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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Grief

Mourning; Grieving; Bereavement

Last reviewed: February 13, 2012.

Grief is a reaction to a major loss. It is most often an unhappy and painful emotion.

Causes, incidence, and risk factors

Grief may be triggered by the death of a loved one. People also can experience grief if they have an illness for which there is no cure, or a chronic condition that affects their quality of life. The end of a significant relationship may also cause a grieving process.

Everyone feels grief in their own way. However, there are common stages to the process of mourning. It starts with recognizing a loss and continues until a person eventually accepts that loss. People's responses to grief will be different, depending on the circumstances of the death.

For example, if the person who died had a chronic illness, the death may have been expected. The end of the person's suffering might even have come as a relief. If the death was accidental or violent, coming to a stage of acceptance might take longer.

Symptoms

One way to describe grief is in five stages. These reactions might not occur in a specific order, and can (at times) occur together. Not everyone experiences all of these emotions:

  • Denial, disbelief, numbness
  • Anger, blaming others
  • Bargaining (for instance "If I am cured of this cancer, I will never smoke again.")
  • Depressed mood, sadness, and crying
  • Acceptance, coming to terms

People who are grieving may have crying spells, some trouble sleeping, and lack of productivity at work.

Signs and tests

Your health care provider will perform a physical exam and ask questions about your symptoms, including your sleep and appetite. Symptoms that last for a while may lead to clinical depression.

Treatment

Family and friends can offer emotional support during the grieving process. Sometimes outside factors can affect the normal grieving process, and people might need help from:

The acute phase of grief usually lasts up to 2 months. Some milder symptoms may last for a year or longer. Psychological counseling may help a person who is unable to face the loss (absent grief reaction), or who has depression with grieving.

Support Groups

You can help the stress of grieving by joining a support group, where members share common experiences and problems.

See also:

Expectations (prognosis)

It may take a year or longer to overcome strong feelings of grief, and to accept the loss.

Complications

Grief and loss can affect your overall health. It can lead to depression or excessive alcohol or drug use. Grief that lasts for more than 2 months and is severe enough to interfere with your daily life may be a sign of complicated grief and more serious illness, such as major depression. Medication may be helpful.

Calling your health care provider

Call your health care provider if:

  • You can't deal with grief
  • You are using excessive amounts of drugs or alcohol
  • You become very depressed
  • You have long-term depression that interferes with your daily life

Prevention

Grief should not be prevented because it is a healthy response to loss. Instead, it should be respected. Those who are grieving should have support to help them through the process.

References

  1. Powell AD. Grief, bereavement, and adjustment disorders. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 38.
  2. Kutner JS, Kilbourn KM. Bereavement: Addressing challenges faced by advanced cancer patients, their caregivers, and their physicians. Prim Care. 2009;36:825-844. [PubMed: 19913188]
  3. Simon NM, Wall MM, Keshaviah A, Dryman MT, LeBlanc NJ, Shear MK. Informing the symptom profile of complicated grief. Depress Anxiety. 2011;28(2):118-126. [PMC free article: PMC3079952] [PubMed: 21284064]

Review Date: 2/13/2012.

Reviewed by: Linda Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington; and Timothy Rogge, MD, Medical Director, Family Medical Psychiatry Center, Kirkland, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

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The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • Effectiveness and cost‐effectiveness of home‐based palliative care services for adults with advanced illness and their caregivers
    When faced with the prospect of dying with an advanced illness, the majority of people prefer to die at home, yet in many countries around the world they are most likely to die in hospital. We reviewed all known studies that evaluated home palliative care services, i.e. experienced home care teams of health professionals specialised in the control of a wide range of problems associated with advanced illness – physical, psychological, social, spiritual. We wanted to see how much of a difference these services make to people's chances of dying at home, but also to other important aspects for patients towards the end of life, such as symptoms (e.g. pain) and family distress. We also compared the impact on the costs with care. On the basis of 23 studies including 37,561 patients and 4042 family caregivers, we found that when someone with an advanced illness gets home palliative care, their chances of dying at home more than double. Home palliative care services also help reduce the symptom burden people may experience as a result of advanced illness, without increasing grief for family caregivers after the patient dies. In these circumstances, patients who wish to die at home should be offered home palliative care. There is still scope to improve home palliative care services and increase the benefits for patients and families without raising costs.
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