Everything You Need To Know About Grief and Loss
Sometimes the pain of grief and loss can be all-consuming—learn the stages of grieving and when it may be time to seek additional help
January 6, 2023
Grief and loss can prove suffocating for those who are impacted by them, especially at first.
Most people have at least some experience with grief, whether first- or second-hand, and understand how loss can affect the person who goes through it. Even those of us who have very little personal experience can still understand the deep toll bereavement takes.
To make matters more difficult, recovering from loss is not a straightforward process.
In her 1969 book “On Death and Dying,” the psychiatrist Elisabeth Kubler Ross identified five stages of grief:
While this model has gained popular traction, it is often misunderstood. And mental health care professionals have moved away from it as a primary model for handling grief.
Keep Reading To Learn
- How grieving works and how different losses can affect its severity
- What types of mental health conditions can occur when an individual is grieving
- When grief is “normal,” and when you should consult a mental health care provider
Grief rarely follows a predictable, linear path.
Normal grieving is messy and varies from day to day and person to person. The grieving individual may show a vast range of emotions in a short period of time, and they may feel those emotions strongly for months or even years.
Grief and loss do eventually abate. While the memory of a loved one never leaves completely, those memories lose their sting, allowing the individual to move forward with their life. If they don’t, that’s a sign that the person struggling may need more help.
Even if someone can adjust to the loss in a typical timeframe, grief counseling and other forms of treatment may still prove helpful.
While there is no “right” way to grieve, it can be helpful to have an expert lead you or your loved one through the process of coping with the trauma of losing someone.
It is also important to note that other losses, such as a relationship, job, or home, can cause someone to grieve. While the clinical definition of “grief” refers to the loss of an important person, that’s not the only reason one might feel the keen sorrow of no longer having something treasured.
Many people do not know helpful ways to grieve. This is often because they do not fully understand grief itself. There is no reason to suffer when support is available for you and those who matter to you.
What Is Grief?
Grief is a normal response to loss. Uncomplicated grief—the typical response to a dear one dying—is full of pain, anguish, regret, confusion, and anger.
Not only does grief impact our innermost emotions, because we no longer have what once meant so much, it also changes other aspects of daily living. These can include:
- Day-to-day routines and activities
- Interactions with the people with whom you spend the most time
- The ways your surviving family members relate to one another
- Feelings of stability
- Your ability to care for yourself and others and navigate the daily demands of living
Unfortunately, as normal as grief and loss are, they may also prove debilitating—at least for a short period of time. Feelings of grief are often overwhelming, especially when the loss pertains to a person.
However, other losses can cause sharp, deep feelings of grief. These can include, but are not limited to:
- A devastating medical diagnosis, for oneself or a loved one
- Loss of a pet
- Loss of a job or retirement
- Loss of a home or of financial stability
- A divorce or a breakup
- Serious injury or accident
- Severe trauma, as might result from a refugee situation
The severity of grief often correlates with the severity of the loss. Accordingly, the loss of a child will likely prove more devastating than the loss of a job, but both can be the cause of heartache, misery, depression, and even suicidal thoughts.
How Long Does Grief Last?
Grief is different for every person and every loss. The manner of the death and your personal circumstances can affect how long you experience grief. If you are grieving now, it may be difficult to imagine an end to the pain you are feeling, but it will come.
Overall, acute grief should pass in 12 months for adults and 6 months for children. If it does not, you may be experiencing prolonged grief disorder and should seek help from a professional.
Impact of Grief on Your Mental Health
Dr. Ipsit Vahia discusses the healthy components of the grieving process, shares ways to strike a balance of coping and grieving, and answers questions about when to seek help for grief and loss.
Understanding Prolonged Grief Disorder
The loss of a cherished loved one usually causes the most acute sensations of pain. In severe cases, the grieving person may be diagnosed with prolonged grief disorder.
Prolonged grief disorder has previously been known as grief disorder or complicated grief.
The clinical definition of prolonged grief disorder is limited specifically to a bereavement situation in which the individual has lost a person.
This disorder is a complex set of symptoms that accompany the death of a family member or friend, and can include:
- Trouble dealing with everyday life
- Difficulty managing relationships with living individuals
- Loneliness and isolation, numbness
- Desperate longing for the person who has passed or disbelief that the person is dead
- Loss of identity due to the loss of the deceased
Mental health professionals diagnose prolonged grief disorder when profound grief persists for more than 12 months in adults or 6 months in children.
