Bereavement is a normal reaction to loss in human beings in virtually every culture across the world. There are no set rules for how long “normal” bereavement lasts, as each person and each loss is very different. Therefore, bereavement tends not to be diagnosed unless it has gone on for a very significant period of time and significantly impacts the person’s life. Getting over or past the lost of a loved one can be challenging for nearly everyone.
But for some, the loss of a loved one is too much, causing them to enter into a clinical depression that may need further attention or treatment.
Bereavement is diagnosed when the focus of clinical attention is a reaction to the death or loss of a loved one. As part of their reaction to the loss, some grieving individuals present with symptoms characteristic of a major depressive episode (e.g., feelings of sadness and associated symptoms such as insomnia, poor appetite, and weight loss).
The bereaved individual typically regards the depressed mood as “normal,” although the person may seek professional help for relief of associated symptoms such as insomnia or anorexia. The duration and expression of “normal” bereavement vary considerably among different cultural groups.
The diagnosis of major depressive disorder is generally not given unless the symptoms are still present 2 months after the loss.
However, the presence of certain symptoms that are not characteristic of a “normal” grief reaction may be helpful in differentiating bereavement from a major depressive episode.
- Guilt about things other than actions taken or not taken by the survivor at the time of the death;
- Thoughts of death other than the survivor feeling that he or she would be better off dead or should have died with the deceased person;
- Morbid preoccupation with worthlessness;
- Significant psychomotor retardation (e.g., it’s hard to get moving, and what movements there are are slow);
- Prolonged and serious functional impairment; and
- Hallucinatory experiences other than thinking that he or she hears the voice of, or transiently sees the image of, the deceased person.