Bereavement is the state of loss when someone close to an individual has died. The death of a loved one is one of the greatest sorrows that can occur in one's life. People's responses to grief will vary depending upon the circumstances of the death, but grief is a normal, healthy response to loss. Feelings of bereavement can also accompany other losses, such as the decline of one's health or the health of a close other, or the end of an important relationship.
A wide and confusing range of emotions may be experienced after a loss.
The bereaved may experience crying spells, trouble sleeping, changes in appetite, or lack of productivity at work. At first, one may find it hard to accept that the loss has actually occurred. Feelings of anger may also arise. The anger may be directed toward doctors and nurses, God, other loved ones, oneself, or even the person who has died. The grieving person may experience feelings of guilt, with sentiments such as "I should have…" "I could have…" "I wish I had…" Emotions may be very intense, and the bereaved person may have mood swings. These are all normal reactions to loss.
According to the National Cancer Institute, recovery does not happen in a set period of time. In normal grief, symptoms will occur less often and will feel less severe as time passes. For most bereaved people having normal grief, symptoms lessen between six months and two years after the loss.
It is normal to experience profound sadness after the loss of a loved one, including symptoms such as insomnia and poor appetite. The DSM-5 terms this experience “uncomplicated bereavement” and describes it as a topic that may be a focus of clinical attention.
The DSM-5 also proposed Persistent Complex Bereavement Disorder as a condition for further study. This disorder would describe those who experience distressing symptoms of bereavement such as persistent longing, intense sorrow, and preoccupation with the death more than a year after the death of a loved one.
The five stages of grief—denial, anger, bargaining, depression, acceptance—was a model put forth by psychiatrist Elisabeth Kübler-Ross in her book On Death and Dying. This model initially described people coming to terms with their own terminal illnesses, yet it spread to describe all forms of loss. Subsequent work has demonstrated that people grieve in different and varied ways—there is no one way, and no “right way,” to grieve.
The reaction to loss will, in part, be influenced by the circumstances surrounding it and one's relationship to the deceased.
Losing a Family Member
The loss of a long-term romantic partner or spouse can be especially challenging. The surviving partner may have to deal with a multitude of decisions regarding funeral arrangements, finances, and more, at what feels like the worst possible time to have to deal with such matters. The bereaved partner may also have to explain the death to children and help them through their grief.
The death of one's child, regardless of the cause of death or the age of the child, is an emotionally devastating event that can overwhelm a parent. As Mental Health America explains, "A child's death arouses an overwhelming sense of injustice—for lost potential, unfulfilled dreams, and senseless suffering. Parents may even feel responsible for the child's death. They may also feel that they have lost a vital part of their own identity."
The death of a mother or father can have a deep impact no matter what age a person is when it occurs. It is only natural to feel consumed by a combination of pain, fear, and deep sadness at such a significant loss. The specifics of how one grieves will depend on a number of personal factors, including one's relationship with the parent, religious beliefs, previous experience with death, and whether or not one believes it was "time" for the parent to die. The loss of a parent may also mean the loss of a lifelong friend, counselor, and adviser. Therefore, the bereaved person may suddenly feel very much alone, even with the support of other family and friends.
A Loss Due to Suicide
A suicide can produce intense grief in parents, partners, children, siblings, relatives, friends, and others. Coping with bereavement after a suicide can be more difficult than dealing with other losses because of the feelings of shame, guilt, and rejection that are often experienced. The stigma that still attaches to deaths by suicide in many cultures can increase the bereaved person's sense of isolation and vulnerability.
A Pet's Death
Animals provide companionship, acceptance, and emotional support. When a beloved pet dies, it's not unusual to feel overwhelmed by the intensity of the sorrow. Other people may find it hard to understand such a reaction to what they may see as the loss of "just" a pet, and they may, therefore, be less understanding of this grief. However, the loss is significant and one should give oneself permission to mourn.
When someone's death is expected, those close to that person may experience anticipatory grief. "Like grief that occurs after the death of a loved one," the National Cancer Institute explains, "anticipatory grief involves mental, emotional, cultural, and social responses." It can involve symptoms of depression, increased concern for the dying person, and emotional preparation for the death.
Bereavement generally brings to mind the death of a loved one, but people can grieve for many different reasons. Sources of grief that are often overlooked include loss of identity through divorce or job loss, loss of safety through trauma, violence, or instability, loss of autonomy through illness, aging, or financial hardship, and loss of dreams or expectations, such as coping with infertility.
Grief and depression can look similar—people in both situations may struggle with deep sadness, to sleep and eat, and to find enjoyment in life. Yet bereavement more often involves preoccupation with the loss and inability to accept the loss, while depression more often involves feelings of hopelessness, guilt, and suicidal thoughts.
Another key distinction is that bereavement often leads a community to come together and provide support after a loss, while depression often encompasses isolation and disconnection.
Grief is painful and exhausting. Therefore, it sometimes seems easier to avoid confronting these feelings. But working through sorrow and allowing themselves to express such feelings can help a bereaved person recover.
If you or someone you know is having difficulty coping with a loss, it's important to seek professional help. While a family physician can often help, grief counseling or therapy may be appropriate. Counseling, which may occur in one-on-one settings with a professional or in a group context, can help someone experiencing normal grief work through the process by, for example, identifying the emotions connected to the loss, helping the bereaved become able to live independently, and illuminating the bereaved person's ways of coping with the loss.
If the symptoms of grief last for much longer than is typical—or, conversely, if one has few or no such symptoms—the bereaved individual may be experiencing what has been called "complicated grief." Psychotherapy may be beneficial in such cases. According to the National Cancer Institute, there is evidence that Cognitive Behavioral Therapy (CBT) and Complicated Grief Treatment (CGT) can be helpful for those experiencing complicated grief. CBT, which focuses on changing clients' thought patterns to change their responses to difficult situations, is applied to a wide range of mental health issues. CGT involves setting recovery goals, discussing the death, and making plans for the future.
The American Psychological Association identifies a number of actions that bereaved people can take, on their own or with loved ones, that may help them cope. These include talking about the death with others; accepting the normal feelings that come with loss; minding one's own health and eating well; and celebrating the life of the deceased person.
People can support their bereaved loved ones by listening, asking questions, and sharing memories of the person who passed away. They can offer practical help as well, such as cooking dinner or providing childcare. Rather than encouraging people to find a sense of closure, supporting them as they integrate the experiences into their identity is often more helpful.
Bereavement is undeniably difficult, yet people sometimes also report that grief provided valuable lessons. People may learn that grief is a normal, necessary, and healthy process, that honoring and replacing what was lost can build resilience, and that loss can illustrate the value of life—people may become more thoughtful, loving, and compassionate after a loss.