This is often confused with depression, but the conditions are not the same, and treatments for them aren’t either. For that reason, it’s very important to diagnose this disorder correctly.
While life feels forever changed after a loss, in normal grieving a person will eventually recover and move on with life.
If you or a loved one feel unable to do this, it may be due to prolonged grief disorder, and you should seek professional treatment.
Reactions and Responses Associated With Grief
Different people may respond to grief and loss differently, depending on the nature of the loss. Factors may include:
- Whether they lost a person or something else (pet, job, etc.)
- How close they were to the person who died
- Whether it was a spouse or a child (including miscarriage), which typically create the strongest reactions of grief
- If, in the cases of children, the loss was a parent or other nuclear family member
- The preexisting state of mental health of the affected individual
- How sudden the death was and how much time the person had to prepare for their loss
- Anything else they have recently been through (for instance, other types of trauma co-occurring with the grief may exacerbate symptoms)
Reactions and responses to grief vary widely, and will change, even over short periods of time.
The most common symptoms of grief are:
Shock and Numbness
Many people find that in the initial days and weeks after they lose a loved one, they are unable to feel much of anything at all.
Denial and Disbelief
The person is unable to cope with the new reality, so they deny its existence and avoid reminders that the loved one has died.
Anxiety, Fear, and Distress
The trauma of losing a loved one may permeate the individual’s everyday experiences in the form of additional fear and paranoia about their surviving loved ones. Anxiety and distress may not be localized to any one situation.
Intense Sadness, or Longing
Feelings of crippling sadness and desperate longing to have the deceased back are also normal.
Anger and Rage
Often, anger and irritability crop up after some time has passed and the person understands that the death is final but has not yet accepted its reality as a part of life.
Withdrawal From Social Activities
The inability to engage with former social activities is also a typical part of grief, as the person has a hard time mustering up energy and enthusiasm. Connections to memories associated with their deceased loved one can be hard to manage.
Loss of Interest in Work or Hobbies
Normal activities may lose their luster for a while.
In their desperate longing for the loved one to return, the bereaved may engage in irrational bargaining with God, the universe, or themselves. A common refrain is “If only I could have them back, I will…”
In some cases, the bereaved may feel guilt, regret, and humiliation at what passed between themselves and the loved one before the loved one died. These feelings are also normal, a result of unprocessed conversations or events, and with time they will resolve like the others.
Some psychologists point out the benefits of grief (as strange as that may sound) once the individual has had time to process the loss. They may become more socially active, interact more deeply with their community, and turn their loss to the betterment of society. They may also find more understanding, tolerance, spirituality, and gratitude because of the hardships they’ve overcome.
Physical Responses to Grief
Many people don’t realize that grief and loss are processed in the body as well as in the mind.
Physical responses to grief include:
- Loss of appetite, trouble eating, or nausea
- Muscle weakness, shaking, and trembling
- Trouble sleeping and waking
- Difficulty breathing or chest tightness
- Increased inflammation, stiffness, joint pain
Many of these physical symptoms result from high levels of stress hormones in the body in the wake of recent tragedy. These levels decrease as the person has time to adjust.
How Do We Cope With Grief Healthily?
While it might not feel like it at first, healthy management of grief is both possible and likely for most people.
It’s true that in some cases, trauma and PTSD may complicate grief and loss, and it is important to seek treatment and understanding for these conditions. The same goes for addiction, depression, and prolonged grief disorder.
With normal grief—absent of complicating mental health disorders or co-occurring conditions—the process of grieving and coping are well-known. You can take several steps, or help a loved one to take those steps, to minimize the amount of disruption and pain experienced over the long haul.
Even if those feelings are very acute at first, healthy coping will mean more effective recovery from the trauma and a better life long term.
Healthy coping strategies include:
- Talking about how you feel with family and friends
- Allowing yourself to feel the pain of the loss without avoidance
- Adjusting to your new reality
- Going out of your way to strengthen existing relationships or form new ones
- Taking care of yourself as well as your family, even if the effort is exhausting at first
- Remembering and honoring the loved one in whatever ways you see fit
Suicide: Know the Signs and What To Do
Suicide is a rapidly growing public health crisis: But by learning about it and reducing its stigma, you can help save lives. Learn more about the signs and symptoms of suicidal ideation and how to help a loved one who is struggling or in crisis.
