Grief is considered a problem area when the onset of the patient's symptoms are associated with a death, either present or past. Note that, for IPT, grief requires the actual death of a loved one; other losses are considered role transitions. Grief associated with the death of a loved one can be normal or abnormal. Efforts to modify IPT for normal bereavement are under way. The following section describes the use of IPT for episodes of depression associated with abnormal grief reactions, i.e., from failure to go through the various phases of the normal mourning process.
The process of normal grief includes a full awareness of the reality of the death. The experience of normal grief after a beloved person dies has much in common with depression, but the conditions are not equivalent. In normal bereavement a person experiences symptoms such as sadness, disturbed sleep, agitation, and decreased ability to carry out day-to-day tasks. These symptoms tend to resolve without treatment in two to four months, as the bereaved person goes through a process of gradual weaning from remembered experiences with the loved one ( Lindemann, 1944; Parkes and Weiss, 1983; Viederman, 1995) and begins to live with the reality of the loss. People who are experiencing normal grief do not generally seek psychiatric treatment, and normal grief is not a psychiatric disorder.