Mar 1, 2003 Table of Contents

Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education Web site.

Information from Your Family Doctor

Grieving: Facing Illness, Death, and Other Losses

Am Fam Physician. 2003 Mar 1;67(5):1053-1054.

What is grief?

Grief is a normal, healthy response to loss. One of the greatest losses that can occur is the death of someone you love. Other losses include the loss of your health or the health of someone you care about, or the end of an important relationship, such as a marriage. Healing from a loss involves coming to terms with the loss and the meaning of the loss in your life.

What are the normal feelings of grief?

As you face a loss, you may have different feelings at different times. These feelings include shock, denial, anger, guilt, sadness, and acceptance. You may find yourself going back and forth from one feeling to another. For example, right when it seems that you are starting to accept your loss, you may find yourself feeling sad or guilty again. Your grief may never completely go away. But the pain you feel will lessen with time as you work through these feelings.

What usually happens first?

In the first hours or days after the loss, you may feel shocked, numb, and confused. You may not remember what people are saying to you. You may feel dazed and as though you are going through things like a robot. You may think and act as though the loss hasn't occurred. This is called denial.

As your shock wears off, reality will slowly break through. You will begin to realize that the loss has happened. It is normal to feel abandoned and angry. You may feel angry at God, religion, doctors and nurses, the one who died, other loved ones, or even yourself.

What happens after the anger wears off?

After you get through some of the anger and denial, it's normal to try to pretend things are like they used to be. If someone you love has died, you may play memories over and over in your mind. You may also feel the presence of your loved one, think you see him or her, or think you hear his or her voice.

Symptoms of Grief

  • Anger

  • Blaming yourself

  • Crying spells

  • Diarrhea

  • Dizziness

  • Fast heartbeat

  • Feeling like there is a lump in your throat

  • Feeling like what is happening around you is not real

  • Headaches

  • Hyperventilating (sighing and yawning)

  • Nausea

  • Not being able to get organized

  • Not feeling hungry, or losing weight

  • Restlessness and irritability

  • Sadness or depression

  • Seeing mental images of the dead person

  • Shortness of breath

  • Tightness in your chest

  • Tiredness

  • Trouble concentrating

  • Trouble sleeping

You may also find yourself talking to your loved one as though he or she were in the room with you. As you begin to realize that your loved one is gone and you can not bring him or her back, you will begin to feel the full effect of your loss. These feelings may be scary because they are so strange and so strong. They may make you feel like you are losing control.

What happens then?

When you begin to realize the full impact of the loss on your life, you may feel depressed and hopeless. You may also feel guilty. You may find yourself thinking things like “if only” or “why me.” You may cry for no apparent reason. This is the most painful stage of healing, but it will not last forever. In normal grief, the depression will begin to lift with time.

What is the first sign of relief?

You may start to feel better in small ways. For example, you may find it is a little easier to get up in the morning, or you may have a small burst of energy. This is the time when you will begin to reorganize your life around your loss or without your loved one.

What is the final stage?

The last stage of accepting a loss is when you begin to reinvest in other relationships and activities. During this time, it is normal to feel a little guilty or disloyal to your loved one because you are moving on to new relationships. It is also normal to relive some of your feelings of grief on birthdays, anniversaries, holidays, and other special times.

How long does grief last?

You will probably start to feel a little better in six to eight weeks. The whole process usually lasts six months to four years. If you feel like you are having trouble getting through the process at any point, ask for help. People who can help include friends, family, clergy, a counselor or therapist, support groups, and your family doctor.

Be sure to talk to your family doctor if you have a lot of trouble eating, sleeping, or concentrating for more than the first couple of weeks. These problems can be signs of depression. Your family doctor can help you work through your depression and start to feel better.

Where Can I Get More Information?

Ask your doctor.

National Foundation for Depressive Illness, Inc.

Telephone: 800-239-1265

Web address: www.depression.org

National Mental Health Association

Telephone: 800-969-6642

Web address: www.nmha.org

Griefnet.org

An online support community dealing with issues of grief and loss.

Web address: www.griefnet.org


This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.

Copyright © 2003 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv@aafp.org for copyright questions and/or permission requests.

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