Prolonged Grief Disorder centers specifically on intense yearning for or preoccupation with a deceased person, persisting well beyond expected sociocultural mourning norms; Major Depressive Disorder centers on pervasive low mood and/or anhedonia not specifically tied to bereavement, though the two can co-occur.
Prolonged Grief Disorder requires 12+ months since the death (6+ for youth) before it can be diagnosed; Major Depressive Disorder has no such bereavement-linked timing requirement and can be diagnosed whenever its own 2-week symptom threshold is met.
Prolonged Grief Disorder requires the specific symptom pattern nearly every day for at least the past month, on top of the 12-month post-death threshold; MDD requires a 2-week episode of pervasive symptoms.
Prolonged Grief Disorder's symptoms are specifically organized around the deceased person (yearning, preoccupation, disbelief about the death); MDD's symptoms (anhedonia, worthlessness, appetite/sleep/concentration changes) are more pervasive and not specifically centered on the loss.
Both cause significant impairment; the two frequently co-occur, and both diagnoses can be given together when each independently meets its own criteria.
The decisive question: is the person's distress specifically and predominantly organized around yearning for/preoccupation with the deceased and clearly exceeding cultural mourning norms, or is it a more general, pervasive low mood/anhedonia not specifically tied to the loss?
Don't diagnose Prolonged Grief Disorder simply because someone is depressed after a loss within the first year -- the diagnosis specifically requires 12+ months to have passed and requires exceeding expected sociocultural mourning norms, not just persistent sadness.
Students often treat "grief that looks like depression" as automatically one or the other. The two require separate, specific criteria and can co-occur -- careful attention to whether symptoms are yearning-for-the-deceased-specific versus generally pervasive is needed.
If a case describes intense, unresolved longing for the deceased specifically, 12+ months out, exceeding the person's own cultural mourning norms, lean Prolonged Grief Disorder. If it describes pervasive low mood, anhedonia, and neurovegetative symptoms not specifically centered on the deceased, lean MDD.
| Feature | Prolonged Grief Disorder | Major Depressive Disorder |
|---|---|---|
| Core symptom focus | Yearning for/preoccupation with the deceased specifically | Pervasive low mood and/or anhedonia, not loss-specific |
| Timing requirement | 12+ months since the death (6+ for youth) | No bereavement-linked timing requirement; 2-week symptom threshold |
| Cultural norm comparison | Must clearly exceed expected sociocultural mourning norms | Not compared against mourning norms |
A persistent and pervasive grief response following bereavement, characterized by intense yearning/longing for the deceased or preoccupation with them, along with additional grief symptoms, that exceeds expected social, cultural, or religious norms and causes significant impairment, present nearly every day for at least a month, at least 12 months after the death (6 months for children/adolescents).
A discrete episode of persistently low mood and/or loss of interest lasting at least two weeks, accompanied by a cluster of physical, cognitive, and behavioral changes severe enough to impair functioning.