The Impacts of Grief on Mental Health
Grief looks and feels different for everyone. Reactions to loss cover a range of feelings and actions.
For some people, grief can take a heavy short-term toll on mental well-being. Many feel extreme emotions, and the affected individual may have a hard time engaging in regular activities for several months. This does not mean they are mentally unwell. In fact, these emotions are signs of grief processing.
In some instances, however, grief becomes unmanageable or is further complicated by other mental health issues.
Two of the most common illnesses (aside from prolonged grief disorder) triggered by grief are depression and addiction.
It’s not always easy to distinguish between depression and other complications of grief. Depression may be preexisting, or the grief may trigger it.
Many people mistakenly assume that the depression is a result of the grief and will pass, but that’s not always the case, especially not without treatment.
The easiest way to distinguish depression from grief is by taking all the person’s emotions into account.
If you or a loved one are having difficulty adjusting to the loss, but still find moments of levity and joy in everyday life and surviving loved ones, that is normal grief.
A depressed person, on the other hand, is far less likely to have these moments. The negative emotions will be predominant, and they may experience severe numbness, sadness, emptiness, and despair.
Additional symptoms that aren’t a normal part of grief include:
- Feelings of worthlessness
- Thoughts of suicide
- A constant preoccupation with dying
- Affected speech and body movements
- Inability to function
You or a loved one can have prolonged grief disorder and depression at the same time. However, it is important to diagnose both separately to receive the most appropriate treatment for each.
Another common complication of grief is addiction. The affected individual may simply be too sad to deal with their feelings and turn to the numbing comfort of substances instead.
While alcohol and drugs may produce feelings of peace and relief from the unrelenting anguish of grief, they are short-term, unhealthy solutions. Substance misuse may end up creating far more misery down the road than bereavement can cause in the present.
In some cases, the bereaved ends up in a never-ending cycle of grief, which they then numb with substances, which they then feel again when they get sober. Substances only delay the healthy grieving process and addiction should be treated immediately.
Grief in Children and Adolescents
While many of the symptoms are the same, and they undergo the same basic emotional process, youth react differently than adults. Grief and loss also manifest differently in childhood and the teen years.
To best help young people through the process of grieving, it is important to understand these differences.
Grief in Children
Because they have a less evolved understanding of death and grief, children may have a more difficult time coping than adults.
Very young children often do not believe death is real and as a result may have a hard time accepting reality. Older children may understand that death can happen but feel disbelief that it could happen to those around them.
When a child loses a loved one, their reactions may include behaviors like:
- Crying and appearing sad
- Acting out or getting angry at those who are still alive
- Having nightmares or trouble sleeping, wetting the bed
- Playing and being social like their old selves (which may confuse adults), engaging in normal activities
- Talking about and missing the loved one
- Avoiding food or activities
Emotional reactions may include:
- Becoming “younger” in their need for affection, play, or speech
- Believing they were responsible for the death
- Denying the death of the loved one
- Avoiding discussions or reminders of the death
- Appearing sensitive at holidays and birthdays
Children, like adults, should be allowed to express their grief whenever they need to. You can help them process grief by:
- Asking and answering questions
- Talking honestly about the deceased (bearing in mind age appropriateness)
- Answering directly, without using confusing euphemisms
- Maintaining routines but increasing levels of physical affection
- Going to funerals, wakes, or memorial services to help them say goodbye
- Talking about spirituality or the afterlife
- Attending to your own grief and letting the child witness it
Like adults, children may have trouble adjusting to the death in a normal amount of time, which can have serious mental health consequences. If you see any of the following symptoms, seek help:
- A belief that they are communicating with the dead person
- Repeated voicing of a wish to join that person
- Inability to engage in normal activities after a few months
- Extended depression
- Significant drop in school performance or reluctance/refusal to go
Grief in Adolescents and Teens
Older kids often experience a mixture of childlike and adultlike reactions to grief. They may withdraw more than young children do and experience more disruption in their physical patterns.
Teens may get more irritated, express their anger more readily, and seek refuge in technology.
One difference between adolescents, as compared to children and adults, is their deep identification with peers.
At this age, the loss of a peer to violence, suicide, or an accident may affect them particularly strongly, even if they were not close with that person. Parents and schools should ready themselves for this eventuality and have plans in place to deal with it when necessary.
