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Grief is one of the most profound and universal human experiences, touching virtually everyone at some point in their lives. While grief is a natural response to loss, particularly the death of a loved one, its effects can extend far beyond the initial period of mourning. Understanding the long-term impacts of grief on physical, mental, and emotional well-being is essential for those navigating the grieving process and for the people who support them. This comprehensive guide explores how grief can affect your health over time and provides evidence-based strategies to address these challenges and move toward healing.
Understanding the Nature of Grief
Grief is a multifaceted emotional response to loss that encompasses far more than simple sadness. It represents a complex interplay of psychological, physical, and social reactions that occur when we lose someone or something significant in our lives. While most commonly associated with the death of a loved one, grief can also arise from other types of losses, including the end of relationships, loss of health, career changes, or major life transitions.
The grieving process is deeply personal and varies significantly from one individual to another. Some people may experience intense emotions that gradually diminish over time, while others may find their grief resurfaces unexpectedly months or even years after a loss. Cultural background, personal beliefs, the nature of the relationship with the deceased, and the circumstances surrounding the death all influence how grief manifests and evolves.
It’s important to recognize that grief is not a linear process with clearly defined stages that everyone must pass through in order. While the widely known “five stages of grief” model proposed by Elisabeth Kübler-Ross has been influential, modern grief research recognizes that people move through grief in highly individualized ways. Some may experience denial, anger, bargaining, depression, and acceptance, but not necessarily in that order, and some may not experience all these emotions at all.
Normal Grief Versus Prolonged Grief Disorder
For most people, grief-related symptoms following the death of a close other decrease over time and do not impact their everyday functioning. However, a significant minority of bereaved individuals experience a more severe and persistent form of grief that interferes with their ability to function and find meaning in life.
Prolonged grief disorder is the newest disorder to be added to the Diagnostic and Statistical Manual of Mental Disorders (DSM). It is included in the text revision of DSM-5 (DSM-5-TR), which was released in March 2022. This recognition represents a major advancement in understanding and treating severe grief reactions.
An estimated 4%-15% of bereaved adults will experience the persistent symptoms of prolonged grief disorder, though rates can vary substantially depending on the circumstances of the death and individual risk factors. The prevalence of PGD can skyrocket to as high as 49% among survivors of traumatic loss, compared to approximately 9.8% among those bereaved by natural, non-violent deaths.
For a diagnosis of prolonged grief disorder, the loss of a close other person must have occurred at least a year ago for adults and at least 6 months ago for children and adolescents. The key distinguishing features include intense longing for the deceased, preoccupation with thoughts of the person who died, and significant impairment in daily functioning that persists well beyond what would be expected based on cultural and social norms.
The Long-term Effects of Grief on Mental Health
The psychological impact of grief can be profound and enduring, affecting mental health in numerous ways. Understanding these effects is crucial for recognizing when grief has moved beyond a normal response and requires professional intervention.
Depression and Grief
Depression is one of the most common mental health challenges associated with long-term grief. While sadness is a natural component of the grieving process, clinical depression involves persistent feelings of hopelessness, worthlessness, and a loss of interest in activities that once brought pleasure. The relationship between grief and depression is complex, as they share some symptoms but remain distinct conditions.
Prolonged grief symptoms predicted higher depression symptoms. This finding highlights how unresolved grief can contribute to the development of depressive disorders over time. People experiencing both grief and depression may find it particularly difficult to envision a future without their loved one or to find meaning and purpose in their continued existence.
It’s important to note that experiencing sadness and crying after a loss does not automatically indicate clinical depression. However, when these symptoms persist for many months, interfere with daily functioning, and are accompanied by other depressive symptoms such as changes in appetite, sleep disturbances, difficulty concentrating, and thoughts of self-harm, professional evaluation is warranted.
Anxiety Disorders
Anxiety is another common long-term effect of grief that can manifest in various forms. Bereaved individuals may experience generalized anxiety about the future, particularly fears about losing other loved ones or concerns about their own mortality. The loss of a significant person can shatter one’s sense of security and predictability in the world, leading to persistent worry and hypervigilance.
Some people develop panic attacks following bereavement, experiencing sudden episodes of intense fear accompanied by physical symptoms such as rapid heartbeat, sweating, trembling, and shortness of breath. Others may develop specific phobias related to the circumstances of their loved one’s death, such as fear of hospitals, certain medical procedures, or situations that remind them of the loss.
