Grief is the natural response to losing someone important. It is not an illness. But in some people it becomes stuck and stops life from moving on.
There is no right way and no fixed timetable for grieving. Every loss is unique, as is the relationship that was lost.
Intense sadness, longing, crying, difficulty sleeping, guilt, anger or the feeling that the person is still present are common reactions after a loss. Over time, the pain tends to become less constant and more compatible with daily life, even if it never disappears completely.
In some people, grief remains intense long beyond what is expected, with persistent longing and preoccupation with the person who died, difficulty accepting the loss, a sense that part of oneself has died, emotional numbness and an inability to resume life. When this persists for a prolonged period and has a marked impact, it is called prolonged grief disorder.
Sudden or violent deaths, the loss of a child, highly dependent relationships and lack of support increase the risk.
In grief, the pain centres on the loss and usually coexists with moments of relief and positive memories. In depression, mood is low more globally, with loss of interest in almost everything, feelings of worthlessness and guilt that go beyond the loss. The two can coexist, and depression should be treated even when it arises in the context of grief.
When the pain does not ease with time, when returning to work or relationships becomes impossible, when sleep, eating or alcohol use change markedly, or when thoughts of wanting to die or to join the person who died appear. The latter require urgent assessment.
Many people grieve with the support of family and friends. When grief becomes complicated, there are specific psychotherapies with proven efficacy. Medication does not treat grief itself, but it may be needed to treat associated depression, an anxiety disorder or insomnia.
There is no set timeframe. The pain usually becomes less intense and constant over the months, but timing varies greatly between people and with the circumstances of the loss.
Normal grief does not need medication. It can help when there is associated depression, marked anxiety or persistent insomnia, assessed in consultation.
Be present, listen without hurrying and without trying to fix the pain, and help with practical tasks. If the person talks about dying, seek help immediately.
This page is for information only and does not replace an individual medical assessment. Clinical review: Pedro Zuzarte, psychiatrist · Published and reviewed: .
A psychiatric assessment can be the first step.