Grief, also sometimes called bereavement, is a hard thing to define. Most often we think of grief as being an emotional response to the death of a loved one, but sometimes grief happens because of other types of major losses, life changes or transitions. Grief is a natural response to loss, not a disorder or illness (unless it’s complicated by other factors).

You might describe grief as being in a state of very low mood. Think about mood as if it were a sliding scale: If someone feels “stuck” in a very low mood for a prolonged amount of time, or finds it hard to feel content or happy for any length of time after experiencing loss, they might be grieving. Grief might also cause a person to feel anger, shock, guilt, disbelief, despair or numbness. Grief isn’t just about feeling something emotionally. Grief can also affect our thoughts, actions and bodies.

Grief is a part of life. At some point, everyone will experience loss, and grief is a natural response to loss, not a disorder or illness. Someone who is grieving can go through a series of emotional phases as they work through their feelings and learn ways to move ahead and cope.

For most, grief is temporary. This doesn’t necessarily mean that people “get over” the loss; the loss of someone close to you will be felt in some way forever. It does mean, however, that the pain and low mood that grief brings usually lessens over time. Because we will all experience loss at some point, coping with grief is a vital part of our mental health.

It’s tricky to decide how long grief should last, and there is no “right” or “wrong” way to grieve. When someone has a loss, they may grieve in some way for the rest of their life.

Sometimes the grieving process is prolonged and turns into “chronic” or “complicated” grief. Complicated grief might be triggered by the circumstances of the loss (like death by suicide, a sudden or unexpected illness or accident, or after a long and painful illness), by life experiences (like lack of support from family or friends, or if a person is also dealing with other mental or physical health issues). The grief process might also be prolonged if the loss causes a big life change for a person (if someone was very dependent on a parent, for instance, and that parent dies) or the loss changes their identity somehow (the loss of physical or cognitive ability, or the loss of a child). The medical term sometimes used to describe prolonged or complicated grief is persistent complex bereavement disorder.

Grief is not:

• Something someone can “snap out of”
• A sign or result of low intelligence or weakness
• The same for everyone

No two people will grieve in the exact same way. The process of grieving will differ according to the circumstance of the loss, the person and their culture. The signs and symptoms listed here can be explained by a number of factors or illnesses. Many signs of grief are similar to the signs or symptoms of depression, but grief is not an illness.

Only if these symptoms are excessive, go on for a longer period of time than is “typical”, and interfere with normal everyday functioning will grief be seen as problematic or “complicated”.

There are a number of feelings that people experience while coming to terms with a loss, and these feelings can come in “waves” or appear to happen in “phases”:

• Shock, numbness, bewilderment, a sense of disbelief, denial.
• Feelings of emptiness or intense suffering.
• Dreams and/or hallucinations that their loved one is still alive.
• Feelings of despair as one comes to terms with the loss.
• Feelings of sadness; the inability to feel pleasure.
• Tense, restless anxiety may alternate with lethargy and fatigue.
• Individuals may alternate between avoiding reminders of the deceased and reclaiming memories.
• Self-blame for treating the deceased badly.
• Feelings of sadness may also be complicated by feelings of relief, fear, guilt, anger, etc.

Physical symptoms of grief can include:

• Weakness
• Sleep disturbances
• Loss of appetite or overeating
• Headaches
• Back pain
• Indigestion
• Shortness of breath
• Heart palpitations
• Occasional dizziness and nausea

Changes in Thinking

• Cognition is slowed down, difficulty thinking, concentrating or remembering.
• Difficulty making decisions, avoiding making decisions.

 Changes in Behaviour

• Social isolation, withdrawal from work, school, friends, hobbies, etc.
• Neglecting duties such as homework, housework, paying bills, etc.
• Decrease in physical activity and exercise.
• Decrease in self care (not showering, grooming, eating, etc.).
• Increased use of alcohol or drugs (prescription and/or non-prescription).

Formal psychological help usually isn’t used unless someone is experiencing complicated grief. In this case, psychotherapy might be helpful for someone to resume daily activities and work through feelings like anger, regret or guilt in order to heal.

For some, complicated grief can turn into or complicate mood or anxiety disorders, in which case a person might need more or different treatment to deal with the symptoms and causes of those illnesses.

Every story is different, and sometimes people need to try different types of supports before they find the right plan for them.

If it is a friend you are concerned about, they may resist help or not even recognize that they need it. They might need you to make the first step.

A person experiencing grief, like any other person, will benefit from maintaining wellness and having good supports in their life.

Supporting someone through their grief can feel uncertain or challenging. It is easy to feel like you’re doing or saying the wrong thing, or feel helpless because you want to help but don’t know how.

Here are some possible ways to help and support a friend or loved one who is grieving:

• Be reassuring and sympathetic company and a good listener. Listen without judging and resist the urge to try and “fix” their problems for them.
• Offer specific support. Saying something like “if there’s anything I can do, let me know” is always done with the best intention, but it puts the responsibility on the grieving person to reach out and ask for help. Instead try “I’m going to drop by tomorrow with some groceries”, “I’m going to call you in a few days and we’ll go catch a movie” or “how about we go for a walk tomorrow?” might be more effective, because they are specific plans to help or connect.
• Saying “God has a plan...” or “time heals…” when someone is experiencing a significant loss may not be helpful. It might be said or thought with the best intentions, but it could also make someone feel like their feelings aren’t validated or appropriate. It’s ok for people to feel angry or sad when they lose something/someone and have their feelings validated.
• Discouraging expressions of grief or shutting off discussions about the person who died is not helpful, because these things are part of the healing process for a lot of people. Don’t worry- talking about the loss isn’t going to “remind” them, because the loss is likely not far from their thoughts anyway. Sharing stories of the person who died or the times in the past before the loss can actually be very comforting and help someone move forward.
• Reassuring someone that their feelings are valid and normal is a very supportive thing to do. Don’t judge a person because they aren’t thinking, feeling or behaving in the same way you would. They need to feel and express themselves in their own way.
• Grief is often bigger than the loss. For instance, if someone loses a parent, there might be other stresses felt around financial support, family roles or security.
• Keep including your friend in your life and social activities. Don’t always assume that they want to be alone or with family. Invite them out to dinner of coffee or for a walk. They might say “no”, but they’ll probably appreciate the offer.
• If you feel like your friend needs extra support or that their grief is prolonged or intense enough that it is interfering with their life, try connecting them to some services in your area for support (see Help Section).
• Stay calm and don’t take things personally. Sometimes grief can really  affect how someone reacts or communicates, which can be confusing, distressing or even hurtful at times. They may be feeling overwhelmed and acting out, and it’s probably not about you.
• Some people need time to themselves, while others might need to spend time with people. Be supportive and try to resist the temptation to tell them what you think they need to do.
• Set some boundaries for yourself, and take care. You can’t help someone if you’re feeling overwhelmed yourself.

See the Help Section for more info about helping a friend and self care and coping with grief and loss.