7 stages of grief and the grieving process

The stages of grief

Grief is a natural experience that helps a person process the pain of loss and move toward healing.

The stages of grief are not necessarily linear, which means people may not go through them in order.

In 1969Trusted Source, Dr. Elisabeth Kubler-Ross established that there are five stages of grief:

• denial
• anger
• bargaining
• depression
• acceptance

However, more recentlyTrusted Source, grief expert David Kressler has discussed additional stages of grief. Therefore, people often refer to seven stages of grief. They consist of the following:

1. Shock

This stage may involve numbed disbelief in response to news of a loss. It may serve as an emotional buffer to prevent someone from feeling overwhelmed.

2. Denial

Denial may entail refuting the reality of the loss or any associated feelings. Once an individual accepts reality, they can move forward through the healing process.

Shock and denial help people manage the immediate aftermath of a loss.

3. Anger

During this stage, an individual may direct their anger toward the person who died, doctors, family members, or even religious entities.

This replaces the numbness of shock and denial. It is important to address the anger.

4. Bargaining

Bargaining involves thoughts such as “I will do anything if you take away the pain.”

This stage may come at any point within the grieving process. Guilt frequently accompanies it.

5. Depression

At this stage, a person may experience feelings of emptiness and intense sadness. They may also withdraw from daily activities and things they once enjoyed.

While this stage is difficult, it is a necessary step toward healing.

6. Testing

Testing is the process of trying to find solutions that offer a means of dealing with loss. Someone may drift in and out of other grieving stages during this time.

7. Acceptance

This is the final stage of the grieving process. Acceptance does not mean people feel OK about a loss. Rather, it means they realize the loss is their new reality. They understand that while life will not continue as it did before, it will go on.

This stage may involve reorganizing roles and forming new relationships.

How long is the grieving process?

The grieving process has no set duration, and people move through each stage at varying rates.

Symptoms of grief largely resolve after 1 to 2 yearsTrusted Source. However, this timeline is different for everyone. Additionally, rather than experiencing a steady decline in grief, a person’s emotions tend to fluctuate over time and come in waves.

It is common for reactions to grief to resurge after many years in response to triggers, which may include:

• birthdays
• special events
• holidays
• songs

Different types of grief

Research from 2020Trusted Source describes the various types of grief. They include:

Anticipatory grief

This is what a person feels when they expect a loss that has not yet happened. It includes many of the same emotions someone experiences after a loss.

Anticipatory grief is more likely in individuals with dependent relationships or limited social support.

‘Normal’ or common grief

“Normal” grief is a gradual progression toward acceptance.

Although people experience difficult emotions, they retain the ability to continue everyday activities. They might have emotional distress, such as crying, low mood, and longing.

Complicated grief

Doctors may also refer to complicated grief as pathologic grief. It resembles conditions such as depression and generalized anxiety disorder.

It may deviate from “normal” grief in the following ways:

• Absent or inhibited grief: This is a pattern of manifesting little evidence of distress or yearning.
• Delayed grief: This is a pattern where symptoms occur much later than is typical.
• Chronic grief: This is a pattern where symptoms persist over a prolonged duration.
• Distorted grief: This is a pattern of extremely intense symptoms.

Persistent, prolonged, or complex grief

This is a type of complicated grief that involves intense sorrow after 12 months have passed — or 6 months for children and adolescents. The intensity and pervasiveness of the reactions can cause disability.

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) recognizes prolonged grief as an independent disorder.

How to support someone who is grieving

It can be challenging to help family, friends, or loved ones who are grieving. People can offer support by:

• Offering a listening ear: A person can remind someone who is grieving that they are available to listen whenever they feel like talking about how they feel or sharing memories.
• Finding practical ways to help: Instead of saying, “Let me know if I can do anything for you,” volunteer to help in specific ways. This could involve preparing a meal, running errands, or helping with child care.
• Assuring them that their feelings are valid: Remember that the sadness can linger in some people for quite some time after a loss. Some days will be better than others.

To support a grieving child, the American Academy of Child and Adolescent Psychiatry recommends:

• asking the child questions to assess their emotional state and understanding of the loss
• maintaining the child’s routine as much as possible
• allowing the child time to express their feelings
• spending time with the child doing things they enjoy
• visiting mental health professional with the child if they are having serious and persistent problems with grief and loss that interfere with their daily life

Resources for grieving

Support groups may provide comfort, companionship, and validation. They can also serve as a source of practical information.

A person can find groups in their community through community centers, hospices, places of worship, and hospitals.

Additionally, the following national resources may help:

• Hope for Bereaved: This offers services and support groups for people who are grieving.
• AARP’s Grief and Loss: The AARP provides articles and tools for coping with grief.
• The Compassionate Friends: This is a resource with online and local support groups for those who have lost a child.
• National Widowers Organization: This group supports men who have lost a loved one.
• Dougy Center: This is a resource for support groups and education for children and teenagers who are grieving.
• What’s Your Grief?: This is a resource for those who are grieving or who are supporting someone who is grieving.

When to contact a doctor

Mourning is a natural process, but it can be harmful if it goes on for too long. If a person’s sadness prevents them from engaging in their everyday activities, they can contact a doctor.

Additionally, if an individual has signs of complicated grief — such as the inability to find meaning in life — they may need professional help.

Summary

The stages of the grieving process include shock, denial, anger, bargaining, depression, testing, and acceptance. However, people do not always go through the process in this particular order, and some steps last longer than others.

Grief symptoms largely diminish after 1 to 2 yearsTrusted Source, but they may reappear years later in response to certain triggers, such as birthdays. Although grieving is a part of life, if the symptoms interfere with daily life, people can talk with a doctor.