This is the most commonly asked question I hear. You might be worried for yourself, or you might be thinking of a family member or friend whose grief feels like it’s getting out of their control. We’ll look at the different ways grief can manifest as both physical and psychological symptoms and give you a few key signs to look out for.

Phases of Grieving

These are the three potential phases that grievers can go through.

1. Acute grief: This is the initial phase of grief that pretty much everyone starts out in. Acute grief is the initial response to loss. Grieving people in this phase are usually distressed, in shock, sad, and even afraid. They may not be able to get calm when their grief hits them, and even though it can be scary to watch, it’s normal.

2. Integrated grief: This is the healthy route for grievers to take. Over time, they will be able to assimilate the reality of their loss and move forward to a new and different life.

3. Complex/prolonged grief: This is the unhealthy potential after the acute phase. In this phase, the integration never happens, there is no sense of moving on or moving forward, and the person may not be able to accept the loss.

Here’s a caveat— people can stay in acute grief for a very long time. It’s totally normal to stay in that first phase for at least a year after a huge, important, or traumatic loss. And the integration process doesn’t mean they don’t still grieve or have hard days, especially around significant anniversaries.

Normal Grief Experiences

1. Physical symptoms: fatigue, nausea, weight changes, aches and pains, tension, sleep disruptions

2. Intense and mixed emotions: wild and unexpected emotional shifts across the spectrum

3. Sense of presence: seeing, hearing, feeling, or otherwise experiencing the deceased person or pet or lost possession

4. Forgetfulness and confusion: cognitive processes are impacted by grief and stress

5. Numbness: physical, emotional, and mental checking out as a way for the mind and body to protect themselves from the reality of the loss

6. Social withdrawal: wanting to spend time alone, pulling back from usual social groups, not responding

7. Change in worldview: questioning and reevaluating beliefs, values, and understanding of self and the world

8. Anxiety: new fears about health and future losses

9. Difficulty moving on: fears about forgetting, worry that moving on will make them vulnerable to future loss

10. Heightened sensitivity: more easily upset or irritated than before

Get Help When…

• They are continually refusing food or water for days at a time.

• Their low moods include suicide ideation. Get crisis help if they mention a specific plan and the means to carry it out.

• They feel so unsafe out in the world they stop going out even for necessary things.

These might look similar to normal grieving on the surface. Remember, the important difference is what’s behind the symptom or behavior.

Normal: Not eating as much because food doesn’t taste like much or the effort of cooking feels like too much. Avoiding the kitchen/cooking because of reminders of the loss. Excessive eating for comfort.

Problem: Signs of severe dehydration or malnutrition. Binge eating to manage emotional distress. Intentionally eating allergy-related foods to harm themselves or risk their own death.

Normal: Feeling intensely sad, having crying spells come out of nowhere, avoiding grief triggers, ruminating on memories related to the loss, thoughts of suicide

Problem: Wanting to die and making preparations for exactly how and when they want to do it. Self harming.

Normal: Not wanting to socialize because others will ask about the loss or want to talk about it. Not wanting to have to get dressed in outside clothes and look happy for others.

Problem: Not wanting to socialize because of a belief that leaving the house will open them up to another loss- if they go out there might be another fire, if they’re busy they might miss an important call about an accident, if they leave the kids with a babysitter they might die.

Worried about yourself or someone you love?

Therapy can help. It doesn’t have to be dangerous or a crisis for you to reach out for support.

As a certified grief counseling specialist, I have the tools to help you through your acute grief and work toward integration. I can work with you to assess the symptoms you’re worried about and let you know what’s normal and what might need more attention. Normal grieving is still painful, and I can walk with you through this time. Contact me to schedule a free 15 minute consultation and I’ll let you know if therapy is right for you or your loved one.