Prolonged grief disorder severity has been significantly positively associated with older age, female sex, anxious attachment style, lower socioeconomic status, and suicidal ideation, indicating that anxiety-related factors play a significant role in complicated grief reactions.
Post-Traumatic Stress Disorder (PTSD)
When a death occurs suddenly, violently, or under traumatic circumstances, survivors may develop PTSD in addition to grief. This can occur following deaths due to accidents, homicide, suicide, or other unexpected events. PTSD symptoms include intrusive memories or flashbacks of the traumatic event, nightmares, avoidance of reminders of the trauma, negative changes in thoughts and mood, and heightened reactivity or being easily startled.
The combination of PTSD and grief can be particularly debilitating, as the traumatic memories interfere with the natural grieving process. Individuals may find themselves unable to think about their loved one without being overwhelmed by distressing images or memories of how they died, making it difficult to remember and honor the person’s life in a healthy way.
Suicidal Ideation and Risk
One of the most serious mental health concerns associated with prolonged grief is an increased risk of suicidal thoughts and behaviors. The intense emotional pain of grief, combined with feelings of hopelessness and a desire to be reunited with the deceased, can lead some individuals to contemplate ending their own lives.
Prolonged grief disorder severity has been significantly positively associated with suicidal ideation, underscoring the importance of assessing suicide risk in individuals experiencing severe grief reactions. Anyone experiencing thoughts of self-harm or suicide should seek immediate professional help.
Emotional and Social Consequences of Long-term Grief
Beyond diagnosable mental health conditions, grief can have profound effects on emotional well-being and social functioning that persist for years after a loss.
Social Isolation and Loneliness
One of the most challenging aspects of long-term grief is the tendency toward social withdrawal and isolation. Bereaved individuals may pull away from friends, family, and social activities for various reasons. Some feel that others cannot understand their pain, while others find social interactions exhausting or fear breaking down emotionally in public.
Prolonged grief symptoms predicted higher social, emotional, and general loneliness. This finding reveals a troubling cycle: grief leads to increased loneliness, which can in turn intensify grief symptoms and make recovery more difficult. Loneliness is often experienced by bereaved persons and can have severe health consequences.
The loss of a spouse or partner can be particularly isolating, as the bereaved person loses not only their loved one but also their primary source of companionship and social connection. Couples’ friendships may fade, and the grieving individual may feel like a “third wheel” in social situations that were previously comfortable.
Anger and Resentment
Anger is a common but often misunderstood component of grief. Bereaved individuals may feel angry at the person who died for leaving them, at themselves for things left unsaid or undone, at medical professionals they perceive as having failed their loved one, at God or the universe for allowing the death to occur, or at others who seem to be moving on with their lives.
When anger persists over the long term, it can damage relationships and prevent healing. Unresolved anger may manifest as irritability, outbursts of rage, or a general sense of bitterness toward life. Some people turn their anger inward, leading to self-blame and guilt that can be equally destructive.
Guilt and Regret
Guilt is another emotion that frequently accompanies grief and can persist for years. Survivors may experience guilt over being alive when their loved one is not, over perceived failures in their relationship with the deceased, over not being present at the moment of death, or over beginning to feel happiness again.
This “survivor’s guilt” can be particularly intense when the death was sudden or when the bereaved person feels they could have prevented it in some way. Parents who have lost children often struggle with profound guilt, questioning every decision they made and wondering if they could have done something differently to prevent the death.
Identity Disruption
Symptoms of prolonged grief disorder include identity disruption (such as feeling as though part of oneself has died). This loss of identity can be one of the most disorienting aspects of long-term grief. When someone loses a spouse, they may struggle with no longer being part of a couple. Parents who lose a child may question their identity as a parent. Adult children who lose parents may feel unmoored, having lost the people who knew them longest and best.
This identity crisis can affect every aspect of life, from how one introduces oneself to others to fundamental questions about purpose and meaning. Rebuilding a sense of self that incorporates the loss while still allowing for growth and new experiences is a crucial part of the healing process.
Physical Health Consequences of Prolonged Grief
The impact of grief extends far beyond emotional and psychological well-being, affecting physical health in significant and sometimes surprising ways. The mind-body connection means that intense emotional distress can manifest in physical symptoms and increase vulnerability to various health conditions.
