Grief is a natural response to the loss of someone or something very important to you. The loss may cause sadness and may cause you to think of very little else besides the loss. The words sorrow and heartache are often used to describe feelings of grief.
Anticipatory grief is grief that strikes in advance of an impending loss. You may feel anticipatory grief for a loved one who is sick and dying. Anticipatory grief helps us prepare for loss.
Grieving is the process of emotional and life adjustment you go through after a loss. Grieving after a loved one's death is also known as bereavement.
Grieving is a personal experience. Depending on who you are and the nature of your loss, your process of grieving will be different from another person's experience. There is no "normal and expected" period of time for grieving.
A wide range of feelings and symptoms are common during grieving. While you are feeling shock, numbness, sadness, anger, guilt, anxiety, or fear, you may also find moments of relief, peace, or happiness. And although grieving is not simply sadness, "the blues," or depression, you may become depressed or overly anxious during the grieving process.
The stress of grief and grieving can take a physical toll on your body. Sleeplessness is common, as is a weakened immune system over time. If you have a chronic illness, grieving can make your condition worse.
Social support, good self-care, and the passage of time are usually the best medicine for grieving. But if you find that your grief is making it difficult to function for more than a week or two, contact a grief counsellor or bereavement support group for help.
If you have trouble functioning for longer than a couple of weeks because of depression or anxiety, talk to your doctor. Treatment with medicines or counselling can help speed your recovery.
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Grief and grieving are the natural response to a major loss, such as the death of a loved one. Loss can cause feelings of grief, sometimes when you least expect it.
You may find that old feelings of grief from past loss can be triggered by current experiences or anniversaries of that loss. This is normal.
Anticipatory grief is grief that happens in advance of an impending loss. You may feel anticipatory grief because a loved one is sick and dying. Anticipatory grief helps us prepare for loss.
Your experience of grief is likely to be different from another person's. Similarly, you will probably grieve somewhat differently each time you experience a significant loss. Your reaction to loss is influenced by the relationship you had with the lost person and by your general coping style, personality, and life experiences. How you express grief is influenced in part by the cultural, religious, and social rules of your community.
Grief is expressed physically, emotionally, socially, and spiritually.
Grief can cause prolonged and serious symptoms, including depression, anxiety, suicidal thoughts and actions, physical illness, and post-traumatic stress disorder.
Intense grief can bring on unusual experiences. After a death, you may have vivid dreams about your loved one, develop his or her behaviours or mannerisms, or see or hear your loved one. If you feel fearful or stressed by any of these experiences, talk to your doctor and a mental health professional or clergy person experienced in grief counselling.
Age and emotional development influence the way a person grieves a death.
Grieving a significant loss takes time. Depending on the circumstances of your loss, grieving can take weeks to years. Grieving helps you gradually adjust to a new chapter of your life.
Full awareness of a major loss can happen suddenly or over a few days or weeks. While an expected loss (such as a death after a long illness) can take a short time to absorb, a sudden or tragic loss can take more time. Similarly, it can take time to grasp the reality of a loss that doesn't affect your daily routine, such as a death in a distant city.
During this time, you may feel numb and seem distracted. You may search or yearn for your lost loved one. Funerals and other rituals and events during this time may help you accept the reality of your loss.
Your way of feeling and expressing grief is unique to you and the nature of your loss. You may find that you feel irritable and restless, are quieter than usual, or need to be distant from or close to others. Or you may find that you aren't the same person you were before the loss. Don't be surprised if you experience conflicting feelings while grieving. For example, it's normal to feel despair about a death or a job loss yet also feel relief.
The grieving process does not happen in a step-by-step or orderly fashion. Grieving tends to be unpredictable, with sad thoughts and feelings coming and going, like a roller-coaster ride. After the early days of grieving, you may sense a lifting of numbness and sadness and experience a few days without tears. Then, for no apparent reason, the intense grief may strike again.
While grieving may make you want to isolate yourself from others and hold it all in, it's important that you find some way of expressing your grief. Use whatever mode of expression works for you. Talking, writing, creating art or music, or being physically active are all ways of expressing grief.
Spirituality often is part of the grieving process. You may find yourself looking for or questioning the higher purpose of a loss. While you may gain comfort from your religious or spiritual beliefs, you might also be moved to doubt your beliefs in the face of traumatic or senseless loss.
Grieving problems. In this complex and busy world, it can be hard to fully grieve a loss. It is possible to have unresolved grief or complications associated with grieving, particularly if you:
It can take years to go through a grieving process. Feelings of grief may return during holidays, birthdays, and other special events.
