Beyond Loss: Grief vs Major Depression

With aging comes the loss of those who mean the most to us. There is no way to prepare for it. We are ambushed and swept away into grief and suffering. After some period of time, we slowly, unevenly crawl back to shore and regain our footing in the world. We are wounded but find a way to carry on. But not always. Sometimes we are lost at sea and can’t make it back. What others see as severe grief is really major depression, a condition that time cannot make better. How do we know what’s normal grief and when we have taken a turn for the worse?

There is a difference if you look closely at how you are thinking and feeling. Grief and depression have different voices about where you are and where you are going:

Despite the pain, grief still feels connected to others who represent a lifeline to surviving the experience.
Depression feels like being an outcast in an indifferent world.

Grief feels “this too shall pass” and at some point things will get better.
Depression feels that bad times will never end.

Grief provokes an internal dialogue between hope and despair.
Depression ruminates between hopelessness and despair.

Grief is where you have to go on the path to getting better.
Depression is emotional quicksand that won’t let go.

Ronald Pies, MD has developed a “screening instrument” to help patients sort this out called PBPI (see below). There are no right or wrong answers, just clues to how you are thinking and feeling and when it might be time to call in mental health reinforcements.