Cardiovascular Effects
We have previously found a connection between high grief symptom levels and higher rates of cardiovascular disease, mental health problems, and even suicide. This connection between grief and heart health is well-documented in research, with studies showing increased rates of heart attacks, irregular heart rhythms, and other cardiac events in the period following bereavement.
The stress hormones released during intense grief can affect blood pressure, heart rate, and blood clotting, potentially triggering cardiovascular events in vulnerable individuals. The phenomenon of “broken heart syndrome” or stress-induced cardiomyopathy is a real medical condition in which intense emotional stress can cause temporary heart muscle weakness that mimics a heart attack.
Immune System Suppression
Prolonged grief can weaken the immune system, making bereaved individuals more susceptible to infections and illnesses. The chronic stress associated with grief affects the body’s ability to fight off pathogens and may slow wound healing. This immune suppression can persist for months or even years after a loss, particularly in cases of complicated grief.
Research has shown that bereaved individuals experience changes in immune cell function, inflammatory markers, and other indicators of immune health. This may explain why grieving people often report getting sick more frequently or taking longer to recover from common illnesses.
Sleep Disturbances
Sleep problems are extremely common among bereaved individuals and can persist long after the initial loss. These may include difficulty falling asleep, frequent nighttime awakenings, early morning awakening, or sleeping too much as a way to escape emotional pain. Some people experience nightmares about their loved one or the circumstances of the death.
Chronic sleep deprivation has cascading effects on physical and mental health, contributing to fatigue, difficulty concentrating, mood disturbances, weakened immunity, and increased risk of accidents. The relationship between grief and sleep is bidirectional: grief disrupts sleep, and poor sleep makes it harder to cope with grief.
Chronic Fatigue and Pain
Many bereaved individuals experience persistent fatigue that goes beyond normal tiredness. This exhaustion can be both physical and emotional, making even simple daily tasks feel overwhelming. The constant emotional strain of grief is genuinely exhausting, and when combined with sleep disturbances and the physical effects of stress, it can lead to debilitating fatigue.
Grief can also manifest as physical pain, including headaches, muscle aches, chest pain, and digestive problems. Some people experience pain in the same location where their loved one experienced illness or injury, a phenomenon known as somatic identification. These physical symptoms are real, not imagined, and reflect the profound connection between emotional and physical well-being.
Increased Mortality Risk
Perhaps most concerning is research showing that prolonged, intense grief can increase mortality risk. Bereaved people with persistent high levels of intense grief used more healthcare services and were more likely to die within 10 years. This finding from a large-scale Danish study highlights the serious health implications of unresolved grief.
People on the ‘low’ trajectory (38%) displayed persistently low levels of grief symptoms, while 6% followed a ‘high’ trajectory with persistently elevated levels. Those in the high grief trajectory group faced significantly elevated mortality risk compared to those with lower grief symptom levels, even after accounting for other health factors.
Healthcare Utilization and Long-term Grief
The health impacts of prolonged grief are reflected in patterns of healthcare use. Bereavement may affect the health of relatives, causing increased use of health care services and increased mortality shortly after the patient’s death. However, the long-term consequences for those with a high level of grief symptoms remain largely unexplored.
These had 186% higher odds of receiving talk therapy or other mental health services, 463% higher odds of being prescribed antidepressants, and 160% higher odds of being prescribed sedatives or anxiety drugs. These statistics refer to individuals experiencing high levels of prolonged grief compared to those with lower grief symptoms, demonstrating the substantial mental health treatment needs of this population.
Despite these elevated needs, many bereaved individuals do not receive adequate mental health support. Underutilization of mental health services among bereaved caregivers with prolonged grief disorder remains a significant concern, with barriers including stigma, lack of awareness about available treatments, financial constraints, and difficulty accessing specialized grief therapy.
Risk Factors for Prolonged Grief Disorder
Understanding who is at higher risk for developing prolonged grief disorder can help with early identification and intervention. Several factors have been identified that increase vulnerability to complicated grief reactions.
Characteristics of the Death
Prolonged grief disorder risk has also varied by kinship relationship to the deceased (e.g., higher among those surviving the death of a child or spouse/partners), violent causes of death (e.g., murder), and location of death (e.g., in an Intensive Care Unit as opposed to death at home). The sudden, unexpected, or violent nature of a death significantly increases the risk of prolonged grief.
