Reactive Depression & Complicated Grief

Reactive depression & complicated grief… Signs of true clinical depression

Reactive depression…

As enormously disturbing and challenging the loss of a loved one is, the fact is that most people do not need professional help to find their way through the mourning process and back to life.

Normal grief is not a psychological disorder, and requires no “treatment” or medication. It heals on its own. You will experience crying spells, profound sadness, and a “depressed” mood, all of which mimic major depression.

However, these are all normal and healthy responses to bereavement, not signs of illness. And they serve an adaptive purpose. As Dennis Klass notes in his book “The Culture of Grief”, healthy grief “lines us up with reality” and helps us come to terms with who we are, apart from our lost loved one.

So periods of “depression” are to be expected during the grieving journey. A true clinical depression, however, lasts for months without change. Normal grief is fluid, always changing, and “all over the map”. You may feel up, then down, from moment to moment.

Normal grief is marked by intensity and constant change, with a gradual progression towards improvement. Clinical depression is dull and constant and pervasive. It is marked by a profound lack of self esteem, and does not improve over time.

True clinical depression is a chemical imbalance in the brain which is usually treated with medication, and sometimes psychotherapy. Grief can sometimes lead to true depression. About 20% of bereaved people will go on to develop major reactive depression.

So it’s important to know the difference between grief and depression. Remember: depression is medically treated; grief is not.

Reactive depression…

These are the warning signs that professional help should be sought:


  • You seriously feel that you may harm yourself or someone else.
  • You hear voices that frighten you, experience hallucinations, or feel you have lost touch with reality.


Prolonged periods of depressive symptoms (lasts for months):
Reactive depression…

  • Hopeless, detached, worthlessness, intense guilt
  • Can’t stop crying. It’s normal to cry, even several times per day in early grief; but it should come and go.
  • Not sleeping at all. It normal to have some insomnia, given your burdens. But if you are not getting at least some stretches of restful sleep, see your doctor.
  • Not getting out of bed, dressing for the day, taking care of hygiene, or eating.
  • Breaking off all social ties as time goes on.

Self destructive behavior:

  • Drinking heavily or relying on drugs, other risky behavior you can’t seem to stop.
  • Suicidal thoughts- It’s normal in grief to sometimes feel like you can’t go on, and even have fleeting stray thoughts of killing yourself. But if you find you are dwelling on it, or even making plans, please get some help immediately.

Unable to function:

  • Physical reactions are slowed.
  • Persistently unable to function with day-to-day activities and work. You can expect some bad days; we’re talking about a persistent pattern.

Stuck in grief:


  • Unable to accept or believe that the death has occurred.
  • Months have passed and you keep reliving the same thoughts, emotions, nightmares, flashbacks. You have been grieving longer than you think is good for you. Grief does not feel “fluid”. Normal grief changes over time. Most people know when they are stuck in grief and need some help.
  • You have been grieving longer than you think is good for you.
  • Your grief does not feel “fluid”. Normal grief changes over time.
  • Most people know when they are stuck in grief and need some help.

How to find a mental health professional to work with? Find out here:  PROFESSIONAL COUNSELING.



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