Understanding Bereavement After a Loss

Table of ContentsView AllTable of ContentsSymptomsDiagnosisCausesTypesTreatmentCopingTakeaways

Table of ContentsView All

View All

Table of Contents

Symptoms

Diagnosis

Causes

Types

Treatment

Coping

Takeaways

The term is sometimes used synonymously with grief and mourning. How people experience this time of grief can vary from one person to the next.

While bereavement is usually associated with death, it can also occur afterother significant losses. The end of an important relationship or a major change in a person’s health, for example, can also lead to feelings of bereavement.

At a GlanceBereavement after a loss is often intense and can profoundly affect your ability to function normally. During this time, you’ll experience symptoms of grief like shock, guilt, sadness, anger, and depression. It’s important to remember that this is a normal reaction to loss. If your feelings continue longer than normal, then you might be experiencing prolonged or complicated grief. Bereavement follows the death of a loved one, but it may also occur after a miscarriage, death of a pet, or a significant change in health. Caring for yourself during this difficult time is important, but you may want to reach out to a mental health professional if you are struggling.

At a Glance

Bereavement after a loss is often intense and can profoundly affect your ability to function normally. During this time, you’ll experience symptoms of grief like shock, guilt, sadness, anger, and depression. It’s important to remember that this is a normal reaction to loss. If your feelings continue longer than normal, then you might be experiencing prolonged or complicated grief. Bereavement follows the death of a loved one, but it may also occur after a miscarriage, death of a pet, or a significant change in health. Caring for yourself during this difficult time is important, but you may want to reach out to a mental health professional if you are struggling.

What I Learned About Grief When My Husband Died

Symptoms of Bereavement

People may experience a wide range of symptoms during bereavement, including:

Depression After the Death of a Parent

How Is Bereavement Diagnosed?

The DSM-5 removed what was known as the “bereavement exclusion” from the diagnosis of major depression. This change made it clear that while bereavement and depression are distinct, depression can occur within the context of bereavement.

“[The] DSM-5 recognizes that bereavement does not immunize the patient against major depression, and often precipitates it. Indeed, grief and depression—despite some overlapping symptoms, like sadness, sleep disturbance, and decreased appetite—are distinct constructs, and one does not preclude the other,” explained psychiatrist Ronald Pies in an article published in the journalInnovations in Clinical Neuroscience.

Press Play for Advice on Coping With Grief

What Causes Bereavement?

Bereavement is a response to loss. The circumstances that surround the loss, as well as the closeness of the relationship, can play a role in how intense the grief is that people experience. Some types of losses that can cause bereavement include:

It is important to note that sometimes people are not able to experience bereavement and grief openly, often due to social stigma. This is known asdisenfranchised grief.

Types of Bereavement

Everyone experiences bereavement and grief differently. However, it often follows a predictable pattern that is often characterized as a normal response to loss. In other cases, people may experience more persistent symptoms that continue to interfere with their ability to function normally for a longer period of time.

Normal Bereavement

Feelings of grief and bereavement typically occur ina series of five stages:

Psychiatrist Elisabeth Kubler-Ross introduced this stage model in 1969 to describe the process of bereavement following the loss of a loved one. However, she later adapted these stages to apply to other types of grief as well.

While it is often presented as a series of discrete stages, it is important to note that people may cycle through these stages at various points and may sometimes return to earlier states, even years after the loss.

Complicated Grief

Bereavement is painful and can be exhausting. While it isn’t something that people “get over,” the intensity of these feelings of grief usually lessen gradually over time. Some people, however, experience a more persistent form of bereavement that is known ascomplicated grief.

Research suggests that around 5.2% of bereaved people experience complicated grief.

Prolonged Grief Disorder

To recognize that long-lasting forms of grief deserve a clinical diagnosis, the American Psychiatric Association added a new condition to the trauma- and stressor-related disorders chapter in the DSM-5-TR (fifth edition, text revision), published in 2022. This condition is calledprolonged grief disorder(PGD).

There is some controversy surrounding the pathologizing of grief into some form of mental illness. Some in the mental health community don’t support labeling grief as a medical condition, but rather, would rather address the fact that there is no “normal” when it comes to grieving, and its severity exists on a continuum.

