Table 2.

Symptom overlap of grief, prolonged grief and major depressive disorder

Grief	PGD	MDD
Arises in response to a death	Arises in response to a death	Can arise spontaneously
Sadness Guilt Anxiety Nightmares Appetite/Sleep changes are acute, if present	Sadness Guilt Anxiety Nightmares Appetite changes Sleep changes	Sadness Guilt Anxiety Nightmares Appetite Changes Sleep changes
Intense yearning in the acute phase, however, should noticeably improve within 2 weeks	Intense yearning and intense preoccupation for the deceased that does not improve	Intense yearning can be present as an expression of depression
Functioning well Not suicidal Can experience joy	Impaired functioning Suicidality can be present Lack of positive emotions	Impaired functioning Suicidality can be present Lack of positive emotions
Typical grieving period is 6 months to 2 years with gradual improvement seen	Lasts more than 6 months and usually sustained, does not remit nor improve	Minimum of 2 weeks, can be recurrent. Can have “good days” but not typical
No response to medication Can resolve naturally Responds to therapy	No response to medication Difficult to resolve naturally Responds to targeted therapy	Does not resolve naturally Responds to medication Responds to therapy