When Your Depression Symptoms Are Grief

By: Kim Hanlon & Ilana Shapiro Yahdav

Depression... or Grief? 

May is Mental Health Awareness Month. While there are many facets of mental health, we want to focus on how grief, often conflated with depression, and mental health can be - and are - intertwined. We believe strongly that one of the most powerful tools is that of awareness and knowledge. Understanding what grief is, and what depression is, can have a big impact on mental health. Our goal is to shed light on how much of our mental health is tied to grief so that as many as possible can start to utilize that tool and take a step toward healing.

Depression and grief can look - and even feel - very similar. Surprisingly, grief is often left out of mental health conversations. It’s that “thing” that everyone experiences, everyone knows that it exists, yet it often doesn’t get a seat at the table.

This is partly because grief can be an uncomfortable or even taboo topic, but it is also because:

• Our definitions are inadequate - looking at too limiting a view of grief, and not accounting for the diverse sources and multitude of layers. Grief is cumulative and cumulatively negative. We can have a full toolkit for navigating death, but it is another thing to a) use those tools, and to b) suffer by not knowing that some of those tools also apply to other life changes such as a career change.
  
  • For example, when Kim’s brother died there was no question that she was grieving. However, when she left one career to finish graduate studies in the process of beginning a new career, not many would have assigned that word “grief” to her experience. Yet, indeed, she grieved her community she left behind, the security of a stable paycheck, the tension she felt not contributing to the family income, and the changes in her routine.
• We really do lack tools for navigating loss. We are not taught how to feel our feelings or process our emotions so it’s no wonder that a lot of grief and depression goes undiagnosed. Just as we are taught basic first aid in school, we should be taught basic mental health first aid as well.
  
  • Heck, Kim’s cousins in Croatia shared that they had never heard of a grief counselor and that they didn’t even have the same concept of grief, or tuga, outside of the death of a loved one. Even if we have the words, much of what we are taught are ways to either “look at the bright side”, “count our blessings” or to find a way to distract or numb ourselves via retail therapy, binge-watching shows, work, or devoting ourselves to a related cause.
• Inadequate Professional Grief Training. The first professionals we may think to go to once we work up the courage or energy after loss - usually doctors or a therapist - frequently, unfortunately, do not have adequate training to support people in grief.

What is Depression?

Why is it that grief is often misdiagnosed as depression? It stems from the fact that the way grief is often defined is not complete. Let’s look at how the World Health Organization (WHO), Mayo Clinic, DSM V, American Psychological Association, define grief and depression: (Note: there are many different ways that grief and depression are defined. We simply choose these because they are from well-known, well-respected entities.)

When reviewing the similarities in how grief and depression are defined, it’s no wonder why it can often be misdiagnosed. There are so many small nuances and both can look similar. To top it off, many practitioners are not grief-informed and would not catch that what they see as depression is actually grief (or sometimes both). This further illustrates how when we define something inaccurately, it leads to the wrong solutions being recommended.

Imagine that you have a broken leg. Odds are, you’d go to the doctor to get it x-rayed, reset, and have a cast put on. Imagine though, that the doctor only put on a cast, but did not reset the bone. Your leg would ‘heal’ but it may not heal properly which would result in more pain and issues down the road. Or, say you didn’t go to the doctor and bought an over-the-counter boot, you’d likely be in continuous pain that may only get worse. 

When a grieving individual is diagnosed with depression, this can be likened to putting on the cast without resetting the bone. While depression treatment can help grief, it is NOT always getting to the root of the issue fully. Medication and therapy can be helpful, but if the practitioner is not trained in grief support, and the grief is not addressed as grief, it can often delay healing, or not help healing at all. 

This breaks our hearts because we know how helpless we felt in the depths of our own painful losses, and we do not wish that for others. So many feel lost, broken, or even scared by their depression after a loss. And knowing that this is common in grief, that it can even be a normal and natural aspect of grief - can help. That said, someone also needs some hope to hold on to, that these overwhelming feelings are not a life sentence - and we are so grateful to share that hope with others as we help them see that there is a way to move through grief and begin to heal our hearts. 

What can help:

• Naming it. Knowing that what you're experiencing is called grief and that it is normal and natural is very powerful. 
• Building Awareness: Expanding your understanding of what grief is and building awareness to what components of your grief symptoms are actually due to grief.
• We define grief as the normal and natural reaction to a loss of any kind and the conflicting feelings about the end of or change of any familiar pattern or behavior (The Grief Recovery Institute). Note how there is no timeline in this definition.
• Ask yourself/journal about: 
  • When did the symptoms start? Do you have a history of depression or did you notice it more after your loss?
    • Some clients feel grief for themselves after a noted change in their personality, especially if they previously thought of themselves as an optimistic, happy person, and now hardly recognize themselves. 
  • What are your symptoms?
• • Fatigue? Changes to your appetite? Difficulty sleeping? Withdrawal?
  • What feels like it could be helpful?
  • Meditation? Therapy? Medication? Exercise? A regular coffee date with a friend? A meal train? Journaling each morning?
  • If you do an Emotional Inventory^TM (EI), do you feel validated or do you feel you have more insight into your depression and grief? Download your EI guide here 
• Hope - this is essential. And hope can come from knowing there are tools and naming what your experience is. 
  • Develop your toolkit - with our Grief & Gratitude workbook and upcoming course.

Depression is More Than “The Blues”

One thing is clearly the same with depression and grief. As The Mayo Clinic said in their definition of depression: “It is more than just a bout of the blues, depression isn't a weakness and you can't simply ‘snap out’ of it.” Both depression and grief take compassion, support, reflection, and allowing ourselves to feel our feelings. Neither have to be experienced alone and we encourage you to seek support and find what works for you.