What is grief?

Worry and anxiety can develop after a major loss. Anxiety is a general feeling of tenseness or uneasiness. You may feel generally anxious (called free-floating anxiety). Anxiety can cause physical symptoms, such as an upset stomach or a headache. Anxiety can also cause you to act in ways that are unusual for you, such as being more demanding, less patient, or more irritable.

Worries and anxiety can sometimes seem to take over your life, making you feel like everything is falling apart at the same time. You may need to slow down and take things one at a time. If you are feeling overwhelmed, ask for help from someone you trust, your doctor, or a counselor.

Feeling and expressing grief

Your way of feeling and expressing grief is unique to you and the nature of your loss. You may find that you feel irritable and restless, are quieter than usual, or need to be distant from or close to others. Or you may find that you aren't the same person you were before the loss. Don't be surprised if you experience conflicting feelings while grieving. For example, it's normal to feel despair about a death or a job loss yet also feel relief.

The grieving process does not happen in a step-by-step or orderly fashion. Grieving can't be predicted. Thoughts and feelings can come and go.

While grieving may make you want to isolate yourself from others and hold it all in, it's important that you find some way of expressing your grief. Use whatever mode of expression works for you. Talking, writing, creating art or music, or being physically active are all ways of expressing grief.

Spirituality often is part of the grieving process. You may find yourself looking for or questioning the higher purpose of a loss. While you may gain comfort from your religious or spiritual beliefs, you might also be moved to doubt your beliefs.

Adjusting to a loss

You may become more aware of your feelings of grief during holidays, birthdays, and other special events.

With loss, your sense of self and security is disrupted. It may help to develop or strengthen connections with other people, places, or activities. These new parts of your life are not meant to replace what you have lost. Instead, they serve to support you.

Your experience of grief is likely to be different from another person's. Similarly, you will probably grieve somewhat differently each time you experience a significant loss. Your reaction to loss is influenced by the relationship you had with the lost person and by your general coping style, personality, and life experiences. How you express grief is influenced in part by the cultural, religious, and social rules of your community.

Grief is expressed physically, emotionally, socially, and spiritually.

• Physical expressions of grief may include crying or sighing, headaches, loss of appetite, difficulty sleeping, weakness, fatigue, feelings of heaviness, aches, pains, or other stress-related ailments.
• Emotional expressions of grief may include feelings of sadness or yearning. But feelings of worry, anxiety, frustration, anger, or guilt are also normal.
• Social expressions of grief may include feeling detached from others, isolating yourself from social contact, and behaving in ways that are not normal for you.
• Spiritual expressions of grief may include questioning the reason for your loss, the purpose of pain and suffering, the purpose of life, and the meaning of death. After a death, your grieving process is influenced by how you view death.

Intense grief can bring on unusual experiences. After a death, you may have vivid dreams about your loved one, develop their behaviors or mannerisms, or see or hear your loved one.

Grief itself is a natural response that doesn't require medical treatment. Social support and good self-care may help. But if you find that your grief is making it difficult to function, contact a grief counselor, bereavement support group, or your doctor.

If you have symptoms of depression, prolonged anxiety, or post-traumatic stress disorder (PTSD), call your doctor.

Getting help for suicidal thoughts

Where to get help 24 hours a day, 7 days a week

If you or someone you know talks about suicide, self-harm, a mental health crisis, a substance use crisis, or any other kind of emotional distress, get help right away. You can:

• Call the Suicide and Crisis Lifeline at 988.
• Call 1-800-273-TALK (1-800-273-8255).
• Text HOME to 741741 to access the Crisis Text Line.

Consider saving these numbers in your phone.

Go to 988lifeline.org for more information or to chat online.

The loss of someone special translates into many separate losses in a person's life. Multiple losses occur when a person loses:

A partner.

Loss of a partner usually also means the loss of a constant companion. Loss of a partner can also cause financial hardship, and sometimes a loss of standing or recognition within the community. It may help to stay connected with friends and family when grieving the loss of a partner.

A child.

Losing a child may cause parents to lose their sense of purpose, hope for the future, and connection to other people. For example, they may lose their connection to the parents of their child's friends. Parents may also lose a major joy in their lives. If parents grieve a miscarriage or child's death differently, they can become more distant from each another or argue more. Counseling may help couples work through their grief together.

A parent.

