Is it sadness or depression? How to tell the difference (Part 2)

Another factor is separating out sadness and depression. Sadness (or grief) is a natural response to loss and the symptoms may seem the same as depression. The major difference with depression is that the person feels that there is something wrong with themselves, “no one likes me, there is something wrong with me.” That usually doesn’t happen with simple grief.

Let me tell you about a teenager I am seeing in my private practice. She came in with most of the above symptoms – not eating, not sleeping, feeling no one liked her. In fact, she scored high on a depression scale I gave her. What became important for me over time is that she kept coming back each time to the fact that she was lonely. That was her predominant symptom. She said she was not suicidal. She made good use of therapy. At first she was quiet and said very little. However, as we continued to meet, she opened up more about her loneliness. I learned, though, that she overemphasized some things. Her perception is that she had no friends, but in conversation, she would name several people that she spoke to. But she said they were not really friends. Her perception of being lonely was important to listen to, because that is how she was operating, based on her perception. Therapy has helped her see things more realistically – that she actually has friends, but that she may have been misperceiving. She did not need to take anti-depressants as therapy was helping her to improve. Sometimes medication is necessary, but I always try to see if therapy will help alleviate the pain they feel first. Sadness is a part of life, just as is grief over a loss. But when it becomes depression, it is time to take action.

Commentary from Margaret Murchan, LCSW


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