Others claim that making grief an official medical condition allows those who experience extreme forms of it to better access treatment—such as therapy and medication if needed—through their insurance carriers.

Treatment for Bereavement

The experience of bereavement is a natural and inevitable part of life, albeit an incredibly painful part. It often temporarily affects a person’s ability to function normally and can affect nearly every aspect of an individual’s life.

During bereavement, carrying on with normal daily tasks, work, school, and relationships can seem difficult or even impossible.

For people who are struggling to cope, professional help may be beneficial. Types of treatment include:

Support groupscan also be a helpful place to explore difficult emotions and findsocial supportfrom people who have had similar experiences.

The American Psychological Association reports that the majority of people can recover from bereavement on their own if they have time, support, and healthy habits.

The 10 Best Online Grief Counseling Services We Tried and Tested

Coping During Bereavement

Some things that you can do when you are bereaved include:

There are a number of different factors that can influence how people cope with bereavement. Access to support, maturity levels, experience with past losses, and the nature of the relationship can all affect how a person manages the loss.

Your own beliefs about death, religious upbringing, and cultural factors may also influence the bereavement and grieving process. A sudden, unexpected, ortraumaticloss can also affect how people cope in the aftermath.

In such cases, consider seeking professional help. It can be a great way to get the extra support you need to cope with the loss and the emotions you are experiencing.

Bereavement is normal after you’ve experienced a loss. What you experience and how long it lasts can vary, but sadness, numbness, crying, guilt, and anger are all common. While we often associate bereavement with the death of a loved one, it can also happen as a result of miscarriage, anticipatory grief, and other painful losses.

You may cycle between various stages of grief that gradually lessen with time. In cases where grief is intense or long-lasting, therapy and medication may help. If you struggle to cope, caring for yourself and reaching out to others for support are vital.

How to Cope When You’re Grieving at Work

18 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Wilson DM, Dhanji N, Playfair R, Nayak SS, Puplampu GL, Macleod R.A scoping review of bereavement service outcomes.Palliat Support Care. 2016;15(2). doi:10.1017/s147895151600047xSealey M, Breen LJ, O’Connor M, Aoun SM.A scoping review of bereavement risk assessment measures: Implications for palliative care.Palliat Med. 2015;29(7). doi:10.1177/0269216315576262American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Zachar P, First MB, Kendler KS.The bereavement exclusion debate in the DSM-5 : A history.Clinical Psychological Science. 2017;5(5):890-906. doi:10.1177/2167702617711284Pies RW.The bereavement exclusion and DSM-5: An update and commentary.Innovations in Clinical Neuroscience. 2014;11(7-8).Mergl R, Quaatz SM, Edeler LM, Allgaier AK.Grief in women with previous miscarriage or stillbirth: a systematic review of cross-sectional and longitudinal prospective studies.Eur J Psychotraumatol. 2022;13(2):2108578. doi:10.1080/20008066.2022.2108578Cesur-Soysal G, Arı E.How we disenfranchise grief for self and other: An empirical study.Omega (Westport). 2024;89(2):530-549. doi:10.1177/00302228221075203Corr CA.The “five stages” in coping with dying and bereavement: strengths, weaknesses and some alternatives.Mortality. 2018;24(4). doi:10.1080/13576275.2018.1527826Nakajima S.Complicated grief: Recent developments in diagnostic criteria and treatment.Philos Trans R Soc Lond B Biol Sci. 2018;373(1754):20170273. doi:10.1098/rstb.2017.0273Thimm JC, Kristoffersen AE, Ringberg U.The prevalence of severe grief reactions after bereavement and their associations with mental health, physical health, and health service utilization: a population-based study.Eur J Psychotraumatol. 2020;11(1):1844440. doi:10.1080/20008198.2020.1844440Boelen PA, Lenferink LI.Prolonged grief disorder in DSM-5-TR: Early predictors and longitudinal measurement invariance.Aust N Z J Psychiatry. 2021;48674211025728. doi:10.1177/00048674211025728Shear MK, Ghesquiere A, Glickman K.Bereavement and complicated grief.Curr Psychiatry Rep. 2013;15(11):406. doi:10.1007/s11920-013-0406-zDavidow JB, Zide BS, Levin LL, Biddle KD, Urizar JC, Donovan NJ.A scoping review of interventions for spousal bereavement in older adults.Am J Geriatric Psychiatry. 2022;30(3):404-418. doi:10.1016/j.jagp.2021.08.002Duffy M, Wild J.A cognitive approach to persistent complex bereavement disorder (PCBD).Cogn Behav Ther.2017;10(16). doi:10.1017/S1754470X17000034Reitsma L, Boelen PA, de Keijser J, Lenferink LIM.Online treatment of persistent complex bereavement disorder, posttraumatic stress disorder, and depression symptoms in people who lost loved ones during the COVID-19 pandemic: study protocol for a randomized controlled trial and a controlled trial.Eur J Psychotraumatol. 2021;12(1):1987687. doi:10.1080/20008198.2021.1987687Grief therapy more effective for bereaved adults than psychotherapy.JAMA.2014;312(20):2083. doi:10.1001/jama.2014.15872Mauro C, Tumasian RA 3rd, Skritskaya N, et al.The efficacy of complicated grief therapy for DSM-5-TR prolonged grief disorder.World Psychiatry. 2022;21(2):318-319. doi:10.1002/wps.20991American Psychological Association.Grief: Coping with the loss of your loved one.

