Grief: Loss of a Loved One

1. The Grief and Mourning Quiz

Medical Author:

Roxanne Dryden-Edwards, MD

Roxanne Dryden-Edwards, MD

Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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• Grief is quite common and is the normal internal feeling one experiences in reaction to a loss, while bereavement is the state of having experienced that loss.
• Although most commonly discussed in reference to the death of a loved one, any major loss (for example, breakup of a relationship, job loss, or loss of living situation) can result in a grief reaction.
• Prolonged grief is a reaction to loss that lasts more than one year and the grief reaction affecting all of the sufferer's close relationships, disrupting his or her beliefs, and resulting in the bereaved experiencing an ongoing longing for their deceased loved one.
• Mourning is the outward expression of the loss of a loved one and usually involves culturally determined rituals that help make sense of the end of their loved one's life and gives structure to what can feel like a very confusing time. It is influenced by personal, familial, cultural, religious, and societal beliefs and customs.
• The potential negative effects of a grief reaction can be significant and are often aggravated by grief triggers, events that remind the bereaved individual of their loved one, or the circumstances surrounding their loss.
• The risk factors for experiencing more serious symptoms of grief for a longer period of time are related to the survivor's own physical and emotional health before the loss, the relationship between the bereaved and their family member or other loved one, as well as related to the nature of the death.
• Bereaved individuals who feel the death of their loved one is unexpected or violent may be at greater risk for suffering from major depression, posttraumatic stress disorder (PTSD), or prolonged grief.
• The seven emotional stages of grief are shock or disbelief, denial, bargaining, guilt, anger, depression, and acceptance/hope.
• Symptoms of grief can be emotional, physical, social, or religious in nature.
• For children and adolescents, their reactions to the death of a loved one usually reflect the particular developmental stage of the child or adolescent.
• To assess grief, a health caregiver usually asks questions to assess what symptoms the individual is suffering from, then considers whether he or she is suffering from normal grief, prolonged grief, or some other issue.
• Coping tips for grieving include the bereaved individual's caring for his or herself through continuing nutritious and regular eating habits, getting extra rest, and communicating with surviving loved ones.
• Bereavement sometimes ultimately leads to enhanced personal development.
• Consulting with an attorney or other legal expert is advisable when either planning for or managing the legal matters associated with a death.
• Some of the major legal issues involved with dying include the person's right to have informed consent to receive or refuse treatment, advance directives, establishing a living will, and making funeral arrangements.

Grief is the normal internal feeling one experiences in reaction to a loss, while bereavement is the state of having experienced that loss. Although people often suffer emotional pain in response to loss of anything that is very important to them (for example, a job, a friendship, one's sense of safety, a home), grief usually refers to the loss of a loved one through death. Grief is quite common, in that three out of four women outlive their spouse, with the average age of becoming a widow being 56 years. More than half of women in the United States are widowed by the time they reach age 65. Every year in the United States, 4% of children under the age of 15 experience the loss of a parent through death.

Although not a formal medical diagnosis, prolonged grief, formerly called complicated grief refers to a reaction to loss that lasts more than one year. It is characterized by the grief reaction intensifying to affect all of the sufferer's close relationships, disrupting his or her beliefs, and it tends to result in the bereaved experiencing ongoing longing for their deceased loved one. About 15% of bereaved individuals will suffer from complicated grief, and one-third of people already getting mental-health services have been found to suffer from this extended grief reaction.

Anticipatory grief is defined as the feelings loved ones have in reaction to knowing that someone they care about is terminally ill. It occurs before the death of the afflicted loved one and can be an important part of the grieving process since this allows time for loved ones to say goodbye to the terminally ill individual, begin to settle affairs, and plan for the funeral or other rituals on behalf of the person who is dying.