Grief

Grief is how we respond to losing someone or something that mattered. It's not a problem to be solved but a process of adjusting to a world that has changed. Bereavement refers specifically to the experience of losing someone through death, while grief describes the feelings and reactions that follow any loss.

People grieve after losing a loved one, such as the death of a parent, partner, child, sibling or friend. They also grieve after pregnancy loss, the loss of a pet, a relationship ending, a serious diagnosis, losing a job or home, or changes in health or identity.

Grieving can feel chaotic. Many people have heard of the "stages of grief," but in reality grief rarely follows a neat order. Feelings come in waves, sometimes triggered by anniversaries, places, songs or ordinary moments.

Grief often reflects love. Over time, most people find ways to carry the loss with them while continuing to engage with life, maintaining a sense of connection with the person they lost.

Grief symptoms affect the whole person, and they're a normal part of grieving.

Emotional
- Sadness, yearning and longing for the person
- Shock, numbness or disbelief
- Anger, guilt or regret
- Anxiety, fear or feeling unsafe
- Relief, especially after a long illness, which can feel confusing

Physical
- Fatigue and exhaustion
- Sleep problems
- Changes in appetite
- Aches, tightness in the chest or throat
- Getting sick more easily

Mental and behavioral
- Trouble concentrating or remembering
- Thinking constantly about the person or the death
- Feeling their presence, or dreaming about them
- Withdrawing from others, or keeping very busy
- Questioning beliefs or meaning

These reactions are usually most intense in the early months and gradually become less frequent, though waves can return for years. Experiencing them doesn't mean you're coping badly.

Everyone grieves differently. Factors that influence the experience include:

• The relationship: the closeness, role and complexity of the bond
• The circumstances of the death: sudden, traumatic or violent deaths, suicide and deaths of children often lead to more intense grief
• Previous losses and life experiences
• Support from family, friends and community
• Cultural and religious traditions around death and mourning
• Additional stresses, such as financial changes, moving or caring for others
• Mental health history, including depression or anxiety

Some losses aren't widely recognized, such as pregnancy loss, losing a pet, the death of an ex-partner or losses within stigmatized circumstances. This "disenfranchised grief" can be especially isolating because others may not acknowledge it.

Grief can also be anticipated, as when a loved one has a terminal illness. People may grieve before the death as well as after.

Grief and depression share symptoms such as sadness, poor sleep and loss of interest, but they differ. In grief, painful feelings tend to come in waves linked to thoughts of the person, and they're often mixed with positive memories. Self-esteem is usually intact. In depression, low mood is more constant, and feelings of worthlessness and hopelessness are common.

Grief and depression can also occur together, and bereavement can trigger a depressive episode, particularly in people with a history of depression.

For a minority of people, grief stays intense and disabling for a long time. Prolonged grief disorder is a recognized condition in which yearning for or preoccupation with the deceased persists, along with intense emotional pain, for at least a year after the death in adults, interfering with daily life. Symptoms can include feeling that part of oneself has died, difficulty accepting the death and avoiding reminders.

If grief feels stuck or unbearable, it's worth seeking support.

There's no right way to grieve, but some approaches tend to help:

• Allow yourself to feel: tears, anger and laughter are all part of grieving
• Talk about the person you lost with people who will listen
• Accept help with practical tasks such as meals, errands and paperwork
• Look after basic needs: sleep, food, movement and time outside
• Keep some routines, which offer stability
• Be cautious with alcohol, which can intensify low mood and disrupt sleep
• Find ways to remember: rituals, photos, writing a letter, marking anniversaries
• Postpone major decisions when possible
• Be patient; there is no deadline

Some people find meaning in faith, community or creative expression. Others find support groups helpful, especially for specific losses like the loss of a child or loss to suicide.

Grief often returns around holidays, birthdays and anniversaries. Planning ahead for these days, and letting others know they may be hard, can help.

Many people grieve with support from family and friends alone. Grief counseling or therapy can help if grief feels overwhelming, you feel stuck, it's affecting daily life after many months, or the loss was traumatic or complicated.

A psychologist, clinical psychologist or psychotherapist experienced in bereavement can offer grief counseling. Approaches include supportive counseling, cognitive behavioral therapy (CBT) adapted for grief and therapies developed specifically for prolonged grief. Trauma-focused approaches like EMDR may help after traumatic deaths.

In a first session, a therapist will invite you to talk about the person, the loss and how you're coping. You don't have to have the right words.

Seek urgent help if you have thoughts of suicide or of wanting to join the person who died: call 911 or your local emergency number, or call or text 988 in the US (Samaritans 116 123 in the UK and Ireland). Children and teens who are grieving may benefit from support designed for their age.