18 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Wilson DM, Dhanji N, Playfair R, Nayak SS, Puplampu GL, Macleod R.A scoping review of bereavement service outcomes.Palliat Support Care. 2016;15(2). doi:10.1017/s147895151600047xSealey M, Breen LJ, O’Connor M, Aoun SM.A scoping review of bereavement risk assessment measures: Implications for palliative care.Palliat Med. 2015;29(7). doi:10.1177/0269216315576262American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Zachar P, First MB, Kendler KS.The bereavement exclusion debate in the DSM-5 : A history.Clinical Psychological Science. 2017;5(5):890-906. doi:10.1177/2167702617711284Pies RW.The bereavement exclusion and DSM-5: An update and commentary.Innovations in Clinical Neuroscience. 2014;11(7-8).Mergl R, Quaatz SM, Edeler LM, Allgaier AK.Grief in women with previous miscarriage or stillbirth: a systematic review of cross-sectional and longitudinal prospective studies.Eur J Psychotraumatol. 2022;13(2):2108578. doi:10.1080/20008066.2022.2108578Cesur-Soysal G, Arı E.How we disenfranchise grief for self and other: An empirical study.Omega (Westport). 2024;89(2):530-549. doi:10.1177/00302228221075203Corr CA.The “five stages” in coping with dying and bereavement: strengths, weaknesses and some alternatives.Mortality. 2018;24(4). doi:10.1080/13576275.2018.1527826Nakajima S.Complicated grief: Recent developments in diagnostic criteria and treatment.Philos Trans R Soc Lond B Biol Sci. 2018;373(1754):20170273. doi:10.1098/rstb.2017.0273Thimm JC, Kristoffersen AE, Ringberg U.The prevalence of severe grief reactions after bereavement and their associations with mental health, physical health, and health service utilization: a population-based study.Eur J Psychotraumatol. 2020;11(1):1844440. doi:10.1080/20008198.2020.1844440Boelen PA, Lenferink LI.Prolonged grief disorder in DSM-5-TR: Early predictors and longitudinal measurement invariance.Aust N Z J Psychiatry. 2021;48674211025728. doi:10.1177/00048674211025728Shear MK, Ghesquiere A, Glickman K.Bereavement and complicated grief.Curr Psychiatry Rep. 2013;15(11):406. doi:10.1007/s11920-013-0406-zDavidow JB, Zide BS, Levin LL, Biddle KD, Urizar JC, Donovan NJ.A scoping review of interventions for spousal bereavement in older adults.Am J Geriatric Psychiatry. 2022;30(3):404-418. doi:10.1016/j.jagp.2021.08.002Duffy M, Wild J.A cognitive approach to persistent complex bereavement disorder (PCBD).Cogn Behav Ther.2017;10(16). doi:10.1017/S1754470X17000034Reitsma L, Boelen PA, de Keijser J, Lenferink LIM.Online treatment of persistent complex bereavement disorder, posttraumatic stress disorder, and depression symptoms in people who lost loved ones during the COVID-19 pandemic: study protocol for a randomized controlled trial and a controlled trial.Eur J Psychotraumatol. 2021;12(1):1987687. doi:10.1080/20008198.2021.1987687Grief therapy more effective for bereaved adults than psychotherapy.JAMA.2014;312(20):2083. doi:10.1001/jama.2014.15872Mauro C, Tumasian RA 3rd, Skritskaya N, et al.The efficacy of complicated grief therapy for DSM-5-TR prolonged grief disorder.World Psychiatry. 2022;21(2):318-319. doi:10.1002/wps.20991American Psychological Association.Grief: Coping with the loss of your loved one.

