlap, and that sometimes makes it hard to know when what we are experiencing is a typical emotional reaction to an event, and when it is a mental health condition.
Grief is a natural response to loss. Depression can last for prolonged periods of time, and may interfere with normal daily life in major ways. It is important to understand where grief ends and depression begins so that you can receive help if you need it.
In this blog, we will look at the overlap between grief and depression and effective treatment options that will help guide you to hope and emotional balance.
Understanding the Nature of Grief and Depression
What Is Grief?
Grief is a common and natural response to losing someone we have loved. Grieving is not a constant state, but a process. In most cases, the grief recedes, and individuals typically heal within a year after a loss. In some cases, grieving individuals experience an extended grieving period.
- The extended grieving period, called prolonged grief disorder, is when an individual cannot progress from acute grief to a more integrated form of grieving.
- Acute grief presents as intense feelings of sadness that may include crying and in some cases not being able to sleep, and usually does not involve medical help.
- Prolonged grief disorder involves intense, and often painful emotions, and an inability to adapt to the loss, for a prolonged time (beyond one year in adults and six months in children or adolescents).
- It is estimated that 7% of people experiencing the loss of some who had loved experience the grief disorder.
- Grief is an individual process that is unpredictable. Elisabeth Kübler-Ross described grieving as often including five identifiable stages; denial, anger, bargaining, depression, and acceptance.
Grieving individuals do not always experience each stage nor follow a particular sequence.
What Is Depression?
Depression, clinically referred to as Major Depressive Disorder, is a serious mental illness characterized by pervasive feelings of sadness, hopelessness and a loss of enjoyment or interest in activities that were previously pleasurable.
- Unlike grief, which is usually a reaction to something specific that has happened or something that was lost, depression can emerge in a person without any specific trigger, and tends to affect all aspects of a person’s emotional and physical health.
- It commonly manifests in symptoms such as a general state of sadness or emotional numbness, a significant change in appetite or weight, sleep issues, fatigue, issues with concentration, and feeling worthless or excessively guilty.
- People with major depressive disorder in more serious circumstances may also experience thoughts of death or suicide.
- Since depression can be a persistent and debilitating diagnosis that can greatly impair day-to-day ability, it requires a professional diagnosis and treatment for effective management.
When Grief Becomes Complicated - Prolonged Grief Disorder
Prolonged Grief Disorder (PGD) is the most recent classification in the Diagnostic and Statistical Manual of Mental Disorders and is included in the text revision of DSM-5 (DSM-5-TR) published in March 2022.
PGD is defined as an intense longing for the deceased individual that lasts longer than 12 months. Other symptoms might be disruption of an individual’s identity, inability to come to terms with the death, emotional numbing, avoidance of reminders of the loss, and feelings of loneliness.
Grief and depression are closely related to PGD but PGD does not equal grief or depression and people that have PGD often also have both grief and depression. Most people that experience PGD require some type of directed treatment to help them move forward in life.
The Manual published by the American Psychiatric Association (APA) serves as the benchmark for diagnosing and the classifying mental health related disorders.
Grief vs. Depression: The Overlap and Difference
Grief and depression often can have overlapping emotional symptoms, this makes differentiating between grieving and depression more complicated.
- Depression and grieving can have both a deep sadness and periods of crying.
- Both can cause a desire to no longer eat or overeat, lack of sleep or sleeping too much, being withdrawn from social activities/participation, and being unable to concentrate.
- Grieving is often a normal process/reaction to loss, and usually improves over a period of time.
Grieving can become clinical depression if the grieving process does not improve after several months or if it develops feelings of hopelessness, worthlessness, includes thoughts of suicide and the emotional distress feels so pervasive that it has disrupted daily functioning.
Understanding when grieving has transitioned to depression can allow you to receive assistants and support where appropriate.
Key Difference
Grief and depression share some similarities, but they are different in important ways.
- Grief is an individualized reaction often connected to a specific loss, such as a loved one passing away, and the intensity of grief often decreases with time. Grief can also take weeks to months to emerge fully.
- Depression can occur without a cause or event to define the feeling and it often lasts at least two weeks or more. In regard to self-esteem, a person grieving will often still feel a sense of self-worth; a person with depression often feels worthless.
- Emotionally, grief comes and goes in waves and bursts defined by moments of intense sadness and periods of relief, while depression is more of a low-level constant.
