Grief & Loss: How to Cope & When to Get Help

Grief is a normal reaction to loss and the life changes surrounding that loss. There are many types of grief, and it can have an impact on a person emotionally and psychologically, and physically.¹ Common reactions that individuals may experience include, but are not limited to, crying, feelings of sadness and depression, avoidance, shutting down, changes in sleeping patterns, and other physical effects of grief.

There are many effective ways to cope when experiencing a loss. Some of the ways to cope include reaching out to a support system (e.g. family and friends) for love and encouragement, practicing self-care, and seeking out the support of a mental health professional.

What Is Grief?

Grief is an overwhelming emotional response to the loss of a loved one, a relationship, or anything that has great emotional significance like a job or moving to a new city. There is no specific time frame associated with grief. Even though grief has universal emotions, each person experiences grief in their own individual ways.

Grief research experts define the immediate grief after a loss as being a “loss of regulation.” This loss of regulation can involve sadness, anger, anxiety, difficulty concentrating, and/or emotional numbness.²

What’s the Difference Between Grief and Depression?

There is often confusion about the difference between grief and depression since they are  so closely associated. Grief is a natural reaction to a major loss that can be easily identified. It is generally not treated with medication unless the symptoms become debilitating.  Depression is a psychological state that must have a specific number and type of symptoms in order to be diagnosed. It must last at least two weeks and may have unclear causes. Medication is a frequent type of treatment for clinical depression.

What Can Cause Grief?

Grief is often associated with death, though grief can be triggered by many life changes, including, but not limited to death. Some losses are more ambiguous, and the grieving process in those cases can be even more difficult.

Common situations that can cause feelings of loss or grief in a person include:

• Loss of a loved one, like a parent or grandparent, due to death
• Loss of a loved one due to incarceration
• Death of a pet
• Life changes (e.g., divorce or breakup, change in living situation, loss of a job)
• Natural disasters or global events, such as a pandemic
• Community violence
• Grieving a celebrity death

While grief can have many causes and circumstances, individuals experiencing these losses exhibit different symptoms of grief. Some people might even try to delay their grief in order to cope with the difficulties of the situation, but they will still need to process their grief eventually.

Symptoms of Grief

People who are grieving may exhibit a wide range of symptoms that vary in type and severity, as well as timing in the grieving process following the loss. These symptoms of grief can impact a person physically, emotionally, behaviorally, or psychologically. It is imperative when one has experienced a loss to seek out mental health support to help with the transition. Quite often right after a loss, a person may experience more intense reactions that are emotional, physical, and behavioral manifestations of grief which can include various symptoms.³

Psychological Symptoms

Psychological symptoms related to grief can vary from person to person. These symptoms can present immediately, after the loss or later on in life when a trigger occurs that is related to the loss. One common and particularly harmful psychological symptom associated with grief is guilt due to wishing things could have been handled in a different manner, such as wishing things that were unsaid could have been resolved, or wondering if anything could have been done to prevent the loss.⁴

Other psychological grief symptoms one may experience include:

• Difficulty focusing
• Depression
• Irritability
• Anxiety
• Feeling overwhelmed

Physical Symptoms

Not only are people impacted psychologically by grief, but one’s physical health can be impacted when grieving a loss as well. These symptoms can also be felt immediately after the loss, or later on in life when a trigger presents that is related to the loss. It should be noted that physical symptoms can be serious, so one should seek medical attention from a physician to rule out any underlying health concerns that could be impacting physical health.

Some physical symptoms of grief one may experience include:

• Headaches
• Loss of appetite
• Chest pains
• Muscle tension
• Appetite changes
• Rapid heartbeat
• Restlessness
• Sweating
• Changes in sleep patterns

Complications From Grief Symptoms

Symptoms of grief and loss can impact a person’s life at home, work, and school. As symptoms progress, relationships may suffer as a desire to withdraw and isolate from the outside world grows. People with severe anxiety due to grief may lose the desire to care for their own personal well-being and struggle to complete even basic hygiene needs.

The Stages of Grief

Elisabeth Kübler­-Ross is well-known for her work pertaining to grief and loss. Her work describes five stages of grief that one may experience when one has experienced a loss. The five stages are denial, anger, bargaining, depression, and acceptance.⁵ It is important to note that all stages do not show up at once and may vary in how they may present throughout a person’s journey. An individual working through the grieving process may not experience these stages in any specific order and may experience one stage longer or shorter than the other.

Denial

The process of a loss can be extremely painful and overwhelming. In order to deal with the array of emotions associated with grief, a common reaction is to deny or refuse to acknowledge the loss. This is a defense mechanism that is sometimes used to help one cope gradually with what has happened and learn to live with the sudden pain of the loss in a more gradual way. When a person is in the denial stage of grief, eventually they will have to deal with the emotions related to the loss. This often happens when a trigger presents related to the loss.

Anger

Anger is a common reaction to grief. During the anger stage of grief, anger is often misdirected towards people who have no control over the loss, as the cause of a loss is often impossible to confront directly. There are different types of anger, and it can present as outbursts, rage, extreme sadness, and an array of other behaviors associated with the grief. This stage can be very challenging for the person who is grieving, as they are often cognizant of misplaced anger and can experience increased levels of guilt. Loved ones attempting to support the grieving individuals are also particularly challenged by this stage.

