Eight weeks ago a 50-year-old man's wife died suddenly. He cries daily but describes his sadness coming in waves triggered by reminders of her, still enjoys meals with friends, and retains his self-esteem. He sleeps adequately and continues working. Which statement best supports that he does NOT have a major depressive episode?

• A His symptoms began immediately after the loss
• B He thinks frequently about his deceased wife
• C He has crying spells several times per week
• D He experiences positive emotions and maintains self-esteem despite painful pangs of grief ✓

Explanation

Normal grief runs in waves or pangs brought on by reminders of the deceased, leaves self-esteem intact, and allows periods of positive emotion and humour. Major depression presents as pervasive low mood and anhedonia present most of the day, nearly every day, with prominent self-critical rumination, worthlessness, and suicidal ideation. Crying spells and preoccupation with the deceased occur normally in bereavement, and DSM-5 permits a depression diagnosis during grief only when full syndromal criteria with such features persist.

Reference: Kaplan and Sadock's Synopsis of Psychiatry, 11th ed.

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Written and medically reviewed by the StethoPrep medical team.