Grieving and Depression

Dear Dr. Bob,
My grandfather died a few months ago and he was more of a father to me than my own absentee father. I still feel sad, but everyone tells me I'm depressed and need help. What kind of help?
Samantha, Hayward


Dear Samantha,
You have actually asked several questions at once. Almost everyone in the psychological field uses the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) to classify emotional problems. The fine lines between the diagnoses of Bereavement, Adjustment Disorder with Depression and Major Depressive Disorder (and Minor Depressive Disorder not officially used yet) are often times obscure. Although the DSM-IV-TR addresses the issues of time spent grieving and the nature of depressive symptoms as part of the differential diagnoses, it is also a well accepted fact that "normal" grieving is different for different people and different cultural groups. To make a generalization for the sake of brevity, the longer the grief (two months or more) and the severity of the experience (guilt, thoughts of death, preoccupation with worthlessness, etc) the more it becomes Major Depressive Disorder.


Feeling sad is considered a typical grief reaction. You do not need to feel depressed to get help through a support group or counseling. Self medicating with drugs or alcohol is a common form of coping with death, but not usually helpful. Ultimately, one still has to grieve and drinking and drugging can lead to other problems in addition to grief or depression. Sort of like jumping out of the pan into the fire! Reach out for some help, you won't regret it.
Dr. B