Skip to main content

Understanding grief


The loss of someone or something we love reminds us of the fleeting nature of life. After a significant loss, people usually react with deep sorrow or distress. While they express their grief, they may also feel anger, fear, and other emotions.

Common types of losses include:

  • The death of a spouse/partner, relative, friend, or pet
  • The loss of good health because of an illness
  • The end of a job 
  • The break-up of a personal relationship
  • The loss of a home, business, or possessions

The effects of a loss can disrupt a person’s life to varying degrees. To cope effectively, it helps to understand how we process grief and loss and how it affects us.

Stages of Grief

Many experts believe that after a loss, everyone goes through different stages of grief. The five stages of grief, originally developed by Dr. Elisabeth Kübler-Ross in her studies, “On Death and Dying,” is an often-cited example and typically follows the order:

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

Researchers have found, however, that not everyone grieves in the same way, in the same order, or for the same length of time. And, some mourners don’t even go through all of these stages.

According to Columbia University’s Center for Complicated Grief, there are three possible types of grief an individual can experience:  

  1. Acute grief – This is the initial period after a loss often includes strong feelings of longing and sadness along with anxiety, bitterness, anger, remorse, guilt, or shame. The griever focuses on the deceased and grief dominates their life.
  2. Integrated grief – The lasting form of grief, in which an individual experiences grief without being dominated by it.  An individual experiencing this type of grief can use the thoughts, feelings, and behaviors related to the loss to honor and remember the deceased.
  3. Complicated grief – This is a persistent and maladaptive form of intense grieving when the bereaved don’t fully adapt to a loss. They can feel intense emotional pain and a future without their loved one seems bleak.

Studies suggest that more than 60 percent of people rebound from grief fairly quickly. About a quarter of people feel better within one to two years, while one in ten mourners experience “complicated” grief, which can last for years.1 Feelings that linger for several months or years and affect a person’s ability to function as they normally would are indications of complicated grief, and may require professional help.

When Grief Becomes Complicated

The signs of complicated grief may include:2

  • Intense sorrow, pain, and rumination over the loss
  • An obsession with the loved one’s death
  • An extreme focus on reminders of the loved one or excessive avoidance of reminders
  • Intense and persistent longing or pining for the deceased
  • Problems accepting the death
  • Numbness or detachment
  • Bitterness about the loss
  • A feeling that life holds no meaning or purpose
  • Lack of trust in others
  • An inability to enjoy life or reflect on positive experiences with the loved one

There may be physical signs too. Research shows that after a loved one dies, blood pressure and stress hormones increase in the bereaved and their immune system weakens. Besides higher stress levels, those who experience complicated grief can also have an imbalance of the hormone oxytocin, which helps people bond with one another.

In addition to the signs, there are also factors that can increase the risk of developing complicated grief, including:

  • An unexpected or violent death
  • The death of a child
  • A close or dependent relationship to the deceased 
  • Social isolation or loss of a support system or friendships
  • A history of depression, separation anxiety, or post-traumatic stress disorder (PTSD)
  • Traumatic childhood experiences, such as abuse or neglect
  • Other major life stressors (major financial hardships, serious illness, etc.)

When symptoms persist, long-time mourners may find relief through mental health counseling. Signs that someone should seek professional help include:

  • Depression
  • Suicidal thoughts or behaviors
  • Significant and ongoing anxiety, including PTSD
  • Major sleep disturbances
  • Increased risk of physical illness, such as heart disease, cancer, or high blood pressure
  • Long-term difficulty with daily living, relationships, or work activities
  • Alcohol or other substance misuse and increased nicotine use

If you or someone you know is struggling with a loss, contact us. We offer tele-mental health services, eye-movement desensitization training (EMDR), depression screening and treatment, and other therapies. For more immediate assistance, call our 24-hour Crisis Hotline: (518) 483-3261 or (518) 891-5535.