Deaths by suicide, homicide, accidents, or other traumatic circumstances are particularly likely to result in complicated grief. The lack of opportunity to say goodbye, the traumatic nature of the loss, and often the presence of concurrent PTSD symptoms all contribute to more difficult grief trajectories.
Relationship to the Deceased
The nature and quality of the relationship with the person who died plays a significant role in grief outcomes. Loss of a child is consistently identified as one of the most devastating losses, with parents experiencing particularly high rates of prolonged grief disorder. The death of a spouse or romantic partner also carries elevated risk, especially for older adults who may have been together for many decades.
Relationships characterized by high dependency, ambivalence, or unresolved conflict may also lead to more complicated grief. When someone loses a person they relied on heavily for emotional or practical support, or when the relationship was troubled and leaves many things unsaid or unresolved, the grieving process can be more difficult.
Personal and Social Factors
Lack of social support is also a risk for prolonged grief disorder. Individuals who are socially isolated, who lack a strong support network, or who feel unable to share their grief with others are at higher risk for complicated grief reactions.
Previous mental health history is another important risk factor. People with a history of depression, anxiety, or other psychiatric conditions are more vulnerable to developing prolonged grief disorder. Additionally, those who experienced high levels of anticipatory grief before the death or who had previous traumatic losses may be at increased risk.
Older adults are consistently identified as being at higher risk for PGD. This may be due to multiple factors, including the accumulation of losses over time, reduced social networks, physical health challenges, and the particular devastation of losing a long-term spouse or partner in later life.
Socioeconomic and Demographic Factors
Lower socioeconomic status, limited education, and financial strain can all increase vulnerability to prolonged grief. These factors may limit access to mental health care, create additional stressors that complicate the grieving process, and reduce available coping resources.
Gender also plays a role, with women generally showing higher rates of prolonged grief disorder than men. However, this may partly reflect differences in help-seeking behavior and emotional expression rather than actual differences in grief severity.
Evidence-Based Approaches to Addressing Long-term Grief
While grief is a deeply personal journey, research has identified several effective strategies and interventions for addressing its long-term effects. The good news is that with appropriate support and treatment, even severe grief reactions can improve.
Professional Mental Health Treatment
Psychotherapy is the main treatment for prolonged grief disorder. Several specialized therapeutic approaches have been developed specifically for treating complicated grief, with strong evidence supporting their effectiveness.
Complicated Grief Treatment (CGT)
CGT has demonstrated efficacy compared with interpersonal therapy in two trials across the adult age spectrum, with CGT exhibiting better response rates, greater symptom reduction, and less prolonged grief disorder–related impairment. This specialized treatment combines elements of cognitive-behavioral therapy with techniques specifically designed to address the unique challenges of grief.
CGT typically involves helping individuals confront the reality of the loss, manage painful emotions, restore effective functioning, and find ways to maintain a connection with the deceased while also reinvesting in life and relationships. The treatment is usually delivered over 16 sessions and has shown significant benefits for people struggling with prolonged grief.
Cognitive-Behavioral Therapy (CBT)
Treatments using elements of cognitive-behavioral therapy (CBT) have been found to be effective in reducing symptoms as have online interventions that permit mourners to express their grief in virtual notes to the deceased person. CBT for grief focuses on identifying and changing unhelpful thought patterns and behaviors that maintain grief symptoms.
This might include addressing beliefs such as “I can’t survive without them,” “My life is over,” or “I should have been able to prevent this.” CBT also helps individuals gradually re-engage with activities and situations they’ve been avoiding due to grief, reducing the avoidance that can perpetuate suffering.
Other Therapeutic Approaches
Additional therapeutic modalities that have shown promise for treating grief include Eye Movement Desensitization and Reprocessing (EMDR), particularly when grief is complicated by trauma; mindfulness-based interventions that help individuals develop a different relationship with painful emotions; and meaning-making therapies that help bereaved individuals find purpose and significance in their loss and their continued life.
Group therapy and support groups can also be valuable, providing connection with others who understand the grief experience and reducing the isolation that often accompanies bereavement. Peer support can be particularly powerful, as it normalizes grief reactions and provides hope through witnessing others’ healing journeys.
Medication Considerations
There are currently no medications to treat specific symptoms of grief, but research is underway to explore medications that might prove helpful in mitigating prolonged grief disorder. While medication is not a primary treatment for grief itself, it can be helpful for managing co-occurring conditions such as depression or anxiety.
