What Is Grief?

July 8th, 2025

Written by: Elreacy Dock, DBH, D.Th
End of Life Content Adviser & Writer

Professionally reviewed by: SevenPonds Team

Two young women hugging each other experiencing grief and loss

According to the American Psychological Association, grief is the anguish a person experiences in response to a significant loss, usually, but not always, the death of a beloved person. Grief is not simply an emotional response; it includes physical and physiologic manifestations, such as sleeplessness, poor appetite, physical discomfort and an increase in stress hormones that can lead to serious and even life-threatening illnesses.

Grief is a universal human experience: Across cultures and nationalities, all people grieve when they lose something they value, whether the loss is in the form of the death of a loved one or something less tangible, such as the end of an important relationship or the loss of a sense of safety after a traumatic event. And while the most intense emotional reaction in grief is usually sadness, other emotions, such as anger, guilt and anxiety often appear at the same time.

Jump ahead to these answers:

Sources of Grief

Many life events and situations can trigger a grief response. Although we tend to think of the death of a significant person in our life as the main source of grief, other situations that can trigger intense grief include:

The death of a pet
Divorce or the end of an intimate relationship
Losing a job
Serious illness and loss of health
Miscarriage or stillbirth
Loss of an important friendship
Retirement
Loss of a cherished dream
Serious illness in a loved one

Even losses that society may view as “minor” or unimportant can lead to significant grief. Known as disenfranchised or unacknowledged grief, this kind of grief may occur following the loss of a person who is not actively in your life, such as a former spouse or an old friend you haven’t seen in a long time.

Symptoms of Grief

Every person grieves differently — there is no “ right” way to grieve any more than there is a “right” way to love. Nevertheless, people tend to experience similar physical, mental and emotional manifestations when they are grieving, although these may differ greatly in intensity from one individual to the next. The most common of these include:

Physical

Headaches and body aches
Nausea, lack of appetite
Fatigue or exhaustion
Dizziness
Shortness of breath
Hypersensitivity to sensory stimuli such as noise, heat and touch
Heart palpitations

Mental

Forgetfulness
Sleep difficulties (too much or too little)
Inability to concentrate
Confusion
Decreased decision-making or problem-solving abilities
Thoughts of self-harm and/or suicide
Loss of interest in things that were once pleasurable

Emotional

Intense sadness
Anger
Guilt
Shame
Helplessness
Anxiety
Mood swings
Loneliness and yearning

These symptoms are usually most troublesome immediately after a loss and dissipate to some degree with time. But even as the overall anguish lessens, most people will experience intense bursts of grief-related emotions for a long time after a loss. In some instances, such as following a violent death or the death of a child, they may persist for as long as the grieving person is alive.

The Physiology of Grief

Grief takes an enormous toll on the body as well as the mind. Health professionals have known for a long time that grievers are at a higher risk of death than others with similar health profiles who are not bereaved. In one study from 1963, newly bereaved widowers had a 40% increased risk of death in the 6 months following the death of their spouses than men with similar health characteristics who were not bereaved. And in a more recent study, bereaved individuals had a higher risk of dying from any cause, including heart disease, cancer, stroke, accidents or violence, than people of similar age and health status who were not bereaved. But until recently, little research has been done to determine what physiologic changes underlie these increased risks.

Recently, however, researchers have uncovered multiple physiological factors that impact the risk of dying following a significant loss. Many of these appear to be self-limiting: that is, they wane with time and cause few long-term effects. Others seem to have a more lasting impact, particularly among the elderly. Some of the most notable of these include:

Increased cortisol levels: Cortisol is a hormone produced and secreted by the adrenal glands. Although it has many important functions in the body, one of its main jobs is to regulate the body’s stress response. When a person experiences a stressor such as the death of a loved one, the adrenal glands release cortisol, which — in the short term — enhances the immune response, suppresses inflammation and releases a short burst of glucose to fuel the “fight or flight” response. But when cortisol levels are elevated for a prolonged period of time, the opposite can occur: that is, increased inflammation, suppression of the immune system and persistently high blood sugar. These changes can have a damaging effect on a person’s overall health.

