Complicated Grief Vs. Depression: What’s The Difference?

Reviewed by Aaron Horn, LMFT

Published 06/24/2022

Losing a loved one is something no one looks forward to, but unfortunatelyit’s something most people will experience at some points in their lives. The vast majority of people learn how to cope. The grieving process usually passes with time. Sometimes however, individuals struggle to accept the loss. The pain can become an ongoing process that takes over their lives and their ability to function. Because of this, complicated grief can share a lot in common with depression. This article will teach the key differences between these two conditions and how people can overcome complicated grief and the feelings that come with it.

What Is Complicated Grief?

It’s natural for people to grieve following the death of someone important to them. It can be extremely painful, but like a physical wound, normally they heal. The grieving process, or bereavement, eventually passes and people heal as they adapt and process their emotions.

Although there is no time limit on how long it takes to heal after the loss of a loved one, when someone experiences complicated bereavement or grief, these feelings become very persistent and won’t go away.

When people are complicated grieving, they will still retain all of the usual signs of mourning; however, they will also have other indicators such as [1]

  • An inability to accept the loss
  • Preoccupation or an obsession with the death
  • Avoiding reminders of the deceased person
  • A longing for the individual
  • Detached feelings or numbness
  • Feelings of bitterness
  • A lack of trust

These features of complicated grief can consume a person and interfere with their ability to live their life. They may feel that their existence is worthless or meaningless, and it’s not worth living.

Some might blame themselves for the death or wish that it happened to them, isolate themselves from people that care about them, stop eating and sleeping properly, and continue to feel extreme sadness daily. Others might resort to substance abuse, self-harm, and even suicide.

These are all things that complicated grief shares in common with depression. Still, these two conditions are fundamentally different in many ways, and in the next section we will explain why.

How Complicated Grief & Depression Are Different

As mentioned before, complicated mourning or grief and major depression have a lot of the same features, but there are a couple of key reasons why they’re not the same things:

They Are Separate Conditions In The Psychiatric Literature

One of the first reasons complicated grief and depression are separate issues is that they are classified as completely different conditions in the DSM-5 by the American Psychiatric Association and the ICD-10 by the World Health Organization.

In the DSM, complicated grief is known as Persistent Complex Bereavement Disorder (PCBD) and can be found under Trauma and Stressor Related Disorders. In the ICD, it is called Prolonged Grief Disorder and found under Disorders Related To Stress. Depression, on the other hand, is in a different category of its own and is treated as such.

Although the DSM is most commonly used by mental health professionals in the United States and worldwide, both are the standard for diagnosing these types of health issues.

Patients must be diagnosed properly because this can impact the course of treatment they can receive. Certain strategies are more appropriate than others, which will be discussed later.

Major Depressive Disorder Starts Within The Brain

Without a doubt, people can become depressed or have their depression made worse by unfortunate life events, such as the death of a loved one or dealing with a break-up or divorce; however, major depression, as a mental health disorder, is primarily a biological phenomenon.

For people with clinical depression, biochemicals known as neurotransmitters are largely to blame for many of the symptoms they experience.One of the main neurotransmitters associated with major depression is serotonin, which is a natural chemical that can influence your mood, appetite, sleep, and other responsibilities within the body.

This is why many people dealing with major depression don’t know why they feel the way they do. It can be a struggle to go to sleep, get out of bed, and carry out daily tasks due to the overwhelming sense of bleakness and fatigue.

Complicated Grief Has An External Cause

Unlike major or clinical depression, complicated grief is caused by a specific event outside an individual’s brain, which is the death of someone.People who are dealing with complicated grief know exactly why they are feeling the way that they do. Still, they are having difficulties coping with someone's death, finding acceptance, and, ultimately, moving on and continuing to live their life.

Once these things are addressed, the depression caused by complex grief can improve. As the person heals from their loss, the treatment for depression is more straightforward.

It isn’t known why many people experience complicated grief disorder instead of going through the healing process. Like depression, it is believed that biological and genetic factors may be responsible, but they haven’t been defined yet.

Treatment Can Vary

Since there isn’t an identifiable biological cause for complicated grief, treatment for it primarily consists of therapy to help address their maladaptive thoughts and behaviors and teach individuals coping skills so that they can regulate their emotions.

Therapy is typically a significant part of the treatment process for clinical depression; however, prescription medication is also prescribed, unlike those who have complicated grief.

Antidepressant medications, such as SSRIs (Selective Serotonin Reuptake Inhibitors) help people with clinical depression because they help modulate their serotonin levels. Those with complicated grief don’trespond well to SSRI’s unless they have a comorbid disorder, like clinical depression or anxiety disorder.

Therefore, medication isn’t usually the first-line treatment for those dealing with complicated grief, but it’s not uncommon for it to improve some of the symptoms that are associated with it. [2]

What Options Are Available To Help People With Complicated Grief?

People who struggle with complicated grief typically do so for a very long time. The symptoms can be severe and can lead to self-harm or suicidal ideation. Because of that fact, a person should get help as soon as possible.It is recommended that if the grieving doesn’t subside within a year, it’s time to reach out to a doctor or mental health professional who can help. [1]

While medication may be prescribed off-label to help deal with some individual symptoms, it’s not very common. Instead, it’s recommended that people seek a grief counselor who is specialized in helping people cope with the death of a loved one for assistance.

Counseling can give an individual a chance to talk in private about the feelings and emotions they are struggling with and how it’s affecting their life. The therapist can provide healthy coping skills for them to start to be happier, healthier, and more productive.

Although it can be hard to predict, it is possible to prevent complicated grief from getting out of hand. This can be done by having a strong support system of friends and family, and a therapist experienced in helping people process their emotions and encourage healing.

If counseling is received as soon a person notices that they are struggling to find acceptance, they can find healthy ways of grieving and going through the process normally.

Do You Have Complicated Grief?

Everyone processes death differently, and it can be difficult to tell if you have a problem until it starts to take over your life.If you’ve noticed you’re experiencing any of the symptoms mentioned above and you’re feeling depressed, you should find someone who can help you get back on track.

Meanwhile, you can also take this free complicated grief test to determine if you are dealing with it right now. By understanding what’s happening, you can take the necessary steps to handle grief better in the future when it arises.


Complicated grief and depression share many similarities and can occur alongside each other, but they are ultimately two separate issues. Nonetheless, both are very treatable, so if you have symptoms of both, there are resources available to help you heal and overcome these negative thoughts, feelings, and emotions.


  1. Mayo Clinic Staff. (2017, October 05). Complicated grief. Retrieved from
  2. Bridges to Recovery. (, 2020). What Are the Signs of Complicated Grief Disorder? Retrieved from