Individuals present symptoms which are characteristic of a Major Depressive Episode. The bereaved individual typically regards the depressed mood as "normal," although the person may seek professional help for relief of associated symptoms such as insomnia. The duration and expression of "normal" bereavement vary considerably among different cultural groups. The diagnosis of Major Depressive Disorder is generally not given unless the symptoms are still present 2 months after the loss. However, the presence of certain symptoms that are not characteristic of a "normal" grief reaction may be helpful in differentiating bereavement from a Major Depressive Episode. These include:

  Guilt about things other than actions taken or not taken by the survivor at the time of the death.

  Thoughts of death other than the survivor feeling that he or she would be better off dead or should have died with the deceased person.

  Morbid preoccupation with worthlessness.

  Marked psychomotor retardation.

  Prolonged and marked functional impairment.

  Hallucinatory experiences other than thinking that he or she hears the voice of, or transiently sees the image of, the deceased person.

Associated Features:

Depressed Mood
Somatic or Sexual Dysfunction
Guilt or Obsession
Addiction

Differential Diagnosis:

Some disorders display similar or sometimes even the same symptom. The clinician, therefore, in his diagnostic attempt has to differentiate against the following disorders which one needs to be ruled out to establish a precise diagnosis.

Adjustment Disorder;
Symptoms of avoidance, numbing, and increased arousal that are present before exposure to the stressor;
Another mental disorder (e.g., Brief Psychotic Disorder, Conversion Disorder, Major Depressive Disorder);
Acute Stress Disorder;
Schizophrenia;
Other Psychotic Disorders;
Mood Disorder With Psychotic Features;
Delirium;
Substance-Induced Disorders;
Psychotic Disorders Due to a General Medical Condition;
Malingering.

Cause:

The impact of the loss of a loved one or friend can be devastating. Individuals who experience the loss of a relationship through either a sudden death or a death following a longer illness may experience many different symptoms. Emotionally, common reactions to death include sadness, anger, guilt, loneliness, and shock. An individual may also notice physical symptoms including fatigue, weakness, and hypersensitivity. It is also not uncommon for an individual's sleeping and eating pattern to change during a period of grieving.

Treatment:

Counseling and Psychotherapy

Therapy can help individuals with either short or long term symptom patterns. Treatment aids in understanding of the loss and eases the life changes as a result of the event. Additionally, therapy can also provide support for the individual who recently experienced the loss.

Pharmacotherapy

Treatment with SRIs. These same SRI medications are also used to treat depression, obsessive-compulsive disorder (OCD) and other anxiety conditions.

Fluoxetine Prozac.
Fluvoxamine Luvox.
Paroxetine Paxil.
Sertraline Zoloft.
Citalopram Celexa.
Clomipramine Anafranil.