What Is Grief? Symptoms, Research, And Treatments

Grief is a complex reaction to loss, such as the loss of a family member or partner. All forms of grief are valid; many support options exist to guide individuals through this part of life. To answer the question “What is grief?”, you might start by understanding its potential symptoms, the research behind grieving, and the treatments available. 

What is grief? 

What are the symptoms of grief?

While each case of grief is unique, individuals with grief may experience several common symptoms in daily life, including but not limited to the following:  

• Physical sensations, such as nausea, upset stomach, headaches, dizziness, weakness or tension in the muscles, gastrointestinal distress, numbness, fatigue, and shortness of breath
• A sense of disbelief or confusion
• Difficulty concentrating
• A tendency to cry without provocation
• Sleep disturbances and restlessness
• Difficulty enjoying previously enjoyable activities
• Irritability or aggression
• Delusions and hallucinations
• Painful emotions 

Individuals with grief may also experience takotsubo cardiomyopathy, also known as broken heart syndrome. This heart condition can cause a person to experience physical symptoms similar to a heart attack, such as chest pains, heaviness, and severe pressure. Unlike a heart attack, which is typically caused by a blockage of the coronary arteries, takotsubo cardiomyopathy can occur in individuals with no evidence of artery blockage and is often incited by intense emotional states, such as grief. Other situations can also cause takotsubo cardiomyopathy, such as:

• Surgery or major illness
• Sudden blood pressure drops
• Experiencing violence
• Public speaking
• Severe pain
• Negative or shocking news

While takotsubo cardiomyopathy and grief symptoms can be difficult to cope with, in some cases, they are temporary or short-lived. However, others may experience a longer form of grief, known as a prolonged grief disorder. Other types of grief include collective grief, disenfranchised grief, and anticipatory grief. 

Grief research: Prolonged grief disorder

In the scientific article Prolonged Grief Disorder: Course, Diagnosis, Assessment, and Treatment, researchers estimate that approximately 10% of bereaved individuals develop a prolonged grief condition. For those who do not develop these conditions, there are typically two primary stages for those who experience grief: acute and integrated. 

Acute grief

Acute grief, which typically occurs immediately after loss, is often associated with more severe symptoms. These symptoms may include intense and confusing emotions, a significant preoccupation with memories and thoughts of their loved one, and reduced engagement with prior life activities. While the length of this period can vary from person to person, researchers estimated that acute grief often lasts approximately six to 12 months after someone has lost their loved one. 

Integrated grief

Integrated grief is a term that can describe the period after acute grief when an individual has adapted to the loss of their loved one. This adaptation may manifest in various ways, indicating that a person has acknowledged their loss and incorporated the experience into their life. Individuals with integrated grief may be capable of enjoying previously enjoyable activities, returning to work or school, and sustaining satisfying relationships. However, this stage does not indicate that a person has forgotten about their loved one, only that they’ve integrated the loss into their current worldview. 

Prolonged grief disorder 

For those who develop prolonged grief disorder, reaching the integrated stage of grief may be difficult. As such, they may continue to experience significant symptoms and mental distress. While every situation is different, researchers indicate that several factors can contribute to the development of prolonged grief disorder, including: 

• Maladaptive thought patterns, such as those that include blame
• Differences in social or health status
• Difficulty managing painful or difficult emotions
• Avoidance behaviors 
• Lack of social support, which can hinder adaptation to loss

Research also suggests that prolonged grief disorder may be associated with adverse outcomes, such as a higher all-cause mortality risk. Prolonged grief may also cause general impairments to health, such as a higher risk of cancer or increased substance use. 

While addressing grief can follow a different process for everyone, it may be challenging to do so alone. In these situations, an individual might seek treatment with a mental health professional like a grief counselor. 

Mental health treatments for grief

There are various mental health approaches that could help individuals experiencing grief. According to Bradley University, these approaches may include the following. 

Traumatic grief therapy

Those who lose a loved one suddenly or without warning may experience traumatic grief. This type of grief may be associated with severe symptoms that can impact a person’s ability to function. Traumatic grief therapy could offer techniques that can allow an individual to regulate their emotions and express their grief healthily. In addition, this treatment may target co-occurring conditions like post-traumatic stress disorder (PTSD) that can result from traumatic grief experiences. 

Complicated grief therapy

Prolonged grief may also be referred to as complicated grief, which can be treated with a specifically designed type of therapy. Complicated grief therapy uses a combination of other therapeutic approaches, such as cognitive-behavioral therapy (CBT) and acceptance and commitment therapy (ACT), to treat this type of grief. This process may involve discussing a person’s memories of their lost loved one, finding ways to remember them without increasing grief, accepting difficult emotions, and improving coping skills. 

Interpersonal therapy

Interpersonal therapy (IPT) may help people address challenges in past and present relationships. Different forms of IPT, including metacognitive interpersonal therapy and dynamic interpersonal therapy, could assist individuals struggling with different parts of the grieving process and how grief impacts their relationships. 

Acceptance and commitment therapy

Acceptance and commitment therapy uses six core processes to assist those experiencing grief or other conditions. These components may include:

• Acceptance: Acceptance may guide those living with grief to experience their emotions fully without self-judgment or attempts to avoid or suppress them. 
• Cognitive defusion: Cognitive defusion may change how individuals interact with their emotions and thoughts, reframing potentially negative thought patterns and behaviors that could contribute to their grief. 
• Being present: ACT can encourage individuals with grief to remain present and engaged in the current moment rather than dwelling on the past or worrying about the future. Mindfulness practices may be calming and grounding. 
• Self-as context: This process involves helping individuals recognize that they are more than their thoughts, feelings, and experiences. By developing a sense of self that is consistent and stable over time, those with grief can create a perspective that allows them to view their grief without becoming overwhelmed by it. 
• Values: Identifying and connecting with personal values is a step of ACT. By understanding what is truly important to them, individuals experiencing grief may find direction and motivation, which can help them understand their loss and its meaning within their lives. 
• Committed action: This component involves taking concrete steps toward living in alignment with one’s values. All value-driven actions may provide a sense of purpose, allowing individuals to progress and integrate their grief. 

Cognitive-behavioral therapy 

Cognitive-behavioral therapy may help individuals identify thoughts and behaviors that are detrimental to their well-being or contribute to their grief, such as thoughts that make them feel guilty. Once thought and behavioral patterns are identified, a CBT provider may show individual ways to reframe and restructure these patterns. Over time, this process may lead a person to accept the loss of their loved one and integrate their grief. 

Receive grief coping techniques in therapy

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How to find support 

While in-person forms of therapy can benefit those experiencing grief, in some situations, they may not be convenient. For example, if an individual doesn’t want to discuss the details of their grief in person or would prefer to talk about their situation from the comfort of their home, they might find an online therapy platform like BetterHelp more accessible. Through an online platform, clients can schedule a session time that works for them, including outside standard business hours. In addition, they can get matched with one of over 30,000 therapists, offering a higher selection of providers.  

Research indicates that online therapy can be as effective as in-person therapy. In one study, researchers compared 12 randomized controlled trials involving the use of psychotherapy delivered online and face-to-face. They found no significant differences between the two therapeutic formats in various metrics, including symptom severity, therapeutic alliance, function, client satisfaction, and overall improvement.