Bargaining

During the bargaining stage of grief, one is attempting to negotiate in order to get the desired outcome from the loss because they are unable to accept the reality of the loss yet. For example, an individual may try to make a deal that if the pain subsides they will do something in exchange. This is a way for a person who is grieving to attempt to take back control of their life.

Depression

Grief elicits various emotions. However, in the depression stage of grief, experiencing the “heaviness” of grief is quite common. A person may feel overwhelmed, inattentive, and just unable to “pull it together,” perhaps having uncontrollable crying spells or being unable to get out of bed. These emotions can cause depression symptoms that can severely impact daily routines. When this happens, the grieving person must be able to ask for help from their support system, which could include family members, friends, mental health professionals, or a spiritual leader.

Acceptance

Many consider the acceptance stage to be the landing point of the grief journey. However, acceptance can have an array of emotions attached to it. Therefore, a person may feel both comfortable and uncomfortable emotions throughout the process. Some of the emotions that one may experience are relief, sadness, happiness, or confusion throughout this stage. During this part of the journey, one begins to accept that the loss is real and that the situation is not going to change.

This stage can be a harsh reality for a person who may have still been in complete denial about the loss and its ongoing impact. During this stage, it is important for the person who has experienced the loss as well as their support system to be patient with the process and also accept that there may be triggers and situations that may cause different feelings related to the loss to resurface–and that these feelings may be ongoing for years after acceptance is reached.

What to Know About the Grieving Process

How do you come to terms with accepting something that is unacceptable? Grief is a universal emotion that we all recognize but experience in different ways. Don’t judge yourself regarding the way that you are grieving as it is your own unique experience. Grief is a new experience for many people, and grief counseling may be needed to learn how to cope.

Elisabeth Kubler-Ross’s stages of grief have been adapted in recent years. There is now a grief model that has seven stages.

The seven stages are:

1. Shock and denial
2. Pain and guilt
3. Anger and bargaining
4. Depression
5. The upward turn
6. Reconstruction and working through
7. Acceptance and hope

Understanding the stages of grief gives you a useful framework to work with—however, they are not linear. Some people may skip a stage, while others may revisit a stage more than once. You may feel you are on solid ground and then experience a difficult time with emotions that overwhelm you. This is not unusual and is to be expected as you move through the grief process.

Types of Grief

Grief can occur in different ways and be experienced for different reasons. With different types of grief the symptoms may be the same, but the source of the grief may differ.

Here are examples of different types of grief:

• Anticipatory grief: This type of grief occurs prior to a loss when you are expecting it and beginning to prepare. This can happen when you know a loved one is dying or has a degenerative illness. It can be an emotional roller coaster sometimes mixed with hope as the status of the loved one changes.
• Disenfranchised grief: This is a lonelier type of grief because the loss feels significant for you but society’s perceptions may be different. It is harder to get support because people don’t know what to say. Examples are instances of suicide, a miscarriage, or the death of a pet.
• Complicated grief: This type of grief is very challenging because it lasts a long time and the symptoms are very debilitating. Symptoms don’t get better and may even worsen over time. It is difficult for people with complicated grief to function in their daily lives without getting additional help from a mental health professional.

How to Cope With Grief

Living with grief and loss can be a challenging journey to process. However, it is important to identify healthy ways to cope with the loss to help with the process of grieving.

Here are some effective ways to cope with grief:

1. Understand That Your Grief Reactions Are Normal

Another way to cope with the loss is to understand that it is normal to experience various emotions that can change and fluctuate throughout the grieving process. Not only is it okay to experience a wide spectrum of emotions, but it is also important to accept that the emotions are normal and other grieving individuals experience these emotions as well.

2. Seek out Individual Therapy

Individual grief counseling sessions can be helpful to allow a person to discuss their grief in a safe place with an objective party unrelated to the grief. During individual therapy, one can discuss emotions related to the loss and find healthy ways to cope based on where the person is in the grieving process. If an individual is in an intimate relationship and the grief is impacting the relationship, couples therapy may be a good option for them to process the experience of the loss and find healthy ways for them to support each other throughout the journey.

3. Participate in a Grief Support Group

There are support groups available for grieving individuals as well as their friends, family, and other members of their support system. A group can be beneficial because the grieving individual is able to connect with others with similar experiences, and as a result, the emotions related to the grieving process can be normalized. A support group also offers a safe place to process the experience and to help find additional resources to help cope with the grief and loss.

4. Utilize Your Support System

Grief can be overwhelming, and a grieving individual may tend to self-isolate. Therefore, it is imperative to identify others as part of a support system who can provide guidance and support when feelings of grief become overwhelming. The support system can be friends, family members, counselors, community leaders, and others who are willing and able to provide support throughout the grief process, including online support communities. These systems can help you rediscover happiness.

