Grief or depression? How to tell the difference

Grief and depression can both bring deep sadness, tears, trouble sleeping, changes in appetite, exhaustion, difficulty concentrating and a pull to withdraw from other people. Both can make ordinary tasks feel enormous. Because of this overlap, grieving people sometimes worry that something is wrong with them, and people with depression sometimes do not realize that is what they are experiencing.

Grief is a natural response to losing someone or something you love. As I often say, grief is not a disease. Grief is a sign of life and love.

Grief tends to come in waves. You may feel almost ordinary for an hour and then be flooded by a memory, a song or an empty chair. The pain is usually tied to the loss itself: the person, the animal, the relationship, the life you had. Even in deep grief, many people can still feel moments of warmth, laughter and connection, especially when remembering the one they lost.

In grief, your basic sense of your own worth usually stays intact. You may feel guilt about specific things you did or did not do, but you do not generally feel that you are worthless.

Depression is more likely to feel constant and pervasive: a flatness or heaviness that colors everything rather than coming and going in waves. Things that once brought pleasure may stop bringing any, even things unrelated to the loss. Many people describe feeling empty or numb rather than sad.

Depression often brings a harsh inner critic: a sense of being worthless, a burden, or fundamentally flawed. The future can look hopeless, not only because of the loss but in general. These features point toward depression rather than grief alone.

Grief and depression can occur together. A loss can trigger depression, especially if you have experienced depression before, if the loss was sudden or traumatic, or if you are also facing other stresses such as caregiving, financial strain or isolation. Grief that has had no room to be expressed can also settle into something that looks like depression over time.

It is not always important to label what you are feeling precisely. What matters is whether you are getting the support you need.

Consider talking with a therapist if:

If you are having thoughts of ending your life or harming yourself, please reach out right away. Call or text 988 to reach the Suicide and Crisis Lifeline, available around the clock, or call 911. You do not need to be sure it is serious enough. Reaching out is always the right call.

In therapy, grief is given room to be expressed, embraced and transformed, rather than pushed away. Depression is met with patient work on the patterns that keep it in place, along with care for daily rhythms, the body and connection with others. When both are present, we tend to both. The aim, in either case, is not only relief. It is the gradual return of peace, joy, purpose and a sense of connection to your life.