What is "Normal" Grieving?

Grief is a normal feeling of sadness usually related to the loss of someone or something
cherished or valued. When a loved one dies, even when it’s expected, we often feel a sense of emptiness, of sadness, we may cry, we may not feel like eating, we might prefer to be alone, we might have a hard time concentrating at work, and our sleep might be disrupted. These are all normal reactions when we’ve experienced loss. Our bodies and our brains need time to manage the flood of emotions that comes with the loss of a mom, a grandparent, a spouse or a friend.

Grief can also occur if faced with a serious medical diagnosis; a beloved pet dies; a job is lost; moving away to a new city; or a divorce. Even retirement can generate a type of grieving. There are many different types of losses which can bring about feelings of sadness, longing, and loneliness, and maybe even some anxiety about what’s next. But again, grief is a normal response to any significant loss – and that loss can be a person, a pet, a place, a job – any number of things can generate feelings of loss and grief.

When reading this, some might see that grief sound a lot like depression. A depressive disorder can look very similar to grief. But some of the differences between grief and depression are found in the DSM-5, which is the major tool providers use to diagnose mental health disorders. The DSM-5 offers these important distinctions:

In distinguishing grief from a major depressive episode, it is useful to consider that in grief the predominant effect is feelings of emptiness and loss, while in MDE (major depressive episode), it is persistent depressed mood and the inability to anticipate happiness or pleasure…The thought content associated with grief generally features a preoccupation with thoughts and memories of the deceased, rather than the self-critical or pessimistic ruminations seen in MDE.

In short, grief is centered on loss - typically of a loved one, and the sadness associated with no longer having that person in our lives.

In 1969, Elizabeth Kubler-Ross wrote a book called On Death and Dying. To my knowledge, it was one of the first mainstream books to take a close look at death and normalize the feelings regarding loss. By breaking down the grief process into 5 stages, she gave us a language for talking, sharing, and understanding this part of life. In her book, she labels the stages: Denial, Anger, Bargaining, Depression, and Acceptance. The beauty of Kubler-Ross’s work and the 5 stages is that she gave people permission to recognize that it’s okay to be sad when we experience loss.

It is very important to note here that these stages can be helpful, but everyone is different. Not everyone is going to experience all five stages, and the order of the stages can shift suddenly. Sometimes it’s more helpful to see these stages as movable parts that can come and go, or sometimes won't show up at all. I have had patients describe grief as “coming in waves” or “pangs” of grief that can come up suddenly and without warning. I encourage anyone grieving to let go of expecting there to be any order to your grief process, especially in the beginning. I also encourage letting go of judgment that you or someone else should be doing better or “over it." There is no time limit to grief, and there is no “right” way to grieve. When we love someone (or something, like a city, experience, or phase of life), letting go takes time and that timing is different for everyone.

In saying that, most people have families, work or school, homes to take care of, and bills to be paid. Grieving continues even back in these routines of daily life. Getting back into this routine can actually be beneficial and help begin blending or integrating the loss into daily life. I’m not saying it’s easy, but it can be done. For most people, the routines of work and family actually help with the grieving process.

For those who may know someone who has lost a loved one, it’s often hard to know what to say or do. My recommendation is to feel free to ask if there’s anything you can do for them; however, you may also want to be more specific. For those who have recently lost someone, the question of “Is there anything you need?” can be a difficult question to answer. Grief sort of jumbles up our brain for a while and the answer to that question is elusive. Examples of other ways to help can include things like offering to get them a cup of tea; to walk their dog; help with thank you notes; babysit the kids; pick up the dry cleaning – everyday acts of service and kindness can really help.

Losses come in many different shapes, sizes, and colors, and grieving the loss is never easy. But grieving is a natural response to losing someone or something we love, are deeply attached to, and will miss. Time has a way of helping us blend that loss into our lives and return to our daily routines. Over time, the feelings of grief may be less obvious to others, but missing the loved one is still there. The loss of a loved one changes us, but we go on. With the support of friends and family, we grieve and move forward in spite of the grief. We find our way.