Wilson DM, Dhanji N, Playfair R, Nayak SS, Puplampu GL, Macleod R.A scoping review of bereavement service outcomes.Palliat Support Care. 2016;15(2). doi:10.1017/s147895151600047xSealey M, Breen LJ, O’Connor M, Aoun SM.A scoping review of bereavement risk assessment measures: Implications for palliative care.Palliat Med. 2015;29(7). doi:10.1177/0269216315576262American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Zachar P, First MB, Kendler KS.The bereavement exclusion debate in the DSM-5 : A history.Clinical Psychological Science. 2017;5(5):890-906. doi:10.1177/2167702617711284Pies RW.The bereavement exclusion and DSM-5: An update and commentary.Innovations in Clinical Neuroscience. 2014;11(7-8).Mergl R, Quaatz SM, Edeler LM, Allgaier AK.Grief in women with previous miscarriage or stillbirth: a systematic review of cross-sectional and longitudinal prospective studies.Eur J Psychotraumatol. 2022;13(2):2108578. doi:10.1080/20008066.2022.2108578Cesur-Soysal G, Arı E.How we disenfranchise grief for self and other: An empirical study.Omega (Westport). 2024;89(2):530-549. doi:10.1177/00302228221075203Corr CA.The “five stages” in coping with dying and bereavement: strengths, weaknesses and some alternatives.Mortality. 2018;24(4). doi:10.1080/13576275.2018.1527826Nakajima S.Complicated grief: Recent developments in diagnostic criteria and treatment.Philos Trans R Soc Lond B Biol Sci. 2018;373(1754):20170273. doi:10.1098/rstb.2017.0273Thimm JC, Kristoffersen AE, Ringberg U.The prevalence of severe grief reactions after bereavement and their associations with mental health, physical health, and health service utilization: a population-based study.Eur J Psychotraumatol. 2020;11(1):1844440. doi:10.1080/20008198.2020.1844440Boelen PA, Lenferink LI.Prolonged grief disorder in DSM-5-TR: Early predictors and longitudinal measurement invariance.Aust N Z J Psychiatry. 2021;48674211025728. doi:10.1177/00048674211025728Shear MK, Ghesquiere A, Glickman K.Bereavement and complicated grief.Curr Psychiatry Rep. 2013;15(11):406. doi:10.1007/s11920-013-0406-zDavidow JB, Zide BS, Levin LL, Biddle KD, Urizar JC, Donovan NJ.A scoping review of interventions for spousal bereavement in older adults.Am J Geriatric Psychiatry. 2022;30(3):404-418. doi:10.1016/j.jagp.2021.08.002Duffy M, Wild J.A cognitive approach to persistent complex bereavement disorder (PCBD).Cogn Behav Ther.2017;10(16). doi:10.1017/S1754470X17000034Reitsma L, Boelen PA, de Keijser J, Lenferink LIM.Online treatment of persistent complex bereavement disorder, posttraumatic stress disorder, and depression symptoms in people who lost loved ones during the COVID-19 pandemic: study protocol for a randomized controlled trial and a controlled trial.Eur J Psychotraumatol. 2021;12(1):1987687. doi:10.1080/20008198.2021.1987687Grief therapy more effective for bereaved adults than psychotherapy.JAMA.2014;312(20):2083. doi:10.1001/jama.2014.15872Mauro C, Tumasian RA 3rd, Skritskaya N, et al.The efficacy of complicated grief therapy for DSM-5-TR prolonged grief disorder.World Psychiatry. 2022;21(2):318-319. doi:10.1002/wps.20991American Psychological Association.Grief: Coping with the loss of your loved one.

