Most people who are deeply grieving worry whether they are grieving “correctly.” If this is you, perhaps in your moments of deep sadness you wonder what the difference is between grief and depression. This may be compounded if others offer comments such as “You seem to be holding up well” when, on the inside, you are not. It is important to understand the difference between clinical depression and the naturally deep sadness that accompanies grief. Grief is the reaction to loss—it is comprised of all the reactions you are experiencing, not just emotionally but spiritually, physically, cognitively and socially. There’s a clear correlation between how much you grieve and how much you love. Everyone grieves differently based on their personality, previous losses, the relationship to the loved one, and their environment, just to name a few influencing factors. This deep sadness serves a specific purpose. When you have those times of deep sadness you naturally turn inward, into yourself. You slow down and become enveloped with a protective layer that causes you to lose some of your focus on the outside world. The key to this deep grief or sadness is to tend to it. In today’s fast-paced world, many tend to block out or shove away times when grief hits you front and center. Doing this doesn’t bypass the grief; it is still there, waiting to be tended to at a later date. It is far better to tune into these times telling yourself to pause and reflect, because the answers for what you need are there within you. By paying attention to this deep sadness you will begin to understand what you need, in that moment and going forward, to move beyond those feelings. The moments will ebb and flow—they come and go. When these episodes occur, you may question “How do I go on?” yet over time, the moments will become less frequent. In between these times of deep sadness, most people are able to experience in some pleasures, such as the support of a good friend or the love of a grandchild. In grief you may have a bad day or bad moment but it eventually passes. Clinical depression, on the other hand, is not intermittent. It is persistent, ongoing, never changing. Depression is accompanied by a feeling of hopelessness and apathy. One will continually question “Why go on?” While deep sadness is usually more focused on feelings surrounding the loss, clinical depression often has a negative self-focus which can become distorted with feelings of worthlessness and guilt. If you find you have lost all interest in everything you previously cared about and can find no joy or meaning in any of the moments of your life, you may be experiencing clinical depression. If your symptoms are not going away or if you have a history of depression, it is important to reach out to a mental health professional or your family doctor. Depression is treatable, often with ongoing counseling and sometimes with medication. Don’t suffer in silence, reach out. There are always others who care. by Patti Anewalt, PhD, LPC, FT, Director of the Pathways Center for Grief & Loss with Hospice & Community Care Journeys with Grief: A Newsletter to Help in Bereavement, copyright Hospice Foundation of America, 2019.