With loss, your sense of self and security is disrupted. It may help to develop or strengthen connections with other people, places, or activities. These new parts of your life are not meant to replace what you have lost. Instead, they serve to support you.
Grief itself is a natural response that doesn't require medical treatment. But sometimes people need help getting through the grieving process.
If you or someone you know exhibits suicidal behaviour (such as showing signs of action on a suicidal threat that seems real), call 911 or other emergency services immediately.
If you find that a major loss has caused complications, such as depression, prolonged anxiety, post-traumatic stress disorder (PTSD), or severe and prolonged grief, see your doctor and a grief counsellor for treatment.
If you have a chronic medical condition that has been made worse by the emotional and physical stress of grief, see your doctor immediately.
If you or someone you know develops complications of grief, such as disturbing or suicidal thoughts, depression, or anxiety, get help.
or other emergency services if:
Call a doctor if:
Counselling is best done by a mental health professional with experience in grief counselling, such as a:
Your family doctor or general practitioner can help you if you are having medical or mental health problems requiring medicine or counselling.
Home treatment plays an important role in working through the grieving process. Talking about the loss, sharing cares and concerns, and getting support from others are very important components of healthy grieving.
If you are caring for a dying loved one, it is important to take good care of yourself also. When you know that a loss is approaching, especially if you are able to participate in the care of a loved one who is dying, you may be better able to recognize and deal with your feelings of grief. It is important that you get caregiver support to help you care for your loved one as well as to help you prepare for your loss.
If you have just had a major loss in your life, it is important to:
To help you work through the grieving process, make sure to:
There are many ways that family members and other people close to a person who is grieving can give help and support. The best way to help a grieving person often depends on how well the person was prepared for the loss, the person's perception of death, and his or her personality and coping style. The person's age and stage of emotional development are also important to think about when you are helping a person who is grieving.
If someone you know is grieving:
Helping young children who are grieving can be challenging for adult caregivers. The best way to help a child varies according to age and emotional development.
Teens may need special consideration and care when they are grieving. Many times it is hard to know how to approach and help a teen in these circumstances.
Older adults may not express grief in the same way as other adults. Older adults are more likely to become physically ill after a major loss. They may already have a chronic physical illness or other conditions that interfere with their ability to grieve or that become worse when they are grieving. Also, older adults may be likely to develop complications associated with grieving. Older adults may be more likely than other people to experience several losses in a short period of time.
Other Works Consulted
Zisook S, et al. (2009). Death, dying, and bereavement. In BJ Sadock, VA Sadock, eds., Kaplan and Sadock's Comprehensive Textbook of Psychiatry, 9th ed., vol. 2, pp. 2378-2407. Philadelphia: Lippincott Williams and Wilkins.
American Psychiatric Association (2013). Conditions for further study. In Diagnostic and Statistical Manual of Mental Disorders, 5th ed., pp. 783-806. Washington, DC: American Psychiatric Association.
Fiorelli R (2011). Grief and bereavement in children. In BM Kinzbrunner, JS Policzer, eds., End-of-Life Care, pp. 635-665. New York: McGraw-Hill.
Gardner SL, Dickey LA (2011). Grief and perinatal loss. In SL Gardner et al., eds., Merenstein and Gardner's Handbook of Neonatal Intensive Care, 7th ed., pp. 898-937. St. Louis: Mosby.
McGolderick M, Walsh F (2011). Death, loss, and the family life cycle. In M McGoldrick et al., eds., The Expanded Family Life Cycle: Individual, Family, and Social Perspectives, 4th ed. Boston: Allyn and Bacon.
Newman BM, Newman PR (2012). Understanding death, dying, and bereavement. In Development Through Life: A Psychosocial Approach, 11th ed., pp. 601-623. Belmont, CA: Wadsworth Cengage Learning.
ByHealthwise StaffPrimary Medical ReviewerAnne C. Poinier, MD - Internal MedicineDonald Sproule, MDCM, CCFP - Family MedicineJohn Pope, MD - PediatricsAdam Husney, MD - Family MedicineKathleen Romito, MD - Family MedicineSpecialist Medical ReviewerSidney Zisook, MD - PsychiatryJean S. Kutner, MD, MSPH - Geriatric Medicine,
Current as ofMay 3, 2017
Current as of: May 3, 2017
Anne C. Poinier, MD - Internal Medicine
& Donald Sproule, MDCM, CCFP - Family Medicine & John Pope, MD - Pediatrics & Adam Husney, MD - Family Medicine & Kathleen Romito, MD - Family Medicine & Sidney Zisook, MD - Psychiatry & Jean S. Kutner, MD, MSPH - Geriatric Medicine,
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