Those receiving CGT (with citalopram or placebo) showed greater reductions in prolonged grief disorder symptoms and suicidal ideation than those on a pill alone, indicating that while medication may provide some benefit, it is most effective when combined with specialized grief therapy rather than used as a standalone treatment.
Antidepressants may be appropriate when someone is experiencing major depression alongside grief, and anti-anxiety medications may provide short-term relief for severe anxiety symptoms. However, these should be prescribed and monitored by a qualified healthcare provider as part of a comprehensive treatment plan.
Building and Utilizing Support Systems
Social support is one of the most important protective factors against complicated grief. Bereavement support groups and peer support can also provide a useful source of social connection and support. They can help people feel less alone; thus, help avoid the isolation that could increase the risk for prolonged grief disorder.
Family and Friends
Maintaining connections with family and friends, even when it feels difficult, is crucial for long-term well-being. Loved ones can provide practical support, emotional comfort, and companionship during the grieving process. It’s important to communicate your needs clearly, as people often want to help but may not know how.
At the same time, it’s essential to recognize that not everyone will understand or respond to your grief in helpful ways. Some people may minimize your loss, offer unhelpful platitudes, or expect you to “move on” before you’re ready. Setting boundaries with people who aren’t supportive while nurturing relationships with those who are can help protect your emotional well-being.
Community and Organizational Resources
Many communities offer grief support resources through hospitals, hospices, religious organizations, and nonprofit groups. These may include support groups, educational workshops, counseling services, and memorial events. Organizations specializing in specific types of loss—such as the loss of a child, spouse, or loss by suicide—can provide particularly relevant support and connection.
Online communities and forums can also offer valuable support, especially for people in rural areas or those dealing with less common types of loss. Virtual support groups became particularly important during the COVID-19 pandemic and continue to provide accessible options for many bereaved individuals.
Workplace Support
For many people, returning to work after a loss is challenging, and workplace support can make a significant difference. This might include flexible scheduling, employee assistance programs that provide counseling, understanding supervisors and colleagues, and reasonable accommodations during the grieving process.
Unfortunately, many workplaces provide minimal bereavement leave and expect employees to return to full productivity quickly. Advocating for your needs and utilizing available resources can help you navigate this difficult transition.
Self-Care Strategies for Managing Long-term Grief
While professional help and social support are important, there are also many self-care practices that can support healing and well-being during the grieving process.
Physical Activity and Exercise
Regular physical activity is one of the most effective self-care strategies for managing grief. Exercise releases endorphins that can improve mood, reduces stress hormones, improves sleep quality, and provides a healthy outlet for difficult emotions. It doesn’t have to be intense—even gentle activities like walking, yoga, or swimming can be beneficial.
Many bereaved individuals find that physical activity provides a temporary respite from grief, a sense of accomplishment, and a way to care for their body during a time when it’s under significant stress. Group exercise classes or walking with a friend can also provide social connection.
Mindfulness and Meditation
Mindfulness practices can help individuals develop a different relationship with painful emotions, learning to observe them without being overwhelmed. Meditation, deep breathing exercises, and other mindfulness techniques can reduce anxiety, improve emotional regulation, and provide moments of peace amid grief’s turbulence.
These practices don’t eliminate grief or make it go away, but they can help create space around difficult emotions and reduce the secondary suffering that comes from fighting against or being consumed by grief. Many people find guided meditations specifically designed for grief to be particularly helpful.
Expressive Writing and Journaling
Writing about grief can be a powerful tool for processing emotions and making meaning of loss. This might include keeping a journal about your feelings and experiences, writing letters to your loved one (whether or not you share them), or engaging in more structured writing exercises designed to facilitate grief work.
Research has shown that expressive writing about traumatic or emotional experiences can improve both mental and physical health outcomes. The act of putting feelings into words can help organize chaotic emotions, identify patterns, and gain new perspectives on the loss.
Creative Expression
Art, music, dance, and other creative activities can provide outlets for grief that don’t rely on words. Many people find that creative expression allows them to access and process emotions that are difficult to articulate verbally. Creating something—whether a painting, a song, a garden, or a memorial project—can also provide a sense of purpose and a tangible way to honor a loved one’s memory.
Creative activities can be done alone or in groups, and no artistic skill is required. The process itself, rather than the product, is what matters for grief healing.
