Are not the same. I remember a client once saying that she had broken up a longstanding relationship and her parents were worried about her becoming depressed. She was, in fact, on antidepressant medication and had been having problems. However in this case, she told them, “I’m not depressed, I’m sad.” It makes sense, doesn’t it? On the other hand, just because you’re sad doesn’t mean you’re not depressed, and vice versa.
In one of the first professional trainings that I attended as a peer counselor, the psychiatrist who was presenting on the subject of co-occurring substance use disorders and other mental disorders repeated several times, “Just because you have one problem doesn’t mean you don’t have another.” This applies just as much to the combination of grief and depression. It is potentially even more applicable because of the existence of complicated grief. A great discussion of all these can be found here.
For me, one of the key points is that grief is not typically associated with feeling like a personally flawed or failed person. Depression, however, often includes such feelings. When I grieve the loss of a loved one, one of the things that I am aware of is that the person had endearing characteristics which I recall fondly, albeit with grief for the loss. Depression rarely includes such positives. Likewise, in grief I am aware that my period of grieving is a tunnel which can have an end, whereas depression is more likely to feel endless.
One of the most memorable things from my training as a therapist was a statement about grief made by a seventy year old professor in a class about what normal humanity looks like. As an older student, I had already experienced some of the normal grief and loss of life, including my grandparents and many friends in the AIDS epidemic. Some of the younger students apparently had not, and one asked the professor, “When you lose a family member, how long does it take to get over it?” The professor answered in a heartbeat: “You don’t get over it, you get used to it.” This is a key thing about grief: we never wish to forget about the loss of a loved one, and the sadness of that loss will always be with us. But we become, in the course of normal grief, reconciled to the loss. In complicated grief, we are having difficulty, sometimes extreme difficulty, in becoming reconciled to the loss. The sadness of it overwhelms the ability to recall fondly the good things about the lost loved one. In depression, there is no positive aspect, no way of becoming reconciled with the suffering, and typically no rational reason for the suffering.
In the article for which I included a link earlier, the idea of “proper sorrows” is included. Life will always bring us sorrow and loss. For some of us, it may bring depression, either separately or together with losses. For some, sorrow and loss can segue into depression. Complications like this are some of the reasons why consultation with a therapist may be a good idea. At the same time, it behooves therapists to be very alert that we do not label normal problems of life as mental disorders.
Top image: Owens Valley from the approach to Shepherd Pass
Bottom image: Pacific coast looking north near San Gregorio