Cardiovascular changes: Studies of people who have experienced a significant loss consistently show that heart rate increases for an extended time period after the loss. This may be of little consequence in a healthy young individual, but in an older person with pre-existing heart disease, the results can be devastating. Similarly, blood pressure has been shown to increase for up to 2 years following a significant loss, which can lead to changes in cardiac function and an elevated risk of heart failure and stroke.

Immune system changes: Immune suppression is a well-documented feature of early bereavement, and may persist longer for people suffering from prolonged or complicated grief. Not only does this put the individual at greater risk for infections such as seasonal colds and flu, but if persistent, it increases the risk of cancer, especially in the elderly.

Sleep disturbances: Disruption in normal sleep patterns is a very common occurrence in the early phase of grieving. And while short-term sleep disturbances are tolerated fairly well by most people, they may lead to chronic sleep disturbances in the bereaved. This can have serious health consequences, including a higher risk of hypertension, cardiovascular disease, metabolic syndrome, and dementia. Even short-term sleep disruption can lead to increased irritability, anxiety, depression and diminished overall quality of life.

Additionally, recent research into the neuroscience of grieving indicates that grief and mourning actually involve changes in the brain. As Mary Frances O’Connor, an associate professor of clinical psychology and psychiatry at the University of Arizona, explains in an interview with SevenPonds,the brain “is a prediction machine” that encodes our closest relationships into its neural pathways, especially those in the areas associated with reward: What this means is that our brains predict our beloved’s presence in our lives. We expect to encounter them in certain situations as we go through our day.. We expect to talk to them about daily events. We expect to see them walk through the front door after work. And when those expectations are no longer met and the person is gone, the brain can’t adjust all at once…it needs time to rewire itself in order to acknowledge and accept the loss. In the interim, the griever may have trouble believing that the loss is real because their brain hasn’t absorbed the reality that the beloved object is gone. As O’Connor frames it: “The brain doesn’t understand “gone”; it understands “far away and must go get.”

Further, the amount of time it takes for the brain to adjust to a beloved’s absence varies based on many circumstances including the closeness of the relationship and the life-stage of the grieving individual. This variation contributes to the unpredictable and non-linear nature of grief.

Grieving Styles

Until fairly recently, most psychotherapists (and by extension the lay people who worked with them} believed that grieving followed a somewhat predictable trajectory. Grief therapy was largely informed by Freud’s psychoanalytic theory of grief, which he set forth in his book “Mourning and Melancholia,” published in 1917. Freud believed that the central task of grieving was to “detach” from the person who died through a process he called “grief work,” which involved intensely thinking about, talking about and engaging emotionally with thoughts of the person who died. He called this work “hypercathexis” and theorized that it was the only way in which a grieving individual could find “closure” and move on with their lives.

Freud’s theory also informed the work of Elizabeth Kubler-Ross, who helped usher in the era of “death acceptance” and championed the hospice movement in the 1970s. It was also the theoretical basis of her seminal book “On Death and Dying,” which famously outlined the five stages of grief. And while Kubler-Ross’ book was meant to describe the anticipatory grieving of people who were dying, the psychological community seized on these stages as a means of conceptualizing the grieving process for those who lost loved ones as well. For years, the five stages model, including the notion that grieving persons needed to “work through” each stage before reaching acceptance, was the basis of most psychological interventions aimed at helping the bereaved.

Today, however, the “one size fits all” model of grieving that Freud and Kubler-Ross embraced. has been replaced by the understanding that people may grieve in very different ways. Thanks in large part to the work of Kennneth Doka and Terry Martin, who authored “Grieving Beyond Gender: Understanding the Ways Men and Women Mourn”, the psychological community now recognizes that healthy grieving can be expressed in vastly different ways. Specifically, Doka and Martin outlined two distinct grieving styles: intuitive and instrumental, while also emphasizing that most people fell somewhere on a continuum between the two.

