How Long Does Grief Last?

When an individual loses a loved one, they may experience an emotional state known as grief. While grief has no set timeline, the American Cancer Society estimates that the grief process may take a year or longer, with symptoms of grief usually becoming less intense over time. However, it can be possible to experience grief for longer or shorter amounts of time, as the process tends to be unique to each individual. For support in coping with grief, consider joining a support group or seeking the help of a licensed mental health professional. 

What are the stages of grief? 

According to Harvard Health Publishing, a person may experience five stages of grief after they lose a loved one. These stages were first listed in the book On Death and Dying by Dr. Elisabeth Kübler-Ross. It can be important to note that not everyone experiences each of the five stages, and that the stages don’t necessarily occur in any particular order.

1. Denial

During the initial stage of grief, it can be difficult for a person to acknowledge or accept that their loved one is gone. As such, they might deny that the event occurred, whether that be internally or externally. Denial can manifest in a variety of ways, such as the following: 

• Refusal to talk about the loss
• Avoiding any thoughts or potential reminders of the lost loved one
• Arguing or lashing out at others for bringing up the loss
• Telling others that their loved one is still alive
• Believing that the facts surrounding the loss are untrue or come from an unreliable source

Whether conscious or unconscious, these and other denial behaviors can serve as defense mechanisms designed to defend oneself from the shock and pain of the loss. In most cases, denial can be a normal and even necessary component of grief, as it may give individuals time to process what has occurred.

2. Anger

After a period of denial, an individual living with grief may begin to understand the evidence or information they have received, and this understanding can be accompanied by anger. The direction of this anger can vary, with common targets including oneself, medical professionals, family members, a higher power, or, in some cases, the deceased themselves. Individuals in this grief stage can experience a variety of thoughts, feelings, and behaviors, such as those listed below:

• Emotional outbursts
• Verbal or physical aggression
• Impatience
• Frustration
• Loss of control
• Pessimism

Anger can be a way to mask the more difficult and painful emotions associated with grief. The reason behind the preference for anger may be that it can offer more of a sense of control than sadness or helplessness. 

3. Bargaining

Once a person's anger subsides, they may start to experience the more difficult aspects of grief. These aspects may include a sense of overwhelm or hopelessness. As a person copes with the loss of control associated with losing a loved one, they can start to imagine how they may have altered the events that occurred. This can include picturing what would have happened if they had made different decisions or intervened in some way. In some cases, these imagined interventions would not have been possible. Individuals may also bargain with other individuals or higher powers, hoping to negotiate the circumstances surrounding the situation or change the outcome.

4. Depression

As a person realizes that there is no way to change what has already occurred, they could enter a period of depression. This phase may be marked by emotions that a person has tried to avoid in earlier stages, including a sense of hopelessness or sadness. Grief-related depression can also come with a specific set of symptoms, potentially including the following: 

• Loss of interest in previously enjoyed activities
• Sleep disturbances
• Fatigue and lack of energy
• Difficulty concentrating
• Restlessness or agitation
• Appetite and weight changes
• A sense of emptiness or isolation
• Uncontrollable crying 

5. Acceptance

After some time, an individual who experiences the loss of a loved one may come to accept the situation. This phase often involves shifting from confusion, anger, or depression to gratitude for the time they had with their loved one. Gratitude can manifest in several ways, including celebrating the person they lost through memorials, sharing memories about a loved one with others, and taking time to think about how this person impacted their life. The acceptance stage can also involve focusing on one’s life by making plans for the future and finding ways to move forward from the loss. 

While these stages may provide a way to understand one’s thoughts, feelings, and behaviors after loss, not everyone may experience the stages in the exact manner or order in which they are described. The duration of each stage can vary and often depends on whether a person experiences a grief-related condition or complicated grief. This type of grief can make it difficult to accept the loss of a loved one and may involve lengthy periods of traumatic distress. 

How to find support for grief 

Many individuals can benefit from assistance and guidance to cope with the grieving process. In some cases, this can involve talking about grief with family members or expressing your emotions to friends. Individuals may also seek help through support groups. According to the Hospice Foundation of America, support groups can offer several benefits: 

• Validation: The way a person expresses their grief can vary, with each stage potentially involving various physical, emotional, and behavioral elements. Some may find it difficult to understand why they are thinking or behaving in certain ways, or they may wonder if they are the only ones experiencing these types of grief-related reactions. 

Support groups can offer a way to validate a person's experiences and show them that others have been through similar processes. Even though each person’s grief is unique, those who have experienced loss may find the validation of support groups to be comforting.

• Socialization: While some individuals may have a reliable group of friends and family members with whom to talk after the loss of loved ones, others might not. For these individuals, support groups can offer relief from the isolation and loneliness that often impact those experiencing grief. 

The social aspect of support groups can also help individuals with grief become more comfortable with the possibility of discussing their losses. While this can be challenging during the denial and anger stages of grief, individuals often find solidarity in support groups and eventually discover that they are willing to talk about what occurred. 

Although talking to family members and attending support groups can be helpful, many cases of grief benefit from the support of mental health professionals. Grief counseling can take many forms and may use various therapeutic approaches, including those discussed below:

• Complicated grief therapy (CGT): CGT can address the symptoms of complicated grief, also referred to as prolonged grief disorder. This type of therapy often uses elements of interpersonal therapy (IPT) and cognitive behavioral therapy (CBT) to create a program that empowers clients to adapt to their situations and confront the losses of their loved ones.
• Cognitive behavioral therapy (CBT): CBT can be used to treat a variety of disorders, such as depression, anxiety, and grief. Research suggests that CBT may help individuals reach the acceptance stage of grief, strengthen their cognitive skills, and adjust their perspectives of the grieving process.
• Acceptance and commitment therapy (ACT): The goal of ACT is typically to accept the experiences a person has had in their life, including those related to their grief. While other forms of therapy may focus on changing the thoughts associated with the grieving process, ACT may allow individuals to acknowledge their experiences without needing to change their thought processes, at least initially.

While therapy can be beneficial for individuals experiencing grief, some may not have in-person forms of treatment. For example, those who lack health insurance might struggle to find a provider. Others could find in-person therapy inconvenient, as discussing the personal details of grief face-to-face can be challenging. Online therapy may be an effective and convenient alternative. 

Research suggests that in-person and online therapy typically have similar levels of efficacy. In a 2021 meta-analysis, researchers compared video-delivered psychotherapy (VDP) and in-person psychotherapy (IPP) in studies involving a total of 1681 participants. They found that VDP generally resulted in significant improvement and had similar results to IPP treatment.