Teens are more likely than children to:
- Self-isolate from family and peers
- Be resistant to seeking help
- Disconnect from former activities and interests
- Mask grief by acting out
- Deal with emotions through risky behaviors (unprotected sex, drugs, or thrill-seeking behaviors)
If the death had stigma attached to it (for example, a parent dying by suicide or substance use), they may feel particularly resistant to talking about it.
You can help adolescents by:
- Offering space to talk, even if they refuse repeatedly
- Answering spiritual and metaphysical questions openly
- Encouraging them to spend time with peers and helping to organize activities
- Keeping as normal a schedule as possible
- Recognizing signs of prolonged grief disorder and seeking help where necessary
Offering support where needed will help teens adjust as much as possible to the trauma of bereavement so that they can move on with their lives as quickly and as normally as possible.
8 Ways To Support Someone—or Feel Supported—Through a Loss
It can be difficult to witness those we care about experience the pain of loss. While we can’t take the pain away, there are ways we can help.
1. Be Present and Be There
Do as much as possible to be physically and emotionally available by attending the funeral, memorial service, or other significant event related to the loss.
Your presence at such times can be the most important form of support for your grieving loved one.
2. Reach Out
While this step may seem obvious, sometimes we can find the topic of death too frightening to confront. Or we fear there’s nothing adequate we can do or say about the loss. Such concerns can lead us to unintentionally neglect a grieving person.
The truth is, when someone is raw with grief, every kind gesture means a lot. Consider making a phone call and sending a card. Even email and text messages can be supportive. Depending on your comfort level and your relationship, let the other person know you are available to meet up to talk whenever they are ready.
The most important thing is that the other person knows you are thinking of them in their loss—that they are not alone in their grief.
3. Continue Reaching Out
Long after people have left the memorial service, grieving will continue. Check in with the bereaved in the days, weeks, months, and years after a loss.
Birthdays, wedding anniversaries, and the anniversary of a death can be particularly challenging times when support can be helpful.
4. Be Sensitive With Your Language
While the most important thing we can do is express support, there are points we can keep in mind when talking about loss.
Avoid statements that a loss was “meant to be,” is “a way to find meaning,” or is “part of God’s plan.” For someone who recently experienced a loss, their loss has no sense or meaning. Platitudes can leave them feeling dismissed in their grief.
5. Be Careful About Comparing Their Loss With Your Own
It’s understandable to want to connect with someone over a topic as profound and universal as loss. It may be helpful for the grieving person to know you experienced a similar loss and hear how you coped and healed.
However, be sure to put the focus on the grieving person and their loss. Be aware that nothing can compare to their unique loss.
6. Help With Practical Matters
Grief is overwhelming—and exhausting. When someone is grieving, they can struggle to manage basic tasks.
Drop off food, coordinate meal deliveries, or purchase gift cards for takeout. Offer to help with housework or childcare.
Depending on the situation and how well you know the person, you can help with some of the hardest tasks, such as sorting through the deceased’s possessions.
7. Acknowledge Their Grief—Even If You Don’t Understand It
The term “disenfranchised grief” refers to grief that is not universally recognized by society. Although attitudes about such losses are changing, miscarriage and pet loss can fall under this category.
It is essential to believe the devastation people experience from such losses. It is also important to understand that the intensity of grief is unique to each individual regardless of the form of loss.
The psychologist Kenneth Doka coined the term “disenfranchised grief.” Listen to him describe the topic in this video.
8. Keep the Memory Alive
Over time, we may talk less and less about someone who has died. However, it can mean a lot to survivors to continue to remember and talk about someone who passed away.
Bring up the deceased’s name in conversation, share memories, and share any old photographs or possessions you come across in the months or years that follow a loss.
Such remembrances can apply to other forms of loss as well: for example, over time, don’t pretend that your friend’s divorce never happened or that your brother was never laid off from his favorite job.
Let the people in your life know you haven’t forgotten the pain they endured.
Managing Grief in the Time of COVID-19
While grief and loss are difficult at any time, they are particularly hard when access to normal coping strategies are limited by uncertain times.
COVID-19 not only caused a lot of death and trauma, but it also hampered people’s ability to seek treatment and the closeness of others.
As the pandemic goes on, we continue to experience interruptions in previously normal day-to-day life. As we encounter grief and loss now, we must continue to strive to stay centered.
