What is Grief: Symptoms and Coping Strategies

Have you experienced the loss of someone or something significant to you? No matter the circumstances, a loss is always challenging to cope with. Losing a loved one like a parent, a partner, or a child can trigger a complex emotional response called grief. Grief can emerge in various ways, ranging from subtle and manageable expressions to overwhelming and debilitating feelings of loss and sadness. However, feeling grief after loss is a normal, natural response. Understanding what grief is and the different ways it can arise are the first steps in healing.

Grief refers to both the thoughts and emotional responses you feel after experiencing loss. It is an individual and universal experience. How you experience grief depends on individual temperament, personality traits, and the type of loss itself.1

There are many different reasons someone might feel grief. For example, you might feel grief after the sudden loss of a loved one, a breakup, or the loss of a family pet. But grief isn’t a feeling limited to the loss of someone important in your life; other times you might feel grief could be after you lose a sports game, move to a new city, or send your child off to college.

The different types of grief

Grief is a complex emotion that emerges in many different ways. According to the Cleveland Clinic, the most common forms of grief can be categorized into six different types, detailed in the chart below.2

Because everyone experiences grief in different ways, there are many different symptoms of grief. Sometimes people feel grief through more physical symptoms, while others might feel grief primarily through their emotions. You can also notice grief by recognizing behavioral changes within yourself or a loved one. The table below details some of the more common symptoms of grief.2

There are many different reasons someone might experience grief. Loss is a very personal experience, and you can feel grief from significant life-impacting losses and smaller, more subtle ones.3

Some more significant and obvious causes of grief can include:

• The loss of a close friend
• The death of a partner
• The death of a coworker, classmate, or colleague
• A breakup or divorce
• The death of a family member
• A miscarriage
• Losing a job

A few more subtle causes of grief may be:

• Moving to a new city or leaving your hometown
• Aging and typical reduction of ability
• A sudden debilitating health concern that isn’t immediately visible (an “invisible illness”)
• A big transition, like graduating from college
• Financial concerns

The concept of grief happening in stages was popularized in 1969 by Swiss American psychologist Elizabeth Kübler-Ross. In her book, On Death and Dying, Kübler-Ross introduced the stages of grief we’ve come to know today.5 However, it’s important to note that Kübler-Ross’ stages of grief are intended to explain the feelings of terminally ill patients, not the bereaving.

Even though the five stages aren’t necessarily intended for the people mourning, Kübler-Ross does write in On Death and Dying that family members do go through similar stages of adjustment. In a subsequent book published in 2004, Kübler-Ross stated that the five stages are “not stops on some linear timeline in grief. Not everyone goes through all of them or goes in a prescribed order.”10

So, while there’s no right or wrong way to grieve, nor are there any particular stages that need to be met in a specific order (or at all), below we examine the stages of adjustment most commonly discussed in the grieving process. These stages include:5

1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance

It’s important to note that while some people may go through each stage in the exact order listed above, you can skip stages entirely, repeat stages, and experience them in any order. Everyone experiences grief in a unique way, and there’s no right or wrong way to grieve.

Denial

Suppose you move to a new city and leave behind your closest friends and family. Instead of making a new community in the new city, you only reach out to your old friends and dedicate most of your free time to driving back to your hometown and spending time there.

This is an example of how denial can emerge; this is when someone doesn’t accept or has challenges comprehending the (often difficult) reality of a situation. Depending on the type of loss you are dealing with, denial can appear in different forms, such as:5

• Not wanting to discuss the loss
• Insisting that you're fine
• Going back to work or school too soon after a loss
• Distracting yourself from your feelings
• Pretending your loved one is still alive
• Speaking about a deceased loved one in present-tense

Anger

Anger is often viewed negatively, but it’s a perfectly natural response and is healthy to feel (as long as it’s not unjustly directed at someone else or yourself). In terms of grief, anger can sometimes manifest as blame. For example, if you lose your job, you might turn that grief inward on yourself or outward on your former coworkers who are still employed at the company. The anger from grief can also be more generalized and not targeted at anyone in particular. You might be more prone to becoming angry at other drivers or normally minor inconveniences when out of the house.5

Bargaining

The next stage is bargaining. This can happen before or after the loss and involves thinking about if-then scenarios. You may think things like, “If she recovers, I’ll never argue with her again.” And, post-loss, you might consider something like, “If I had taken him to a different doctor, this wouldn’t have happened.”5

Depression

The fourth stage is depression. After a loss, it’s common and perfectly normal to feel sad. If you’re concerned about not feeling saddened by a loss, it may be because you’re going through another stage of grief. The level of sadness you feel after a loss also depends a lot on the type of loss you’re experiencing and the way you’re processing your feelings. The more coping strategies and support systems you integrate into your life after a loss, the easier it will be to move through this stage of grief. And, while the depression felt during grief isn’t the same as clinical depression, it can turn into it if your emotions aren’t properly processed.5

Acceptance

The final stage is an acceptance that the loss has happened and that you are still okay. Of course, you might always feel a sense of loss knowing you will never see your mom again or that you can no longer snuggle with your family pet, but you can accept the loss, reflect on good memories, and look forward to the future. When someone is at the stage of acceptance, their grief no longer prohibits them from living their life.5 However, they still may feel intense emotions about the loss and dip into other stages at various times.

