The APA Makes a Distinction Between Teen Grief and Teen Depression

In May 2013, the American Psychological Association (APA) published a new edition of The Diagnostic and Statistical Manual of Mental Disorders (DSM), the standardized text and clinical reference used by psychologists and therapists across North America to diagnose their clients. The manual includes the names, features, symptoms, and demographical information on all the recognized mental illnesses, including addictions. The DSM, fifth edition came out in the Spring of 2013, twenty years after the first edition was published in 1994.

Distinction Between Teen Grief and Teen Depression

Prior to the most recent version of the DSM, clinicians were asked to refrain from using the diagnosis of depression for individuals who experience a loss in the past two months. This was known as the Bereavement Exclusion. However, what the APA recognized was that grieving was somehow a protection against or exclusion to the experience of depression. In other words, a client might have all the symptoms of teen depression but if he or she experienced a recent loss, the diagnosis is teen grief and not major depressive disorder. The danger here is that an individual can indeed also experience major depression despite a recent loss. And making that distinction is what clinicians are being asked to do with the removal of the Bereavement Exclusion. Therapists and psychologists now have the opportunity to differentiate between normal grieving and the experience depression in their clients.

Differences Between Depression and Grief

Certainly, depression and grieving can occur together. However, research has shown, and the APA also acknowledges, that their symptoms can be slightly different. The following points out some of the differences:

  • In grief, painful feelings come in waves, mixed with positive memories and feelings of the deceased or loved one. Whereas in depression, mood and cognition are almost always negative.
  • In grief, self-esteem and one’s sense of self doesn’t change, whereas in depression, an individual often experiences self-loathing and unworthiness.
  • According to psychologist Kay Jamison, in her book, Nothing Was the Same, a grieving person maintains the ability to be consoled. Whereas in depression, a change in mood is more difficult to achieve.

Another distinction is that grief is considered to be a normal process in response to a loss. Whereas depression is seen as a mental illness that warrants treatment. Teen Depression Disorder includes symptoms of:  persistent sadness, loss of interest in daily activities, occupational and educational impairment, along with eventual emotional and physical problems. It usually requires long-term treatment, including psychotherapy and medication.

Complicated Grief

The distinction between teen grief and teen depression can get a bit confusing. Especially when grieving from loss lasts for an extended period of time. Complicated grief is a term used to describe when a teen has not moved through the stages of grief in a standard amount of time. Although some clinicians vary on their definition of a standard amount of time. Typically, if an adolescent is still in a mourning process after six months or longer, he or she might be suffering from complicated grief. The symptoms are typically intense separation distress, intrusive and emotionally troubling thoughts about the loss of death of a loved one, a sense of meaninglessness, and the inability to accept the loss. In these cases, a parent or caregiver might watch for severe isolation, a decline in physical health, suicidal ideation, and symptoms of post-traumatic stress disorder.


The benefit of learning about these differences and the way that they are diagnosed is that it might provide information that indicates whether a problem exists. Although it is not advised for a layperson to diagnose him or herself, the above information can indicate whether assistance from a teen depression treatment facility is necessary.



Major Depressive Disorder and the “Bereavement Exclusion”. American Psychological Association. Retrieved on April 3, 2014 from:

Jamison KR: Nothing Was the Same. Vintage Books, 2011.


Pies, Ronald, M.D. “The Two Worlds of Grief and Depression | World of Psychology.” Psych PsychCentral, n.d. Web. 12 Mar. 2014.