Intuitive grievers are people who tend to express their grief in what many of us look at as “typical” for someone experiencing a loss. They experience very strong emotions and express them quite openly. They process their feelings externally and tend to gain comfort from talking about their loss. Doka and Martin found that this grieving style was more common among women than men.
Instrumental grievers are more intellectually and behaviorally oriented in their grief. They tend not to express their feelings as openly as intuitive grievers, and may process the loss by thinking about what happened and problem-solving ways to adapt to the loss. Often, but not always male, instrumental grievers may choose action rather than words to process their grief: for example, by building a monument or planting a garden versus joining a support group.

Additionally, recent research has identified another type of griever, the “resilient griever.” A term that applies to nearly one-half of individuals who experience a loss, resilient grievers tend to show few of the typical manifestations of grief. They feel pain and sadness, of course, but they tend to cope with those emotions well and continue to function quite effectively after the loss. According to Kenneth Doka, these resilient grievers tend to have a number of things in common:

They have had relatively few losses in their lives
They were psychologically healthy before the loss
They have a strong support system
The death they are mourning was not sudden or traumatic
They had the opportunity to say goodbye
They do not feel that the death was preventable
They believe that something good can come from the loss
The consciously try to recall positive memories of the person who died

Doka emphasizes, however, that no grieving style is “better” than another, and that every individual must find their own path through grief. Whether you cry or don’t cry; sleep too much or too little; feel exhausted or energized; go back to work immediately or take a month off to heal, what you’re experiencing is normal for you.

The Grief Journey

In 2016, Kenneth Doka authored a book titled “Grief Is a Journey.” Written with the express intent of reassuring those mourning a loss that grief follows no timetable and no fixed trajectory, the book painstakingly outlines the many ways grief affects the body and the mind while simultaneously dispelling some of the most widely accepted but erroneous beliefs about grief.

We have already explored some of the truths contained in Doka’s book, but as we discuss the journey of grief, it’s worthwhile to mention the most important points again. These include the following:

Every person’s grief is unique. Further, people grieve every loss in a unique way. What this means is that it’s impossible to predict how you will react to today’s loss based on how you reacted to yesterday’s. The nature of your relationship to the valued person or object, your current life circumstances, and even your age can affect how you respond to a death or other significant loss.

Grief is not at all about “letting go.” Human beings are not wired to “let go” of the people they value and love, and may actually fear that releasing the pain of grief will allow them to forget the relationship and memories they once shared. In fact, explains Doka, the opposite is true. As the sadness and difficult emotions of grief begin to lessen, happy memories and a new sense of connection emerge. One of the tasks of grieving is to find ways to honor that connection as you move forward with your life.

Every loss is actually many losses, and those losses need to be named and grieved as well. When a loved one dies, for example, their death is accompanied by the loss of a relationship, the loss of future hopes and dreams, the loss of roles and responsibilities (e.g. as a wife, caregiver, lover etc.) and, in many cases, the loss of social ties. Understanding that those losses impact your life and learning to acknowledge and deal with them is an important part of mourning a loss.

“Closure” is a myth. Much like the myth that “letting go” of a beloved person or relationship is possible or desirable, the idea that it is possible to “close the book” on grief is deeply flawed. While it is true that certain rituals can bring a measure of comfort: for example, a funeral or memorial service can be both therapeutic and meaningful, no single event or series of events marks the “end” of grief.

Mourning is not simply about coping. In the initial stages of mourning, painful emotions and physical discomfort almost demand that we find ways to cope with what is happening to us emotionally, physically and spiritually. But as time passes, it’s possible to find meaning in our loss and even learn from what we are experiencing.

The grief journey, in other words, is a long-lasting individual experience that never truly ends. It affects every aspect of our being, and it is impacted by our personality, culture, life experiences, gender and our relationship to the person or object that is gone from our life. Grief hurts: No one escapes the pain of loss. But grief also has the power to heal and shape us into even better versions of ourselves.