There are a lot of misconceptions about grief. The chart below details some of the more common myths and what the facts really are.4

There are many unique ways to deal with grief. Depending on your healing process, you may find that some coping strategies work better than others. Here are some ideas that might help you process grief:

• Talk to a therapist or join a support group
• Reach out to close friends or family
• Journal your feelings
• Disconnect from technology and spend time in nature
• Practice self-care (eat healthy, exercise, get adequate sleep)
• Allow yourself to feel your honest emotions
• Don’t minimize your loss

There is no set time limit for experiencing grief. Everyone grieves at their own pace, and allowing yourself time to heal and feel is okay. The length of your grief can depend a lot on what type of grief you’re experiencing.

Uncomplicated grief is a term that typically refers to the more common style of grief. This is when someone experiences a loss, goes through their stages of grief, and enters a level of acceptance within 1-2 years after the experience.5

Complicated grief (sometimes called prolonged grief disorder) is an extended, deep sadness that can feel debilitating. With uncomplicated grief, it’s typical to have the feelings of sadness gradually subside and become less overwhelming. If you are experiencing complicated grief, then your sadness and emotions may feel all-consuming and stop you from moving forward in the healing process. This type of grief is often seen after the loss of a loved one. Some of the symptoms of complicated grief include:6

• Difficulty focusing on anything other than the loss
• Ruminating about your lost loved one or completely avoiding anything to do with them
• Wanting to isolate and detach from support systems
• Refusing to accept the loss or feeling bitter about it
• Feeling hopeless, without purpose, and that nothing matters
• No longer trusting others
• Numbness or detachment
• Trouble carrying out normal routines
• Perpetually feeling like it's your fault (self-blame, guilt, depression)
• Wishing you had died with your loved one
• Suicidal thoughts

Differences between grief and depression

Depression and grief can manifest similarly, and depression is even a common symptom of grief. However, the two are distinct, with grief being a transient emotional state and depression being a persistent mood disorder. (It is possible to have both at the same time, though, and those with depression may experience grief more intensely.)

Grief is often felt in waves. Sometimes you may feel extremely sad and overwhelmed when talking about what you lost, while, other days, you might be perfectly fine discussing your loss and find joy in past memories of the person or thing. Comparatively, a depressed person will almost always experience some form of negative mood or thoughts.7

Another distinction between grief and depression is self-esteem. A person's grief will generally not impact their self-esteem, while someone who is struggling with depression will often have overwhelming feelings of worthlessness or self-loathing.7

Even though grief and depression are separate things, grief can turn into depression if your emotions and feelings aren’t properly processed. Some other ways to potentially prevent grief from turning into depression are practicing a self-care routine and reaching out to your support circle. Depression thrives in isolation, so the more you connect with your community during times of loss, the more likely you are to experience positive outcomes.8

When to seek professional help

There is no one ideal time to start looking for professional help, but the more support you integrate into your life after a loss, the easier it will be to move through your grief. Therapy is a great way to process grief and loss; a trained professional can help support your healing journey and help you feel less alone. And with so many online therapy options, it’s easier now more than ever to find a therapist for you.

While professional help could potentially benefit anyone experiencing loss, there are certain signs that point more strongly toward a need for therapy:9

• If your grief is stopping you from following through on your responsibilities
• If you have thoughts or feelings of self-harm or suicide
• If anxiety or sadness feels overwhelming
• If you deliberately avoid anything to do with the person you have lost
• If your grief turns into extreme anger and becomes destructive
• If your physical symptoms don't go away
• If your grief triggers substance use, overeating, or other maladaptive habits

Below, we’ve compiled a collection of resources to help you process and cope with grief, including resources for those in a crisis situation.

• National Suicide Prevention Lifeline - Call 988 or chat online.
• Crisis Text Line - Text HOME to 741741.
• Veterans Crisis Line - Free, confidential assistance from people qualified to support Veterans. Call 988 and press 1 or text 838255. Online chat is also available.
• The American Psychological Association (APA) offers a database of psychologists, which you can use to find ones in your area.
• Mental Health America (MHA) provides a guide on how to choose the mental health provider for you, including topics like referrals, insurance, and how to prepare yourself for an appointment.
• The Here Right Now campaign from the Centers for Disease Control and Prevention (CDC) is designed to “promote and strengthen emotional well-being and resiliency.” The page dedicated to dealing with grief can be found here.