5. Practice Self-Care

Throughout times of loss, grieving individuals can feel quite overwhelmed and may begin to neglect themselves. It is important during times of loss to be intentional about self-care and prioritize physical and mental health. Some great ways to practice self-care are to do enjoyable activities, spend quality time with friends, get massages and/or pedicures, take walks in the park, journal thoughts from the day, or any other activity that brings joy and calm.

6. Draw Comfort From Your Faith

For many people their faith and spirituality can help bring new meaning to your life after the loss of a loved one. Some religions believe that after death people are in a peaceful, loving place. This can be a source of comfort for those that are grieving after the death of a loved one.

7. Find Tangible or Creative Ways to Express Your Grief

Create meaningful ways to remember a lost loved one. People find strength and comfort in creating ways to remember a loved one or helping others who have gone through a similar experience. For example, helping create gun control policy after losing a loved one to gun violence or volunteering at a drug abuse program.

8. Journal Your Feelings

There are many ways you can use journaling to express your grief. It helps to understand your feelings and offers someone greater insight about themselves. It can be a safe, comforting way to communicate with a lost loved one. You can use grief journaling prompts to get started with a journaling practice.

9. Try to Maintain Your Schedule, Especially Hobbies

Creating a schedule is a powerful tool when struggling with grief. Having a regular schedule adds a sense of normalcy to your day to day life. Providing structure can bring comfort and a sense of control when life feels unmanageable.

Hobbies offer an escape or distraction which can feel welcome. They also offer creative outlets for expressing feelings and emotions to help you on your healing journey.

10. Plan Ahead for When You Might Be “Triggered”

It is important to understand that there are things that can trigger grief even when you feel you have moved forward. Common triggers are birthdays, anniversaries of the death, or visiting places you went with loved ones who have died. Unexpected triggers might be a familiar song or seeing a shirt a loved one had. Prepare yourself for triggers by identifying potential triggers for yourself and accepting whatever feelings emerge. For anticipated triggers, find a place you can grieve or identify a support person to be with to help you cope.

When to Get Help for Grief

It is never too early to get help with symptoms related to grief and loss. Getting help early while symptoms are mild can resolve the problem and prevent the grief from causing significant impairment in a person’s everyday life. On the other end of the spectrum, there are some people when grieving who may experience extreme sadness and feelings of being overwhelmed. When this begins to happen, it is important to seek out professional help for treatment, as these symptoms may be related to depression and should be closely monitored and treated in a clinical setting.

If a grieving individual is experiencing depression symptoms persistently, they should seek treatment.

Other symptoms of depression include:

• Various emotions that can lead to hopelessness
• Feelings of worthlessness and guilt
• Loss of interest in hobbies and other previously enjoyed activities
• Constant fatigue
• Inattentiveness
• Sleep concerns
• Changes in weight or appetite
• Restlessness or irritability
• Having suicidal thoughts or wishes of being dead

Finding a Therapist

Individuals experiencing depression symptoms relating to grief, or simply need help managing it, can benefit from the support of a therapist who has expertise in grief therapy. Fortunately, accessing professional mental health treatments is simple and straightforward in many situations.

Ways to connect with a mental health professional include:

• Contacting a primary care physician or mental health practitioner directly
• Using an online therapist directory where you can sort by specialist and insurance coverage
• Speaking with friends and loved ones who have firsthand experience with mental health concerns and diagnoses
• Calling a mental health hotline for suggestions about treatment options
• Contacting your insurance company to learn more about coverage for mental health treatment providers in the area

What to Look For in a Therapist

The following are essential considerations when finding a mental health professional who specializes in grief and loss:

• Whether or not the therapist is accepting new clients
• Confirmation that the mental health professional accepts your insurance plan
• Has availability on days that you are available
• Meets your guidelines of characteristics to feel safe and comfortable speaking about your concerns
• Holds expertise in the area of concern in which you are seeking treatment 

How to Be a Supportive Friend or Family Member Through Grief & Loss

If you have a friend or family member who is grieving a loss, it is important to understand that everyone has different grief reactions and may respond differently when grieving a loss. Some people have noticeable physical, behavioral, and/or emotional symptoms when it comes to grief, and some people grieve silently and subtly. Therefore, it is imperative for loved ones to provide support to those who are grieving, whatever that support looks like for that individual at that particular time.

Here are a few actionable steps on how to help a grieving friend or family member:

Be a Listening Ear

Provide support to your grieving loved one by simply listening. During this time, it is important to not try to solve the problem for your loved one but to listen and be there. When listening to what it is that they are experiencing, know that there may be times when the person is laughing and then other times when the person is crying. These fluctuating emotions are normal, and it is important to let them experience those emotions without minimizing how they feel about the loss.

Share Mental Health Resources

If you know of local resources that can provide support to your grieving loved one, this is now the time to share those resources. Resources can include, but are not limited to, support groups, counselors in your area, and other activities that could benefit them throughout the process.

Know That Grief Is Personal

Understand that someone else’s grief may differ from how you may have experienced grief, or how you believe you would experience it. Grief reactions vary from person to person and may present themselves in different ways at different times. Reassure your loved one by affirming and supporting their individual grief experience, even if you personally don’t relate to it