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The Difference between Grief and Depression: How Are They Related?
Erika Krull, MSEd, LMHP
Grief can hit hard, especially in the early moments of dealing with a loss. Your emotions can become so overwhelming that you might wonder if the sadness will ever go away. Depression can feel this way, too, and it helps to know the difference between grief and depression as you cope with your loss.
Grief can be uncomfortable, but in most cases you adjust to your loss and start feeling better over time. If you're still struggling for months, your grief may have developed into depression. While this may prolong your grief for a while, depression treatment can help. Here, we'll look at what a typical course of grief looks like, how it compares to depression, and some effective treatment options to consider.
What Typical Grief Looks Like
A
typical grief experience includes several phases of emotion, each one showing a different way of coping with loss. These phases can include denial, anger, barganing, sadness, and acceptance. It's common to go through these phases in any order and often with phases occurring more than once.
Grief reactions come in waves with periods of adjustment in between. One week may seem calm, while the next could be full of emotional turmoil. Riding the ups and downs can be overwhelming at times, but these reactions are normal.
Your grief experience may follow some patterns, but your reaction to any particular loss is unique. Relationships, age, and life circumstances all play a part in how grief affects you and for how long. For most people, the first few weeks can be the hardest.
As the initial shock wears off, people start taking small steps back into their normal routines. Ups and downs are normal, but many people get engaged in their lives again after several months. Supportive relationships can help a grieving person find their new normal.
When Grief Turns into Depression
For some the grief can take a different direction. Grief can become depression when some of these symptoms linger or intensify:
- Sadness
- Loneliness and persistent longing
- Isolation
- Difficulty accepting a new reality
- Numbness
- Loss of meaning or purpose in life
Grief and depression share many symptoms and expressions. However, there are several ways to tell the difference between grief and depression. The difference often comes down to the duration and focus of symptoms. For example:
- In Depression, symptoms can persist nearly all the time, while grief can come and go or you can predict when you may be feeling lower than usual, such as around your loved one's birthday or during the holidays.
- Depression is often associated with feelings of worthlessness, while grief usually preserves self-worth.
- Depression can cause someone to be inconsolable and isolate, while someone who is grieving usually accepts support from family and friends.
- Suicidal thoughts are more commonly associated with depression than in grief.
There is substantial overlap between grief and depression. Previous distinctions between the two have been updated and no longer are considered mutually exclusive. If someone meets criteria for depression while dealing with a loss, the diagnosis of depression and treatment should be strongly considered.
One study of bereaved caregivers found that after about six months, up to a third of those experiencing grief met the criteria for major depression. A year after a loss, about one out of every four still had symptoms of depression. Whether you're experiencing grief or depression, it's important to get the care you need to start feeling better again.
Depression: Getting the Treatment You Need
Depression is common, but it can be harmful and may not resolve on its own. Whether depression is influenced by grief or develops for other reasons, it's a condition that requires treatment. Antidepressants and counseling therapy are the two most common treatments for depression. Each treatment can be used on its own, but they are most effective when used together.
If you are among the 30 percent of people who try antidepressants but don't feel better, you may be looking for other options. Transcranial Magnetic Stimulation (TMS) is a non-medication therapy that targets specific areas of the brain to reduce depression symptoms. A magnetic coil is placed near your skull to deliver brief pulses. These pulses are focused on areas of the brain that regulate mood. If you're still looking for relief after trying other treatments, TMS could be an effective option for you.
Find a Way to Move Forward
Grief is difficult for everyone. But if you can't move forward and feel like you're sinking, your grief may have turned into depression. Antidepressants and counseling therapy may provide what you need to recover from depression. TMS is another effective treatment method to consider as well, and you can reach out to Greenbrook TMS for more information. Sadness is a natural reaction to loss, but depression is a treatable condition that isn't part of typical grief. Get the support you need to keep moving forward.
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You may feel isolated and alone when you have clinical depression, and depression also affects your relationships with family and friends. While the primary focus of your treatment is to improve your mental health, it’s also essential to understand your loved ones may experience their own issues as they try to support you. An understanding of how depression affects relationships can help everyone maintain healthy connections and navigate problems. Here are some of the ways depression may affect the people in your support network.
