By Beth Erickson, Ph.D.

Grief is often misdiagnosed as depression.  Of course, if grief is misdiagnosed, it may not be treated properly, particularly if only medication is used to ease the symptoms.  Some studies have shown that psychotropic medications for people who are grieving may not be as effective on their own as they are when combined with “talk therapy.”   

Signs and Symptoms of Grief & Depression

The classic signs and symptoms of grief do mimic depression, so it is easy for the unsuspecting clinician to spot depressive symptoms and inquire no farther.  Then, unless patients bring up their loss, it is likely that they will be just be treated for depression and sent on their way.  They are then at risk for that loss to become chronic and unresolved. 

The following symptoms are markers similar to both grief and depression:

• Sleep disturbances (either insomnia or sleeping too much)
• Poor appetite or overeating
• Low energy or fatigue
• Low self-esteem
• Poor concentration and difficulty making decisions
• Feelings of hopelessness
• Emotions on a roller coaster

What, then, makes the primary difference in whether grief is acknowledged and treated, or merely medicated and ignored?  Often, it is the personal experience of the practitioner.  Providers who have unresolved grief issues themselves can be unconsciously loathe to identify their patient’s grief, lest it remind them of their own. Or, they may just minimize the reality of grief.

Find the Right Therapist & Doctor

I once saw a patient in psychotherapy whose suicidal thoughts were so urgent and precarious that I determined on the intake phone call that she needed to be seen as soon as I could get her into my office. Through our work and after a period of time, the suicide risk passed.  Her thoughts of suicide had been driven by grief, but had never been identified.

During the course of our conversations over many months, she mused that she had seen a psychologist in another city for two years, yet she had remained dangerously suicidal.  By coincidence, I knew this doctor, since we took our postdoctoral training together.  I also knew from conversations with him that when his father died, he “went out for an afternoon and took care of it.”  When I queried further, he said, “I sat and thought about my dad, and then I was done.”

Does that sound like a normal grief process to you?  Not by a long shot!  No wonder he was ill-equipped to help the client with her long-standing grief, when he was so coldly “efficient” and mechanistic about his own.

Most physicians can be forgiven for inattention to this profound issue, because that is not where their training lies.  But perhaps the first question to ask when interviewing a psychotherapist is about his/her personal experiences with loss.  Grief is unlike other issues such as autism or schizophrenia, where you don’t have to experience those conditions personally to help clients. With loss, it surely helps when clinicians have earned their stripes, and can practice what they preach as they walk with you through the maze of your grief.