Mental Health Week: When Grief Becomes Depression

To mark this year's Mental Health Week (8-14th May 2017), we speak to leading mental health expert, Sarah Bateup, about bereavement. One in four of us (25.4%) suffering a bereavement have been diagnosed with 'complicated grief' – is there a point at which grief morphs into clinical depression? 

Image: IngImage.

The line between grief and depression 

The death of a loved one is one of the most common adverse life events of older age. Although it is a disrupting event and the majority recover, a portion continue to grieve for an extended period of time and begins to exhibit symptoms of a state known as ‘complicated grief’. 

We’ve recently heard how Prince Harry reacted to his mother’s death by blocking it out for years. This is not at all unusual, particularly for a young child. Many people attempt to control their grief in this way, rationalising it by telling themselves that it’s too sad to think about, so they simply stop thinking about it.

Complicated grief is a prolongation of the normal grieving process with distinct characteristics. It impairs mental and physical health and can potentially greatly impact the quality of life of sufferers and their families.

Although they are quite different, they look surprisingly alike – with both grief and depression people cry, they feel depressed, they have trouble sleeping. They may not have much of an appetite. They may not feel like doing anything and they may not take pleasure in anything.

In a 2011 study it was found that as many as one in four (25.4%) suffering a bereavement has been diagnosed with complicated grief. 

Symptoms of complicated grief 

Many signs and symptoms of normal grief are the same as those of complicated grief. However, while normal grief symptoms gradually start to fade over time, those of complicated grief linger or get worse. Signs and symptoms of complicated grief may include:

* Intense sorrow and pain at the thought of a loved one

* Focus on little else but your loved one's death

* Extreme focus on reminders of the loved one or excessive avoidance of reminders

* Intense and persistent longing or pining for the deceased

* Problems accepting the death

* Numbness or detachment

* Bitterness about your loss

* Feeling that life holds no meaning or purpose

* Irritability or agitation

* Lack of trust in others

* Inability to enjoy life or think back on positive experiences with your loved one 

Treating complicated grief with CBT 

Cognitive Behavioural Therapy (CBT) is the main non-drug intervention in psychology and psychiatry and not just in the treatment of complicated grief anxiety, but for depression, phobias, obsessive-compulsive disorder, panic, post-traumatic stress disorder and eating disorders too.

This is due in large part to the broad and consistent success of CBT in the treatment of several psychological conditions, its highly structured format, and its acceptability to patients.

Complicated grief specific CBT consistently outperforms other active psychotherapeutic treatments in clinical trials. About 50 to 70% of those treated with complicated grief-specific CBT benefit from the treatment and of those patients who do respond, many achieve long-lasting results.

If you, or someone you know, is suffering from anxiety or depression, there are many places you can turn to for help, including your local GP, the Mental Health Foundation and Mind

Many are also choosing to access mental health services online, which allow patients to meet with an accredited therapist in a secure virtual therapy room, at a time and location that is convenient to them, accessing services from their mobile phone, tablet or desktop.

As a British Association of Behavioural and Cognitive Psychotherapy (BABCP) CBT therapist Sarah Bateup has delivered 27,000 hours of cognitive behavioural therapy over the last 28 years. As Clinical Director of Ieso Digital Health, Sarah Bateup heads up one of the UK’s largest teams of therapists delivering cognitive behavioural therapy (CBT) online, to treat psychological disorders including anxiety, depression, phobias, obsessive-compulsive disorder, panic, post-traumatic stress disorder and eating disorders. To find out more, go to


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