Whether you're an adult or a child, losing a parent can interfere with the ability to be truly connected to another person. Adults and children grieve in different ways. When grieving the loss of a parent, it may help to reach out to others for support.

If you are caring for a dying loved one, it is important to take good care of yourself also. When you know that a loss is approaching, especially if you are able to participate in the care of a loved one who is dying, you may be better able to recognize and deal with your feelings of grief.

It is important that you get support to help you care for your loved one as well as to help you prepare for your loss.

Grief is a natural response to the loss of someone or something very important to you. The loss may cause sadness and may cause you to think of very little else besides the loss. The words sorrow and heartache are often used to describe feelings of grief.

Grieving is the process of emotional and life adjustment you go through after a loss. Grieving after a loved one's death is also known as bereavement.

Grieving is a personal experience. Depending on who you are and the nature of your loss, your process of grieving will be different from another person's experience. There is no "normal and expected" period of time for grieving.

Health problems that can develop from grieving include depression, anxiety, suicidal thoughts, and physical illness. If you or someone you know experiences any of the following problems, contact a doctor or mental health professional for counseling, medicine, or both.

Depression

Depression is the most common condition that can develop when a person is grieving. It's common in adults who experience a divorce or death of a spouse or child.

High levels of anxiety

Anxiety also is common during the grieving process. But anxiety can last longer than expected. And it can also become intense and include extreme guilt. Anxiety can:

• Make you feel like you are losing control of your emotions. Overwhelming fear is also common.
• Trigger episodes of physical symptoms (anxiety attacks) that you might mistake for a heart attack. During an anxiety attack, you are likely to have a feeling of intense fear or terror, trouble breathing, chest pain or tightness, heartbeat changes, dizziness, sweating, and shaking.

Physical illness

People who have chronic medical conditions may have a recurrence or their symptoms may get worse when they are grieving. Adults who lose a loved one sometimes develop new health problems. Children can also have stress-induced physical problems while grieving.

Post-traumatic stress disorder

People who experience a traumatic loss are at risk for post-traumatic stress disorder (PTSD). PTSD is an intense emotional and psychological response to a very disturbing or traumatic event, such as a rape, assault, natural disaster, accident, war, torture, or death. You can develop PTSD symptoms right after such an event. Or PTSD may develop months or even years later.

Symptoms may include:

• Persistent and painful re-experiencing of the event through dreams (nightmares) or while awake (flashbacks).
• Emotional numbness, or being unable to feel or express emotions toward family, friends, and loved ones.
• Avoiding any reminders of the event.
• Being easily angered, aroused, or startled (hyperarousal).

Counseling and medicines can be helpful for people who have PTSD.

Prolonged grief

Prolonged grief may also be called by other names, such as complicated grief. Symptoms include:

• Longing and yearning for the loved one.
• Intense loneliness.
• Being upset by memories of the loved one.
• Trouble doing everyday things without the loved one.

Prolonged grief is different from post-traumatic stress disorder (PTSD). With PTSD, a person is anxious and fearful that the traumatic event that caused the loss will occur again. In prolonged grief, anxiety results because the person is searching and yearning for their loved one.

If you or someone you know has symptoms of prolonged grief, seek help from a doctor or professional counselor specializing in grief counseling.

Suicidal thoughts

Sometimes when grieving, people have thoughts of ending their own lives. If you have been depressed or have had thoughts of suicide in the past, you may be at risk of having suicidal thoughts while grieving.

Talk to someone. Be open about your feelings. Reach out to a trusted family member or friend, your doctor, or a counselor.

Where to get help 24 hours a day, 7 days a week

If you or someone you know talks about suicide, self-harm, a mental health crisis, a substance use crisis, or any other kind of emotional distress, get help right away. You can:

• Call the Suicide and Crisis Lifeline at 988.
• Call 1-800-273-TALK (1-800-273-8255).
• Text HOME to 741741 to access the Crisis Text Line.

Consider saving these numbers in your phone.

Go to 988lifeline.org for more information or to chat online.

Grief and grieving are the natural response to a major loss, such as the death of a loved one. Loss can cause feelings of grief, sometimes when you least expect it.

You may find that old feelings of grief from past loss can be triggered by current experiences or anniversaries of that loss. This is normal.

Anticipatory grief happens in advance of an impending loss. You may feel anticipatory grief for a loved one who is sick and dying.