Wilson DM, Dhanji N, Playfair R, Nayak SS, Puplampu GL, Macleod R.A scoping review of bereavement service outcomes.Palliat Support Care. 2016;15(2). doi:10.1017/s147895151600047x

Sealey M, Breen LJ, O’Connor M, Aoun SM.A scoping review of bereavement risk assessment measures: Implications for palliative care.Palliat Med. 2015;29(7). doi:10.1177/0269216315576262

American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.

Zachar P, First MB, Kendler KS.The bereavement exclusion debate in the DSM-5 : A history.Clinical Psychological Science. 2017;5(5):890-906. doi:10.1177/2167702617711284

Pies RW.The bereavement exclusion and DSM-5: An update and commentary.Innovations in Clinical Neuroscience. 2014;11(7-8).

Mergl R, Quaatz SM, Edeler LM, Allgaier AK.Grief in women with previous miscarriage or stillbirth: a systematic review of cross-sectional and longitudinal prospective studies.Eur J Psychotraumatol. 2022;13(2):2108578. doi:10.1080/20008066.2022.2108578

Cesur-Soysal G, Arı E.How we disenfranchise grief for self and other: An empirical study.Omega (Westport). 2024;89(2):530-549. doi:10.1177/00302228221075203

Corr CA.The “five stages” in coping with dying and bereavement: strengths, weaknesses and some alternatives.Mortality. 2018;24(4). doi:10.1080/13576275.2018.1527826

Nakajima S.Complicated grief: Recent developments in diagnostic criteria and treatment.Philos Trans R Soc Lond B Biol Sci. 2018;373(1754):20170273. doi:10.1098/rstb.2017.0273

Thimm JC, Kristoffersen AE, Ringberg U.The prevalence of severe grief reactions after bereavement and their associations with mental health, physical health, and health service utilization: a population-based study.Eur J Psychotraumatol. 2020;11(1):1844440. doi:10.1080/20008198.2020.1844440

Boelen PA, Lenferink LI.Prolonged grief disorder in DSM-5-TR: Early predictors and longitudinal measurement invariance.Aust N Z J Psychiatry. 2021;48674211025728. doi:10.1177/00048674211025728

Shear MK, Ghesquiere A, Glickman K.Bereavement and complicated grief.Curr Psychiatry Rep. 2013;15(11):406. doi:10.1007/s11920-013-0406-z

Davidow JB, Zide BS, Levin LL, Biddle KD, Urizar JC, Donovan NJ.A scoping review of interventions for spousal bereavement in older adults.Am J Geriatric Psychiatry. 2022;30(3):404-418. doi:10.1016/j.jagp.2021.08.002

Duffy M, Wild J.A cognitive approach to persistent complex bereavement disorder (PCBD).Cogn Behav Ther.2017;10(16). doi:10.1017/S1754470X17000034

Reitsma L, Boelen PA, de Keijser J, Lenferink LIM.Online treatment of persistent complex bereavement disorder, posttraumatic stress disorder, and depression symptoms in people who lost loved ones during the COVID-19 pandemic: study protocol for a randomized controlled trial and a controlled trial.Eur J Psychotraumatol. 2021;12(1):1987687. doi:10.1080/20008198.2021.1987687

Grief therapy more effective for bereaved adults than psychotherapy.JAMA.2014;312(20):2083. doi:10.1001/jama.2014.15872

Mauro C, Tumasian RA 3rd, Skritskaya N, et al.The efficacy of complicated grief therapy for DSM-5-TR prolonged grief disorder.World Psychiatry. 2022;21(2):318-319. doi:10.1002/wps.20991

American Psychological Association.Grief: Coping with the loss of your loved one.

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At a Glance#

Symptoms of Bereavement#

How Is Bereavement Diagnosed?#

Press Play for Advice on Coping With Grief#

What Causes Bereavement?#

Types of Bereavement#

Normal Bereavement#

Complicated Grief#

Prolonged Grief Disorder#

Treatment for Bereavement#

Coping During Bereavement#