Definition

Grief is a reaction to a major loss. It is most often an unhappy and painful emotion.

Alternative Names

Mourning; Grieving; Bereavement

Causes, incidence, and risk factors

Grief may be triggered by the death of a loved one. People also can experience grief if they have an illness for which there is no cure, or a chronic condition that affects their quality of life. The end of a significant relationship may also cause a grieving process.

Everyone feels grief in their own way. However, there are certain stages to the process of mourning. It starts with recognizing a loss and continues until a person eventually accepts that loss. People's responses to grief will be different, depending on the circumstances of the death.

For example, if the person who died had a chronic illness, the death may have been expected. The end of the person's suffering might even have come as a relief. If the death was accidental or violent, coming to a stage of acceptance could take longer.

Symptoms

There can be five stages of grief. These reactions might not occur in a specific order, and can (at times) occur together. Not everyone experiences all of these emotions:

• Denial, disbelief, numbness
• Anger, blaming others
• Bargaining (for instance "If I am cured of this cancer, I will never smoke again.")
• Depressed mood, sadness, and crying
• Acceptance, coming to terms

People who are grieving may have crying spells, some trouble sleeping, and lack of productivity at work.

Signs and tests

The doctor will perform a physical exam and ask questions about your symptoms, including sleep and appetite. Symptoms that last for a while may lead to clinical depression.

Treatment

Family and friends can offer emotional support during the grieving process. Sometimes outside factors can affect the normal grieving process, and people might need help from:

• Clergy
• Mental health specialists
• Self-help groups
• Social workers

The acute phase of grief usually lasts up to 2 months. Some milder symptoms may last for a year or longer. Psychological counseling may help a person who is unable to face the loss (absent grief reaction), or who has depression with grieving.

Reviewer Info: Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Timothy A. Rogge, MD, private practice in Psychiatry, Kirkland, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., 05/26/2008