The Tasks of Grieving

Although grief research is an emerging field, and different grief “models” explain the process of mourning somewhat differently, in recent years there has been some consensus among grief experts that grieving involves the completion of certain tasks.” Different experts may present this concept somewhat differently, but at their most basic they include the following:

To accept the reality of the loss. After a death or significant loss of any kind, it is natural to use denial as a defense against painful reality. Especially if the loss was unexpected, it is often impossible to accept the truth of what happened and its impact on our lives all at once. But as time goes on, continued denial can be unhelpful and even harmful. Acceptance of reality is an essential part of moving forward through grief.

To experience the pain of loss. Again, every individual will experience grief in their own unique way. Some people are intuitive grievers, and will process the loss emotionally and verbally. Others are instrumental grievers, who may say very little and express very little emotion, but instead process their grief by “doing something” with it physically. Most people will fall somewhere on a continuum between these two extremes and spend some time outwardly expressing their emotions and some time channeling their grief into activities they find meaningful. What’s important is not how a person experiences their grief, but that they acknowledge it in some way, if not to others, at least to themselves.

To adjust to a new “normal.” Whether you have experienced the death of a loved one, the end of a relationship, or the loss of a cherished dream, life will be very different after a significant loss. It’s normal to feel as if the world has shifted on its axis and that nothing will ever be the same. It takes time — sometimes a great deal of time — to adjust to this new reality, and the process is rarely a smooth one. You may find yourself feeling afraid of assuming new roles and responsibilities and angry that the need to do so has been thrust on you. Or you may feel guilty and ashamed for “moving on” too soon. But accepting that life will and must go on is an important part of journeying through your grief.

Find an enduring connection to that which was lost as you adjust to a new life.

Arguably the most important task of mourning, finding a way to maintain a connection to a beloved who has died or another significant relationship while still moving forward is an essential aspect of “healthy” grief. Love never ends, but it can change form. And it is possible to remain connected to someone or something we have lost while experiencing life in new ways. Celebrating birthdays and anniversaries; visiting a favorite vacation spot; holding a yearly memorial service, or tending and maintaining a loved one’s garden are all ways to honor their continued presence in our hearts and minds while we embark on a new life.

Again, the tasks of grieving, like the “stages” of grief, is a theoretical model. How one individual grieves and mourns will always be unique. But as you follow your own path through grief, it can be helpful to keep these tasks in mind as guideposts to help you find your way.

Coping With Grief

As we have already emphasized, grief looks, feels and behaves differently for every person and in every situation. There is no set formula for coping with a significant loss. However, there are some coping strategies that have proven to be effective for many people who are coping with grief. Some of these are outlined below.

Acknowledge that you are not “yourself”

Grief changes us. As we have outlined above, a significant loss causes physical, emotional and physiological shifts that profoundly affect how we feel, react and behave. Unfortunately, we live in a grief-averse society, so there is often intense pressure on grieving individuals to “get back to normal” quickly after a loss. Despite this pressure, it is essential that you allow yourself to experience and honor your truth. Pretending to be okay when you are not will not make your grief symptoms disappear, and may actually make them worse.

Seek Out and Accept Support

Following a significant loss, it is sometimes difficult to allow those close to you to offer solace and support. This is especially true for instrumental grievers, who tend to process their emotional responses through actions rather than words. Yet even those who find talking about their loss difficult need to know that they are not alone. Allow others to be there for you, whether that is by preparing meals, doing household chores or helping you plant a garden to honor your loved one’s memory. Grief is a heavy burden; don’t try to carry it alone.

Practice Self Care

Immediately after a significant loss, friends, relatives and neighbors are typically available to help a grieving person care for their needs. But as others return to their everyday lives, you may find yourself struggling to care for yourself.Low energy, poor sleep, and appetite disturbances are common in bereaved individuals and may get in the way of your practicing self care. Nonetheless, it is essential that you do your best to care for yourself as best you can so that you can begin to heal.

