It is hard to tell depression from grieving. Many people go through periods of sadness in response to stress, misfortune, and various personal afflictions.

Depression

It’s disheartening when our significant other or life spouse forgets an anniversary. It’s mildly disappointing when we get into an online relationship and discover that the hot guy (or girl) is neither hot nor even remotely interesting. Emotional upsets can range from a roommate eating all the chocolate ice cream, to a guy facing progressive baldness. For women, these crises can happen once a month – and no one but the sufferer gets to say which one is worse.

Given a little encouragement by a caring therapist, and some coping tools like willpower and optimism, most of us get past sadness, or depression in about three months. For some, who have gotten lost in their own “bad side” it could take years, but eventually sufferers find the tools they need to see the positive side of life and discover that even sorrow passes.

Clinical Depression

In clinical depression, feelings of sorrow, loss, and futility do not result from bad experiences but from a lack (or excess) of the chemicals the brain uses to keep us feeling normal.

Telling clinically depressed people that they will “get over it”, or suggesting that they should try to cheer up, or act more normal, simply doesn’t work, because brain chemistry – the most controlling part of the human body – doesn’t work.

Sometimes depression is the result of a physical condition like arthritis, cancer, diabetes, heart disease, HIV/AIDS, kidney disease, lupus, and multiple sclerosis (MS), and thyroid imbalances.

There are, in fact, almost 20 medical conditions that can result in depression, and only testing will rule them out. Depression can also result from some prescribed medicines and even vitamin deficiencies, but here again doctors and therapists must evaluate and test to make a determination.

When therapists and other mental health professionals can’t find a physical cause for depression, and it has gone on for more than three months with worsening symptoms, they may administer tests, either verbal or written, using the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) Depression Screening Test checklist, among others.

When It Is Just Grieving

When someone or something you love dies, or is lost to you, grieving is normal. Whether it is the death of your mother or your pet – or the loss of your job, a good friend, a romantic partner, or a personal goal (i.e., becoming a popular musician) – you may experience grief. Again, no one but your therapist gets to tell you how much or how long (or how deeply) you should grieve, because the loss of anything important to you is a cause for sorrow.

Symptoms of grief may include:

• Aches and pains
• Crying
• Extreme fatigue
• Headaches
• Heaviness or weakness
• Loss of sleep and appetite
• Sighing

You may also experience concern, anxiety, difficulty thinking clearly, restlessness, anger, frustration, or guilt. You may not want to go out in public, where once you loved a good shopping trip, a pickup basketball game, a visit to the zoo, or a party. You may even begin to question the meaning of life, the cause of death, and your long-held spiritual beliefs.

Age and emotional development can skew these reactions. Very young children, lacking language skills, may act out their sadness in ways that disturb or anger adults. Older children may feel they are responsible for a death or divorce. They may feel abandoned, and will be reluctant to let go of the person who cares for them. Other children may withdraw, putting physical, social or emotional detachment between themselves and the people they like, both at home and at school.

What Is Complicated Grief

These symptoms are all normal. However, thoughts of suicide – marked by preoccupation with death, giving away belongings, or dangerous behaviors that “invite” death – are not normal. The intervention of a therapist and/or doctor is essential, to prevent grief from becoming an actual condition known as “complicated grief”.

Dwan Reed, PhD, LCSW, DTM, of Tallae Counseling & Wellness Center is a therapist specializing in Depression Counseling in Houston TX.