This story originally ran April 6, 2022 and was updated Aug. 1, 2023.
Grief is a part of life. It’s a natural response to any significant loss, whether that’s the death of a loved one or a pet, the loss of a job, the end of a marriage or a decline in health.
Chances are that you will experience grief at some point, if you haven’t already. Although grief usually lessens over time, it can be hard to see hope when it is fresh or the loss is especially profound.
We spoke with UNC Health psychiatrist Donald Rosenstein, MD, about grief, each person’s unique experience living with grief and how to connect with others to get through a difficult time.
There Is No “Right Way” to Grieve
It’s important to know that no two people experience grief the same way, Dr. Rosenstein says. The loss of one person, for example, will often feel very different from the loss of another, even if you loved them both very much.
Researchers have long tried to understand how people experience grief. You’ve probably heard of the five stages of grief, which date to psychiatrist Elisabeth Kubler-Ross’ 1969 book On Death and Dying. Kubler-Ross interviewed people dying of a terminal illness and proposed five stages of emotion: denial, anger, bargaining, depression and acceptance. People tend not to experience all of these stages or move through them in a sequence, Dr. Rosenstein says.
The dual process model of grief describes two tracks of actively grieving—feeling deep sadness and yearning—and engaging in the forward-facing daily tasks of life, such as work, child care and errands. People typically move back and forth between the two modes, and that’s normal, Dr. Rosenstein says.
Researchers have found—and people’s lived experiences confirm—that most people are able to respond to the loss of a loved one with resilience, meaning that they can continue to go to work, take care of children and pets and function normally while experiencing great sadness at times. If you are able to manage the loss of a loved one with sadness but not distress, you may worry there’s something wrong with you. There isn’t.
“Dozens of studies have demonstrated that most people are, in fact, quite resilient, meaning that even though they may be deeply affected by the loss, they continue to carry on and cope well emotionally,” Dr. Rosenstein says.
Ways to Cope with Grief
In the first days and weeks after a loss, people may feel adrift in their deep sadness. Over time, these feelings should lessen, but periods of sadness and yearning to have what is lost may persist indefinitely, even for a lifetime.
While acknowledging that grief experiences vary, Dr. Rosenstein shares some strategies he recommends to help people cope with grief.
- Allow yourself to experience the loss without judgment or expectation. Try not to worry about what you should or shouldn’t be feeling and how long it should last. “Trying to suppress grief typically doesn’t work well and probably delays the healing process,” Dr. Rosenstein says. If you are doing better than you might expect, that’s OK, too.
- Spend time thinking of your loss but stay engaged in your daily life. “There’s nothing wrong with reminiscing,” Dr. Rosenstein says, “but you don’t want to get stuck there.” Check in with yourself to make sure you are continuing the important day-to-day responsibilities of taking care of yourself, your children or pets and other obligations.
- Connect with family and friends or a support group. “Most people will fare better if they grieve with others instead of isolating themselves in their grief,” Dr. Rosenstein says. Grief counselors and support groups are available, often based on specific types of loss. This support can be especially helpful when there were complications or unresolved issues at the time of the loss.
- If you have a religious community, seek support. Many religious organizations have programs in place to process loss that you might find helpful.
- Take time to grieve before making major decisions. It’s probably best to pause before quitting your job, moving or making other sudden decisions when grief is new.
- Seek help if you’re engaging in self-destructive behavior. If you’re abusing substances, behaving recklessly or your relationships are suffering, seek out a therapist or counselor who can help.
How to Help Someone When They’re Grieving
- Give them space, but don’t disappear. You may be close to someone grieving and want to help them, and it’s critical for grieving people to have support from family and friends. But it’s important not to overwhelm the person with visits, calls or advice. “They may want some time to themselves and not be told that if you just do X, Y and Z, you’ll be better,” Dr. Rosenstein says. This doesn’t mean, however, that you should avoid the person or the subject of their loss. Try to remain available to them and take their cues on how to proceed.
- Ask them how they’re doing and whether they want to talk about it. Checking in with your friend or family member is important, as is being available to listen when they’d like to talk. Equally important is allowing them to decide if and when they want to talk about their grief. They may prefer to keep some areas of life close to the way they were before—for example, in the office or on the sidelines of their kid’s soccer game.
- Perform acts of service. It’s good to ask people what would be helpful for them, but sometimes it can put a burden on them to come up with something. Think about things that would lighten their load. Delivering a meal is a great idea and easy to organize with others using online resources. Offer to pick up their kids after school or take them to activities. Be specific about what you can do, including dates and times, to provide practical help in addition to emotional support.
Intense or Long-Term Grieving: When to Get Help
With so much variability in the experience of grieving, you may wonder what’s normal and how to know when you need help from a professional.
Grief can become problematic because of its intensity or duration.
“If you’re so profoundly sad that there is no joy in your life whatsoever, you might need help,” Dr. Rosenstein says. “If you can’t sleep, can’t eat, if you are so anxious that you have a drink at night to calm down and then you have two, three or four more … if you are so down and depressed that you can’t function, then you should get help.”
The American Psychiatric Association says prolonged grief disorder is marked by severe and incapacitating grief that lasts more than a year.
“This new diagnosis has been the subject of extensive research and in development for a long time,” Dr. Rosenstein says. “Most mental health professionals are supportive of this new diagnosis and point to compelling evidence that a small percentage of people struggle so profoundly in their grief and are deserving of thoughtful attention and treatment to alleviate their suffering.”
According to Dr. Rosenstein, it’s also common for people who are grieving to think about self-harm.
“If you do have thoughts of suicide and feel that you might act on those thoughts, you absolutely need to get help,” he says. If you are thinking about suicide, act now and call or text 988 for the Suicide & Crisis Lifeline.
Talk to your doctor if you are experiencing ongoing feelings of sadness that interfere with your ability to function. If you are thinking about suicide, act now. Call or text 988 for the Suicide & Crisis Lifeline.