Some grief experts conclude that grieving may last six to twelve months while others believe the grieving process can last longer. Every person who experiences loss needs time to grieve and heal. However, how long the process lasts varies for each person and depends on several factors, including personal circumstances and cultural context. Seek treatment if you are unable to cope with your grief.
The Duration of Grief
In response to a loss, the expected symptoms of uncomplicated grief, such as crying, sorrow, sleeplessness, poor appetite, disrupted thinking, fear, anxiety and depression, are self-limiting for most people. In an investigation of the stages and duration of grief, reported in 2007 in the Journal of the American Medical Association (JAMA), Yale researchers found that on the average the symptoms of grief peaked in six months and diminished during the year. The intensity of symptoms felt and how many symptoms are experienced will vary from person to person. Some thoughts or symptoms of grief may also include:
- Longing for the deceased individual and wishing you could join them.
- Feeling helpless and lonely.
- Wishing you weren't going through this.
- Feeling unlike yourself and wondering when you'll feel okay again.
- Feeling a deep sadness and/or anger about this loss.
- Experiencing numbness.
- Being easily triggered by others.
- Wanting to isolate.
- Avoiding or seeking out places that remind you of the deceased.
- Experiencing physical pain such as headaches, stomachaches, and general tension throughout your body.
- Believing you hear or see the deceased, dreaming about your loved one, or feeling their presence.
- Attempting to make meaning of the loss and/or death in general.
What to Ask Your Doctor About Grief
If you are experiencing self-harming thoughts and/or are having a hard time managing tasks of daily living due to grieving symptoms, it's important to reach out to your doctor. Be as honest as possible so they are able to give you appropriate resources and referrals. When speaking with your doctor, it's important to ask about or discuss:
- How you are currently processing your loss and how long ago your loved one passed away: "My loved one passed away (insert how long ago), so I was wondering if it was normal for me to experience (insert thoughts/symptoms?"
- The duration of your symptoms: "My symptoms have been going on for (insert time frame), and I was wondering if that is to be expected for this type of loss?"
- How long grieving lasts for this particular type of loss.
- The intensity of your symptoms: "My (insert specific symptom) has been going on for (insert time frame) and feels like a (insert number) out of 10 in terms of intensity."
- If they believe your symptoms may qualify for a diagnosis of persistent complex bereavement disorder, or another mental health disorder.
- How intrusive your thoughts are.
- Any unhealthy coping methods you are using such as self-medication: "I'm finding myself drinking more alcohol since the loss, is there anything else I can be doing instead?"
Keep in mind that everyone's normal in terms of symptom manifestation will be different. For instance, some individuals may experience a few bouts of sadness, but feel comfortable with that, while someone else may find that intolerable and look to self-medicate. For this reason, it's critical to discuss the full range of what you are experiencing without dulling down your symptoms so your doctor has a fuller picture before treating or referring you.
When and How Does Grief End?
Based on the Yale study findings, it is normal for people to experience some symptoms of grief for two years or more. According to Dr. J. William Worden's book, Grief Counseling and Grief Therapy (Chapter two, pages 36 to 46), it is not possible to predict exactly when grief should end because of the differences in the circumstances of people's lives.
Someone who is grieving progresses to a resolution of grief and returns to her previous level of function as the acute grief symptoms improve. As long as there is progressive resolution and an improvement in well-being, there should be no cause for worry. Grief ends when a person reaches a place of inner peace and stability and adapts to a vision of a life without the deceased in her physical world, notes Dr. Worden.
Prolonged Grieving
Prolonged grieving beyond a year can be considered dysfunctional if persistent symptoms are severe enough to disrupt a person's return to usual function. Some individuals may continue to have one or more symptoms of grief for years but still function normally as noted in a review in the American Journal of Psychoanalysis.
For those who move on from their grief, it is not abnormal for some to have a brief return of a few previous symptoms on significant dates, such as holidays, anniversaries and birthdates, according to a 2009 World Psychiatry review of grief.
Factors That Influence the Duration of Grieving
Because of a variety of factors, no two people grieve alike. In the World Psychiatry review, the authors write that the following factors influence the severity and duration of a person's active grieving:
- The relationship of the griever to the deceased
- How the person died, such as an expected, natural death versus a violent, unexpected death
- Difficulty accepting the loss
- The type of loss (death versus divorce, job loss, or loss of physical abilities)
- A previous loss or multiple losses
- Existing vulnerabilities such as other stressors, or a psychological disorder
- Cultural context, cultural beliefs, and mourning rituals
- Personal beliefs and outlook on life, which help mold coping skills and resilience
When to Seek Professional Help
Because the duration of grief varies for each person, it might not be easy to tell when you, a relative, friend, or coworker need help. If the acute grief symptoms are not improving after six to twelve months, there is a risk of progressing to dysfunctional grieving or complicated unresolved grief. Consider seeking professional help if your grieving is not resolving and:
- Grief is disrupting your quality of life, your relationships, or your ability to keep up with work or school.
- You don't have an adequate support system, or you isolate yourself from others.
- You lose interest in activities you normally enjoy.
- You have thoughts of suicide.
- You are drinking too much or abusing illegal substances or prescription or non-prescription medicines.
- You continue to have major signs or symptoms of grief-related depression or anxiety such as hopelessness, fear, or panic attacks.
- You develop signs and symptoms of a physical illness, such as chest pain, palpitations, or recurring or persistent headaches.
Self-Care Tips for Coping With Grief
As you move through the grieving process, different symptoms and thoughts may come up based on how long it has been since you lost a loved one. Taking care of yourself and knowing when to reach out for additional help is extra important during this painful time. Coping looks different for everyone and it can take some time to figure out what works best for you. Some potential coping methods include:
- Reaching out to and speaking honestly with a counselor or your doctor when you need additional support.
- Connecting with others who will allow you to process in your own time.
- Journaling with a focus on the grieving process.
- Joining a support group with a focus on your particular type of loss.
- Being sure to remind yourself to eat throughout the day, drink plenty of water, and to maintain your sleep routine.
- Spending time outside and making sure you are getting some fresh air every day.
- Processing creatively through art, music, and dance.
- Taking a grief centered yoga course.
Treatment and Support
Treatment by a professional may include grief counseling, cognitive-behavioral therapy, and pastoral or spiritual counseling, as well as depression and anti-anxiety medicines. A grief support group can also help you, especially if you lack family and social support. These strategies can improve your coping skills and help you resolve your grief and return to your previous equilibrium, so don't hesitate to go for help.
