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In DSM-IV, there was an exclusion criterion for a major depressive episode that was applied to depres-
sive symptoms lasting less than 2 months following the death of a loved one (i.e., the bereavement
exclusion). This exclusion is omitted in DSM-5 for several reasons. The first is to remove the implication
that bereavement typically lasts only 2 months when both physicians and grief counselors recognize
that the duration is more commonly 1–2 years. Second, bereavement is recognized as a severe psy-
chosocial stressor that can precipitate a major depressive episode in a vulnerable individual, generally
beginning soon after the loss. When major depressive disorder occurs in the context of bereavement, it
adds an additional risk for suffering, feelings of worthlessness, suicidal ideation, poorer somatic health,
worse interpersonal and work functioning, and an increased risk for persistent complex bereavement
disorder, which is now described with explicit criteria in Conditions for Further Study in DSM-5 Section
III. Third, bereavement-related major depression is most likely to occur in individuals with past personal
and family histories of major depressive episodes. It is genetically influenced and is associated with
similar personality characteristics, patterns of comorbidity, and risks of chronicity and/or recurrence
as non–bereavement-related major depressive episodes. Finally, the depressive symptoms associated
with bereavement-related depression respond to the same psychosocial and medication treatments as
non–bereavement-related depression. In the criteria for major depressive disorder, a detailed footnote
has replaced the more simplistic DSM-IV exclusion to aid clinicians in making the critical distinction be-
tween the symptoms characteristic of bereavement and those of a major depressive episode. Thus, al-
though most people experiencing the loss of a loved one experience bereavement without developing
a major depressive episode, evidence does not support the separation of loss of a loved one from other
stressors in terms of its likelihood of precipitating a major depressive episode or the relative likelihood
that the symptoms will remit spontaneously.