Maintaining Physical Health
Given the significant physical health impacts of grief, taking care of your body is essential. This includes eating nutritious foods even when appetite is poor, maintaining a regular sleep schedule as much as possible, staying hydrated, limiting alcohol and avoiding substance use as coping mechanisms, and keeping up with routine medical care and medications.
It’s common for bereaved individuals to neglect their physical health, but doing so can worsen both physical and emotional well-being. Treating your body with care and compassion during this difficult time is an important form of self-care.
Spiritual and Existential Practices
For many people, grief raises profound questions about meaning, purpose, mortality, and what happens after death. Engaging with these questions through religious practice, spiritual exploration, philosophical reading, or conversations with others can be an important part of the healing process.
This might include attending religious services, prayer, meditation on existential questions, reading spiritual or philosophical texts, or connecting with nature. Even for those who don’t consider themselves religious or spiritual, finding ways to grapple with the big questions that grief raises can facilitate healing and growth.
Establishing New Routines and Finding Meaning
As time passes after a loss, establishing new routines and finding ways to create meaning can support the transition from acute grief to a more integrated form of mourning.
Creating Structure and Routine
Grief can be disorienting and chaotic, making even simple daily tasks feel overwhelming. Establishing routines can provide structure, predictability, and a sense of control during a time when life feels out of control. This might include regular wake and sleep times, scheduled meals, designated times for work or other responsibilities, and planned activities or social connections.
Routines don’t have to be rigid, and it’s important to allow flexibility for difficult days. However, having some structure can reduce decision fatigue, ensure that basic needs are met, and provide a framework for gradually rebuilding life.
Exploring New Activities and Interests
While it may feel disloyal or premature, eventually engaging in new activities and interests can be an important part of healing. This doesn’t mean forgetting your loved one or replacing what was lost, but rather allowing yourself to continue growing and experiencing life.
New activities can provide distraction, opportunities for social connection, a sense of accomplishment, and the discovery of new sources of meaning and joy. Some people find activities that their loved one would have enjoyed or that honor their memory, while others explore entirely new interests.
Commemorative Practices and Continuing Bonds
Modern grief theory recognizes that healing doesn’t require “letting go” of the deceased or severing the emotional bond. Instead, many people find comfort in maintaining a continuing connection with their loved one in healthy ways. This might include creating memorial rituals or traditions, celebrating the deceased’s birthday or other significant dates, keeping meaningful objects or creating memory boxes, sharing stories and memories with others, or engaging in activities the deceased valued or enjoyed.
Some people find meaning in transforming their grief into action, such as advocating for causes related to their loved one’s death, supporting others who have experienced similar losses, or creating scholarships, foundations, or other memorials. These activities can provide a sense of purpose and help ensure that the loved one’s life and death have lasting positive impact.
Post-Traumatic Growth
While grief is undeniably painful, some individuals experience what researchers call “post-traumatic growth”—positive psychological changes that can emerge from struggling with highly challenging life circumstances. This doesn’t mean that the loss was “worth it” or that grief is a good thing, but rather that some people find unexpected benefits alongside their pain.
Post-traumatic growth might include deeper appreciation for life and relationships, increased personal strength and resilience, discovery of new possibilities or life paths, enhanced spiritual or existential understanding, or closer relationships with others. Recognizing these changes doesn’t diminish the loss or the pain of grief, but it can provide some comfort and meaning.
Special Considerations for Different Populations
While grief is universal, different populations may face unique challenges and require tailored support.
Children and Adolescents
An estimated 5-10% of bereaved children and adolescents will experience depression, PTSD, and/or PGD. Young people grieve differently than adults, and their grief may manifest in ways that aren’t immediately recognized as grief-related, such as behavioral problems, academic difficulties, or physical complaints.
Children need age-appropriate information about death, permission to grieve in their own way, continued routine and stability, and ongoing support from caring adults. Adolescents may struggle with grief while also navigating the normal developmental challenges of their age, and may benefit from peer support groups specifically for bereaved teens.
Older Adults
Older adults often face multiple losses in a relatively short period—spouses, siblings, friends, and sometimes even adult children. They may also be dealing with their own health challenges, reduced mobility, and smaller social networks, all of which can complicate grief.
The loss of a long-term spouse in particular can be devastating for older adults, affecting every aspect of daily life and identity. Older bereaved individuals may benefit from support groups specifically for widows and widowers, assistance with practical matters, and help maintaining social connections and engagement.
