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Grief

Mourning; Grieving; Bereavement

Grief is a reaction to a major loss of someone or something. It is most often an unhappy and painful emotion.

Causes

Grief may be triggered by the death of a loved one. People also can experience grief if they have an illness for which there is no cure, or a chronic condition that affects their quality of life. The end of a significant relationship may also cause grieving.

Everyone feels grief in their own way. But there are common stages to the process of mourning. It starts with recognizing a loss and continues until a person eventually accepts that loss.

People's responses to grief will be different, depending on the circumstances of the event. For example, if the person who died had a chronic illness, the death may have been expected. The end of the person's suffering might even have come as a relief. If the death was accidental or violent, coming to a stage of acceptance might take longer.

Symptoms

One way to describe grief is in five stages. These reactions might not occur in a specific order, and can occur together. Not everyone experiences all of these emotions:

  • Denial, disbelief, numbness
  • Anger, blaming others
  • Bargaining (for instance, "If I am cured of this cancer, I will never smoke again.")
  • Depressed mood, sadness, and crying
  • Acceptance, coming to terms

People who are grieving may have crying spells, trouble sleeping, and lack of productivity at work.

Exams and Tests

Your health care provider will perform a physical exam and ask about your symptoms, including your sleep and appetite. Symptoms that last for a while may lead to clinical depression.

Treatment

Family and friends can offer emotional support during the grieving process. Sometimes, outside factors can affect the normal grieving process, and people might need help from:

  • Clergy
  • Mental health specialists
  • Social workers
  • Support groups

The acute phase of grief may last up to 2 months. Milder symptoms may last for a year or longer. Psychological counseling may help a person who is unable to face the loss (absent grief reaction), or who has depression with grieving.

Support Groups

Joining a support group where members share common experiences and problems and help relieve the stress from grieving especially if you have lost a child or spouse.

Outlook (Prognosis)

It may take a year or longer to overcome strong feelings of grief and to accept the loss.

Possible Complications

Complications that may result from ongoing grief include:

  • Drug or alcohol use
  • Depression

When to Contact a Medical Professional

Contact your provider if:

  • You can't deal with grief
  • You are using excessive amounts of drugs or alcohol
  • You become very depressed
  • You have long-term depression that interferes with your daily life
  • You have suicidal thoughts

If you or someone you know is thinking about suicide, call or text 988 or chat 988lifeline.org. You can also call 1-800-273-8255 (1-800-273-TALK). The 988 Suicide and Crisis Lifeline provides free and confidential support 24/7, anytime day or night.

You can also call 911 or the local emergency number or go to the hospital emergency room. DO NOT delay.

If someone you know has attempted suicide, call 911 or the local emergency number right away. DO NOT leave the person alone, even after you have called for help.

Prevention

Grief should not be prevented because it is a healthy response to loss. Instead, it should be respected. Those who are grieving should have support to help them through the process.

References

American Psychiatric Association website. Trauma- and stressor-related disorders. In: American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013:265-290.

Powell AD. Grief, bereavement, and adjustment disorders. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 38.

Substance Abuse and Mental Health Services Administration. Tips for survivors: coping with grief after a disaster or traumatic event. HHS Publication No. SMA-17-5035 (2017). store.samhsa.gov/product/Tips-for-Survivors-/SMA17-5035. Updated December 2017. Accessed August 17, 2022.

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Review Date: 4/30/2022

Reviewed By: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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