- A person grieving can have periods of time where they are able to enjoy life, but a person with depression hardly experiences pleasure or interest.
Signs You May Need Help
If you’re experiencing grief and aren’t sure if it is developing into depression, there are specific signs to look out for.
- You may have trouble getting out of bed or completing day-to-day responsibilities.
- If the bad feeling of sadness and grief is not improving over time and you have no interest in activities you used to enjoy, that should be a cause for concern.
- Withdrawing from friends, family, or work, feeling helpless about the future, having thoughts of self-harm or suicide are serious warning signs.
- These symptoms indicate you should seek professional help and discuss your concerns with a mental health provider.
Treatment Option For Grief and Depression in NYC
In New York City, many treatment options are helpful to individuals suffering grief and depression.
- Individual psychotherapy is a common foundation, with Cognitive Behavioral Therapy (CBT) to help reframe negative thoughts, Complicated Grief Therapy (CGT) to address extended grief, and Interpersonal Therapy (IPT) to assist with grief caused by interpersonal relationship issues.
- Support groups are also helpful because group members recognize shared experiences and value connection with one another, reducing the feelings of isolation caused by grief.
- For patients who have moderate to severe depression, medications like SSRIs, SNRIs, or atypical antidepressants are prescribed based on good psychiatric management.
- In addition to psychotherapy and prescribed medications, lifestyle changes are also important for healing. Practicing sleep hygiene promotes regular sleep patterns. Maintaining a balanced diet is important to physical and mental wellbeing.
- Light exercise can positively stimulate behavior; when a routine is established returning one to life provides a healthy rhythm.
- Mindfulness practices like meditation help thwart overanxiety and provide space for calming emotions; and creative practices, such as journaling or art, induce positive emotional draining and regulation.
- Holistic therapies like acupuncture, massage, aromatherapy, and spiritual counselling may also provide comfort as adjunct treatment for patients undergoing times of grief and depression.
Final Thought
Grief and depression are certainly two different experiences and the two often overlap or intensify each other which may affect your overall emotional health.
- It’s important to be able to differentiate when you are moving from grief to depression so that you can seek help in a timely manner.
- There are many ways to cope and heal from grief and depression such as psychotherapy, medication, lifestyle changes, and complementary care.
- You can heal from grief; and you can heal from depression. Grief and Depression Therapy in New York provides therapeutic support that includes professional compassion and is tailored to meet individual needs.
If you are feeling sad, please do not hesitate to ask for help or to reach out for support. You are not alone, and with the right support, you can restore your emotional balance and return to an engaged and meaningful life.
Reference
- Schoo, C., Azhar, Y., Mughal, S., & Rout, P. (2025, April 12). Grief and prolonged grief disorder. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK507832/
- Grief. (2025, June 2). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/24787-grief
- Eisma, M. C. (2023). Prolonged grief disorder in ICD-11 and DSM-5-TR: Challenges and controversies. The Australian and New Zealand Journal of Psychiatry, 57(7), 944. https://doi.org/10.1177/00048674231154206
- Prolonged grief disorder. (n.d.). https://www.psychiatry.org/patients-families/prolonged-grief-disorder
- Simon, N. M. (2013). Treating Complicated Grief. JAMA, 310(4), 416. https://doi.org/10.1001/jama.2013.8614
- Komischke-Konnerup, K. B., O’Connor, M., Hoijtink, H., & Boelen, P. A. (2025). Cognitive-Behavioral Therapy for Complicated Grief Reactions: Treatment Protocol and Preliminary Findings From a Naturalistic Setting. Cognitive and Behavioral Practice, 32(1), 29-43. https://doi.org/10.1016/j.cbpra.2023.11.001
- Chadda, R., Rajhans, P., Hans, G., & Kumar, V. (2020). Interpersonal Psychotherapy for Patients with Mental Disorders. Indian Journal of Psychiatry, 62(8), 201. https://doi.org/10.4103/psychiatry.indianjpsychiatry_771_19
- Huang, Y., Hsu, L., Chao, P., Shang, H., Tsai, S., & Wu, C. W. (2020). Mindfulness‐based cognitive therapy on bereavement grief: Alterations of resting‐state network connectivity associate with changes of anxiety and mindfulness. Human Brain Mapping, 42(2), 510. https://doi.org/10.1002/hbm.25240
