Grief and Depression: the Overlap between

Unfortunately, in 2021, grief has become almost a universal emotion. There is not one person in your neighborhood, in your community, who has not experienced some degree of loss. You’ve probably read, or been told of the five stages of grief- denial, anger, bargaining, depression and acceptance. It’s so important to remember that this process is not exhaustive, nor is it linear. Every person’s experience of grief is just that- personal. Each experience is different, and even if the 5 stages seem like a good criterion, it’s not a checklist of grief by any means. 

Sigmund Freud, perhaps the world’s most famous (and maybe infamous) psychologist, wrote a lot about grief. In his many years as a clinician, he published several hundred articles, a lot of which likened clinical depression to grief. In his view, depression and grief were the same things; depression (and by default of association, grief) is “anger turned inwards.” For him, loss of something external reflects the loss of something internal. 

Freud made tens of hundreds of claims about the human mind that he claimed were verified through his medicinal ventures, but most of the things he said had absolutely no evidence. In simpler terms, he said a lot of things, but very few of those things were actually true. Regardless, we study him today because of the impact he made on the psychological community. Despite some of the crazy things that he swore were true, he still was one of the first people to question the wonder of the human mind. And what he said about clinical depression is certainly one way to look at grief, psychologically speaking. If you believe in psychoanalytical theory, you might wonder if your experience of grief is the same as sadness, and can be treated as such. 

As a side note, I want to clarify the difference between being sad and being clinically depressed. While the former is adaptive in small quantities, as it gets us to think about our behaviors in the world, the latter can impair functioning and a host of other real problems. Real bad problems. Clinical depression can co-exist with psychotic features, like delusions or hallucinations, as well as physical issues, like heart dysfunction or liver problems. 

Grief and clinical depression share a comorbidity percentage of almost 40%. What this means is that people who are grieving are 40% likely to also have clinical symptoms of depression. This overlap is pretty severe, since research has also shown anti-depressants used to treat depression can also help relieve some of the negative symptoms of grief in certain people. The “broken-heart” phenomenon is a situation where people who face a loss are likely to die from sudden heart failure, implying they literally died from a broken heart. Grief and depression have a huge influence on mental health, for sure, but it also has a huge impact on physical health, particularly that of the heart. 

So now you’ve learned a little bit of the psychology behind grief and depression. What about the neurobiological part of the story? It turns out that grief and depression both work through similar brain pathways- the reward center of the brain, scientifically known as the caudate nucleus. In the brain, tiny cells called neurons each talk to each other through chemical messengers known as neurotransmitters. In the reward center, the most important neurotransmitter is dopamine. Too much dopamine firing in the reward center may lead to unforeseen feelings of reinforcement, which would make the behavior seem desirable and worth repeating. For example, a person with depression and grief-like symptoms might break down in a grocery store crying, but because their dopamine levels are too high, their brain will think of the behavior as “good,” and probe the person to keep acting that way.  

Understanding the connection between grief and depression goes a long way beyond just examining their correlation of incidence, in other words, how often the two occur together. This article took you beyond the stats and gave you a look at some psychological and neurobiological features of the overlap. The next time you see someone (even yourself) experiencing grief, wonder about how their brain is reacting to it- and be prepared to treat symptoms of clinical depression. 

— Allie Yuxin Lin