Find a Support Group

Support groups are not for everyone. But if you find yourself feeling isolated, alone, or alienated from those around you, you may benefit from spending time with others who have experienced a similar loss.

Accept your feelings

Whatever you feel after losing a loved one is normal for you. Many grievers judge themselves for not reacting as they expected—whether that’s crying endlessly, feeling relief, or experiencing numbness. These reactions, whatever they may be, are valid and may persist for a while. Embrace your reality and trust that your feelings are appropriate.

Take care of yourself

Taking care of yourself during intense grief can be challenging, but it’s essential. Grief affects your body and mind, impacting your appetite, sleep, energy, and focus. You might feel disconnected, exhausted, or fragile—these feelings are normal and should improve with time.

In the beginning, loved ones may support you with meals and arrangements, but eventually, you’ll need to focus on self-care. Start small things you can try and then build on include the following:

Eat well: Prepare simple, healthy meals, avoiding processed foods high in sugar or salt. Eat at regular times, even if just a few bites.
Move daily: Exercise for at least 15 minutes, preferably outdoors, to boost your mood.
Sleep better:
- Keep a consistent sleep schedule.
- Avoid caffeine after 3 PM and limit alcohol. Herbal teas with chamomile, valerian root, or lavender can help.
- Turn off electronics an hour before bed.
- If you can’t sleep, get up and read or meditate before trying again.
- Persistent insomnia? Talk to your doctor.
Stay hydrated: Aim for 10–12 glasses of water daily.
Prioritize your health: Keep medical appointments and take prescribed medications.
Find calm: Add meditation or yoga to your routine—even 10 minutes a day helps.

Grief is a marathon, not a sprint. Some days will be better than others. Be patient and kind to yourself as you navigate this journey.

Comfort yourself with ritual

Rituals are symbolic actions that bring meaning and connection. After losing a loved one, rituals can honor their memory and help you find meaning in your grief. For some, these rituals are tied to religious or cultural traditions, like the Jewish practice of sitting shiva, which includes wearing mourning attire, covering mirrors, and reciting prayers.

However, rituals don’t have to follow any specific tradition or faith. Many people create personal ways to remember their loved ones. You might continue a shared habit, like enjoying a sunset with a glass of wine, doing the Sunday crossword, or taking a daily walk. These simple acts can keep their memory alive as you navigate your new reality.

Reach out to clergy

If you’re a person of faith, losing a loved one—especially suddenly or traumatically—may challenge your beliefs. Tragic deaths, like accidents, suicide, homicide, or the loss of a child, often leave people questioning their faith and searching for answers. It’s natural to feel angry or to blame God when nothing else seems to make sense.

If you’re struggling, take a step back and reflect. Many people in your position have wrestled with similar feelings and eventually found their way back to faith. Rabbi Harold Kushner, in When Bad Things Happen to Good People, offers a helpful perspective:

“Being sick or being healthy is not a matter of what God decides we deserve. The better question is, ‘If this has happened to me, what do I do now, and who is there to help me do it?’… It becomes much easier to take God seriously as the source of moral values if we don’t hold Him responsible for all the unfair things that happen in the world.”

Consider reaching out to a pastor, rabbi, or spiritual advisor to talk through your feelings. They may not have all the answers, but they can offer guidance and support as you navigate your grief and questions of faith.

Find creative outlets for grief

Creative expression can be a powerful way to process the complex emotions of grief. While you may not feel ready right away, consider exploring an artistic outlet as you regain focus and energy.

If you enjoy writing, start a journal or blog—platforms like Wordpress.com make it easy to create a free personal site. If you like sewing, you could make a quilt or blanket using your loved one’s favorite clothes. From painting and poetry to mosaics or glassblowing, any form of art can provide a healthy distraction and a sense of purpose.

