Johns Hopkins Health Alerts | Depression and Anxiety | Is it Normal Grief or Depression

• A good sign that grieving is successful is a shift to positive and realistic plans for the future.

The loss of a loved one can cause intense mental anguish. Occasionally, this anguish triggers a major depressive episode, but few people in mourning experience true clinical depression.

Grieving may produce a wide range of feelings. The grieving process is considered successful when it permits the mind to adjust to the acute sorrow of a loss. The end of the grieving process is not marked by an end of sadness—deep sadness over a death may last a lifetime. Instead, it is indicated by the griever’s acceptance of the loss.

A good sign that grieving is successful is a shift to positive and realistic plans for the future. As this shift occurs, and the mourner enjoys life more than feeling weighed down by it, the work of grieving proceeds.

The sadness of grief usually comes in “waves,” with varying degrees of intensity. In contrast, the sadness of major depression is persistent or varies by time of day. Grieving may have been unsuccessful and require the help of a physician or other health professional if the following symptoms are present for a prolonged period or if they arise months or even years after the loss:

• physical symptoms that mimic the illness or injury of the person who died
• overuse of alcohol, illicit drugs, or prescription medications
• persistent signs of major depression, which include loss of interest in everyday activities formerly enjoyed, noticeable changes in appetite and weight, decreased energy and/or sexual drive, inability to concentrate, feelings of worthlessness, and helplessness
• chronic sleep difficulties
• thoughts of or attempts at suicide (a health professional should be seen immediately if this occurs)
• an inability to carry out normal daily routines

It is important to seek medical help for physical symptoms that arise during grieving and to attend to conditions that existed prior to the loss. Some evidence suggests that acute grieving may suppress the immune system and make people more susceptible to illness.

Johns Hopkins Health Alerts | Depression and Anxiety | Is it Normal Grief or Depression