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Starting any medical treatment for the first time can leave you with questions, especially if you’re looking forward to the benefits it may bring. It’s no different when you’re preparing for your nasal esketamine treatment. Your previous mental health treatments may have consisted solely of taking antidepressants at home or visiting a therapist’s office for cognitive behavioral therapy (CBT), so nasal esketamine is probably a new treatment experience for you. If you're wondering what it's like to start nasal esketamine and get ready for your first session, keep reading. Getting Started with the Nasal Esketamine Treatment As with any new treatment, you’ll first talk to your primary care provider or psychiatrist about whether nasal esketamine is a good fit for you. Alternatively, you can schedule your esketamine nasal spray consultation with a treatment center (such as Greenbrook) that has certification by the FDA’s Risk Evaluation and Mitigation Strategy (REMS). At Greenbrook's REMS-certified nasal esketamine treatment centers, our Greenbrook-affiliated psychiatrists and psychiatric nurse practitioners will review your medical history and also conduct our own assessment to help determine whether nasal esketamine treatment is right for you. Certain conditions, including blood vessel disease and a history of psychosis, may make treatment a risk for you. Make sure you discuss all previous and present conditions with your doctor or nasal esketamine provider before beginning treatment. If the medication is deemed a good fit, you’ll receive your prescription from the Greenbrook-affiliated provider. Your Greenbrook Care Team will put together a personalized care plan for the weeks and months to follow. Keep in mind that you will need to take a standard (oral) antidepressant along with your nasal esketamine treatment. There are two important regulations to note when it comes to preparing for treatment: Each treatment is followed by a mandatory two-hour observation period. This means you will need to plan to stay at the center for at least two hours following your self-administration of the esketamine nasal spray. You cannot drive during the rest of the day after treatment and must arrange for transportation. These regulations are mandatory. It may be helpful to sit down and plan out several weeks’ worth of transportation once you know your treatment schedule. In addition, if you’re wondering what to bring for the treatment, we recommend entertainment such as an audiobook or playlist of favorite songs and a pair of headphones. You may want them during the two-hour observation period. What to Expect During Nasal Esketamine Treatment On the day of treatment, you’ll need to stop eating any food two hours before your appointment and stop drinking all fluids 30 minutes before you come in. Your Greenbrook Care Team will confirm that you are prepared for the two-hour observation period and that you have a ride home. You’ll get the opportunity to practice using a “trainer sprayer” that mimics the real nasal esketamine sprayer but does not release any medication. The Care Team will encourage you to use the restroom and set up your preferred environment in your private treatment bay or room. Some patients like reduced lighting, for example, while others don’t request light adjustments. You’ll complete a depression scale before each treatment session. Your Greenbrook provider will confirm that the dose kit is yours, show you how to administer it, and then hand it to you. Each sprayer contained 28mg of Spravato esketamine nasal spray. Patients usually start with two sprayers (56mg) and soon increase to 84mg (three sprayers) per treatment. But, your dosage maybe vary. Should you be left with a metallic taste by the spray, the Care Team will offer suckers to help make the flavor dissipate. After your dose, you’ll be encouraged to lie back in your comfortable recliner. While most patients enjoy a quiet setting, Greenbrook is prepared to accommodate patients with a more animated reaction to the medication. You may feel sleepy, dizzy, mildly dissociated, and/or nauseated during treatment. Greenbrook's Care Team is readily available if you need assistance. How to Prepare for after your Nasal Esketamine Treatment Most side effects begin to wane in the second hour of observation, but if you’re wondering, “Is it safe to drive immediately after nasal esketamine treatment?” the answer is a resounding no. In addition to the mandatory ride home, you will need to block off time to rest and let side effects fully dissipate. This extended rest period is especially important in the first weeks of treatment when you’ll have treatment twice a week. Do not drive or operate machinery of any kind until the day after treatment. Just take it easy, relax, and take care of yourself. If you’re unsure what activities you can do or should avoid during this time, talk to your Care Team for more information. While side effects tend to dissipate completely after a good night’s sleep, many nasal esketamine patients begin feeling relief from depression symptoms within hours of their treatment. Other Tips in Preparing for Your Nasal Esketamine Treatment At Greenbrook, we make every effort to schedule your treatment in the afternoons or whenever it is most convenient for you. We encourage you to see each treatment session as an opportunity to relax and take care of your mental health. If you have any questions or concerns, talk to your doctor or the Greenbrook Care Team. At Greenbrook, we’ll help you feel at ease when preparing for each treatment session. Schedule A Free Consultation To get started with nasal esketamine, schedule your free consultation today.
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