Don’t worry about your skill level; this isn’t about creating a masterpiece. It’s about finding an outlet that helps you heal. Search online for local or virtual classes in something that interests you—there are countless options to explore. Through creative expression, you may find moments of joy and connection as you navigate your grief.Find comfort through reading

Explore books about grief

Known in the world of psychology as “bibliotherapy,” reading books, stories and poetry that deal with grief and loss is often an effective way to cope with grief. Whether you have lost a spouse, a child, a sibling, a friend, or a beloved pet, there are books available that were written by people who have been in the same situation that you are now. Similarly, films that deal with grief can be both cathartic and healing.

To find an extensive selection of books, films and poetry that deal with grief and loss, visit our Healing Library. You may also want to visit the Opening Our Hearts column in our online magazine to read true short stories about grief and loss that others have shared with us.

Explore natural healing

Natural, non-pharmacologic therapies such as acupuncture, Reiki, chiropractic and aromatherapy can be extremely healing for the body and the mind. This is especially true when they are combined with the other suggestions mentioned above. To learn more about these and other complementary therapies, visit our Learn About End of Life Section, Complementary and Alternative Medicine.

Consider grief counseling

Grief is a normal reaction to loss, not a pathological process. After the death of someone you love, it is normal to experience many difficult emotions, including sadness, anger, yearning, betrayal, emptiness, guilt and regret. It is normal to hurt, physically and emotionally. And it is normal to want these feelings to go away. But the difficult truth, for most people, is that there is no antidote to the pain of grief but time.

However, sometimes, counseling is essential for navigating grief. Consider seeking help if you experience the following:

Traumatic Grief: Sudden or devastating losses—such as the death of a child, suicide, homicide, or prolonged suffering—can cause overwhelming emotional and physical pain. Professional support is often necessary to process this grief.
Complicated Grief: While grief usually eases over time, some remain stuck in intense pain, unable to find hope or integrate the loss into their lives. Complicated grief therapy can help break this cycle and allow you to move through your grief in time.
Symptoms of Depression: Grief and depression share symptoms like sadness, sleep and appetite changes, and loss of joy. If you have disturbing thoughts, suicidal feelings, or your distress disrupts daily life, professional help is crucial. A therapist can guide you and, if needed, refer you for medication.

If you are in crisis and need help immediately, please call one of these agencies

SAMHSA National Helpline — 1-800-662-HELP (4357)
National Suicide Prevention Helpline — 1-800-273-8255

To learn more about caring for yourself while navigating grief, see our Comprehensive Step-by-Step Planning Guide:Grief Healing Process

Conclusion

In conclusion, grief and loss are profound experiences that touch all of our lives, often in unexpected ways. While the journey through grief can feel isolating and overwhelming, it is essential to recognize that it is a natural response to losing someone or something we love. Embracing the complexity of our emotions can be challenging, but as we do so we can begin to heal from even the most difficult loss. Ultimately, acknowledging and honoring our grief not only honors those we have lost but also paves the way for renewal and hope in the future.

Sources:

“Grief”. American Psychological Association. https://www.apa.org/topics/grief

“Physiological correlates of bereavement and the impact of bereavement interventions”. National Library of Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC3384441/

“The long-term impact of bereavement upon spouse health: a 10-year follow-up”. National Library of Medicine. https://pubmed.ncbi.nlm.nih.gov/26952830/

“Cortisol”. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/22187-cortisol

“Can a Weak Immune System Cause Cancer?” MedicineNet. https://www.medicinenet.com/can_a_weak_immune_system_cause_cancer/article.htm

“Short- and long-term health consequences of sleep disruption”. National Library of Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC5449130/

“Metabolic Syndrome”. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/metabolic-syndrome/symptoms-causes/syc-20351916

“Sleep well — and reduce your risk of dementia and death”. Harvard Health Publishing. https://www.health.harvard.edu/blog/sleep-well-and-reduce-your-risk-of-dementia-and-death-2021050322508

“Building Resilience after Loss”. HuffPost. https://www.huffpost.com/entry/building-resilience-after-loss_b_59b6b15fe4b0e4419674c372

“The 4 Tasks of Grieving”. Psychlogy Today. https://www.psychologytoday.com/us/blog/mental-health-nerd/201911/the-4-tasks-grieving

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