It is important to have coping strategies. These can include:
- Connecting with others, even if it is only digitally
- Engaging in analog forms of connection, such as sending letters by mail
- Holding memorials, even if they look different than they often do
- Remembering the deceased through pictures, writing, or even planting trees
- Seeking grief counseling, even if it is remote
- Seeking spiritual support
- Acknowledging your feelings
- Sharing feelings openly with those you trust
- Adjusting the rituals of daily life with intention, to both honor the deceased and fill in the gaps left by their absence
If you live with people, it is important to give one another space. If you live alone, it is critical you seek connection outside your home.
When To Seek Professional Treatment for Grief
Sometimes, for whatever reason, we are unable to deal with grief and loss in healthy ways. That may make grief last longer, make the feelings more acute, or trigger or exacerbate other mental health conditions.
If you aren’t adjusting well to grief and loss, you may need help.
Signs you should seek treatment include:
- Feeling worthless or empty
- Acute guilt or feeling that it was your fault
- Wanting to join the dead loved one
- Numbness or disconnection that lasts more than a few weeks
- Trust issues
- Inability to engage in daily life successfully
We Are Here To Help
If you or a loved one needs help managing mental health symptoms, McLean is here to help. Contact us today to learn more about treatment options.
How Grief Is Treated
There are many treatments for complications with grief and loss.
Prolonged Grief Disorder Therapy
Prolonged grief disorder therapy (PGDT) is a short-term treatment that uses clearly defined goals to reach a healthier state of acceptance. This is a unique treatment that is specific to grief.
Cognitive Behavior Therapy
Cognitive behavior therapy (CBT) is a form of talk therapy that focuses specifically on identifying issues and setting goals, which you will then check back on later. While CBT is widely applied, a therapist will use it to directly target the issues associated with the loss.
Meaning in Loss Therapy
This therapy aims to help the individual accept the bereavement and integrate that loss into their life in a way that makes constructive sense to them.
Family Bereavement Program
This form of therapy is targeted toward children. Therapists meet with children and caregivers simultaneously, offering extra instruction to the caregiver to help the child through the grieving process.
Grief and Trauma Intervention for Children
When children witness traumatic events, it is especially hard for them to cope with death. If they saw a loved one die, especially by violent means, they will likely need specialized treatment.
As with 12-step programs for substance addition, peer-based programs are proven to give members the support and understanding they need to process their grief in healthy ways. This is often an addendum strategy along with professional treatment.
If you need additional or emergency help, please try one of the following sources:
Grief is devastating. Loss is part of being human, and we can take comfort in knowing we’re all connected through this universal experience.
It’s important for us to recognize how to care for ourselves and others when the unimaginable happens.
When we understand how grief works, what support can look like, and when to seek additional help, we can eventually move forward—even in the most painful times—and engage with life again.
Want More Information?
Looking for even more information about grief and loss? You may find these resources helpful.
Interesting Articles and Videos
- Video: The Truth About Trauma
- Everything You Need To Know About Anxiety
- Understanding Anxiety in Kids and Teens
- Deconstructing Stigma: Ann’s story
- Video: Depression 101
- Everything You Need To Know About Addiction
- Grief and Bereavement
If you think you or a loved one may attempt self-harm or suicide, call 911 or your local emergency number immediately.
Talking about suicide is the best way to prevent it. Visit our suicide prevention resource page if you or someone you know needs help.
These organizations also offer information on suicide prevention:
American Foundation for Suicide Prevention
This organization is dedicated to saving lives and bringing hope to those affected by suicide. AFSP creates a culture that’s smart about mental health through education and community programs, develops suicide prevention through research and advocacy, and provides support for those affected by suicide
Suicide Prevention Lifeline
If you are suicidal, please call 988 or 800.273.TALK(8255). You’ll be connected to a skilled, trained counselor at a crisis center in your area. Counselors are available 24 hours a day, seven days a week.
A nondenominational, not-for-profit volunteer organization dedicated to reducing the incidence of suicide by befriending individuals in crisis and educating the community about effective prevention strategies. Call or text the 24/7 free and confidential helpline at 877.870.4673.
Stop A Suicide Today!
A nationwide campaign to empower individuals to help themselves, colleagues, friends, and loved ones who are concerned about or feel suicidal.
Suicide Prevention Resource Center
The only federally supported resource center devoted to advancing the implementation of the National Strategy for Suicide Prevention.