Caregivers
People who served as caregivers before their loved one’s death face unique grief challenges. They may experience relief alongside sadness, which can trigger guilt. They may also struggle with the sudden loss of the caregiving role that structured their days and gave them purpose. Caregiver grief can be complicated by exhaustion, unresolved feelings about the caregiving experience, and the need to process both the loss and the often-difficult period leading up to it.
Disenfranchised Grief
Some losses are not socially recognized or validated, leading to what’s called “disenfranchised grief.” This might include the loss of an ex-spouse, a partner in a non-traditional relationship, a pregnancy or infant, a pet, or a loved one to stigmatized causes of death such as suicide or overdose. People experiencing disenfranchised grief may lack social support and feel unable to openly mourn, which can complicate the grieving process.
The Impact of COVID-19 on Grief
The COVID-19 pandemic has had a profound impact on grief and bereavement. Not only have millions of Americans lost loved ones to the COVID-19 pandemic (including more than over 200,000 children who lost a parent to COVID-related deaths), but many others continue to lose loved ones every day to other public health issues.
The pandemic created particularly difficult circumstances for grief, including inability to be present at the time of death due to hospital restrictions, lack of traditional funeral and memorial services, social isolation during lockdowns, and the collective trauma of the pandemic itself. These factors may increase rates of prolonged grief disorder among those bereaved during this period.
Additionally, the pandemic highlighted the importance of recognizing grief as a public health issue and ensuring access to grief support services, including telehealth and online options that became more widely available during this time.
When to Seek Professional Help
While grief is a normal response to loss, there are times when professional help is necessary. Consider seeking support from a mental health professional if you experience thoughts of self-harm or suicide, inability to carry out basic daily activities for an extended period, severe depression or anxiety, substance abuse as a coping mechanism, or intense grief symptoms that persist beyond a year without improvement.
Awareness of prolonged grief disorder by general health practitioners, as well as mental health specialists, is key to appropriate early intervention. Don’t hesitate to reach out to your primary care physician, who can provide referrals to mental health specialists with expertise in grief and bereavement.
It’s also important to remember that seeking help is not a sign of weakness or a betrayal of your loved one. Professional support can provide tools and strategies to honor your loved one’s memory while also caring for your own well-being and gradually rebuilding your life.
Resources and Support Organizations
Numerous organizations provide support, information, and resources for bereaved individuals. National organizations such as the American Foundation for Suicide Prevention offer support for those who have lost someone to suicide, while The Compassionate Friends provides support for bereaved parents, siblings, and grandparents. Organizations like the National Alliance for Grieving Children support young people who have experienced loss.
Many hospice organizations offer bereavement support services to the community, not just to families of their patients. Online resources, including grief support forums, educational websites, and virtual support groups, can provide information and connection, particularly for those in areas with limited local resources.
For immediate crisis support, the National Suicide Prevention Lifeline (988 in the United States) provides 24/7 support for people in distress. The Crisis Text Line (text HOME to 741741) offers text-based crisis support. These services are available to anyone experiencing emotional distress, including those struggling with grief.
Conclusion: Moving Forward with Grief
Grief is one of the most challenging experiences humans face, with effects that can persist for years and impact every aspect of well-being. The long-term effects of grief on mental health, emotional functioning, physical health, and social connections are significant and should not be underestimated or dismissed.
However, it’s equally important to recognize that healing is possible. With appropriate support, effective treatment, self-care practices, and time, most people are able to integrate their loss and find ways to continue living meaningful lives while maintaining a connection to their loved one. The goal is not to “get over” grief or to return to who you were before the loss, but rather to find ways to carry your grief while also experiencing joy, connection, and purpose.
Understanding the long-term effects of grief is the first step toward addressing them effectively. Whether you are grieving yourself or supporting someone who is, knowledge about grief’s impacts can guide you toward helpful resources and strategies. Remember that grief is not a problem to be solved but a process to be navigated, and there is no “right” way to grieve or timeline for healing.
If you are struggling with grief, please know that you are not alone and that help is available. Reaching out for support—whether from friends and family, support groups, or mental health professionals—is a sign of strength and self-care. Your loved one would want you to take care of yourself and to eventually find peace and meaning in your continued life.
For more information about grief support and mental health resources, visit the Substance Abuse and Mental Health Services Administration, the American Psychological Association, or the American Psychiatric Association. Additional resources on bereavement and coping with loss can be found through the National Cancer Institute and Mayo Clinic.