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Q.

What are the signs, symptoms, and stages of grief?

 

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A.

Perhaps the most well-known model for understanding grief was developed by Elisabeth Kübler-Ross, MD, in her 1969 book titled On Death and Dying. The five stages of the grief cycle that she outlined are:

  • Denial.
  • Anger.
  • Bargaining.
  • Depression.
  • Acceptance.

She described the stage of denial as the bereaved having difficulty believing what has happened, the anger phase as the survivor questioning the fairness of the loss, the bargaining stage as wishing to make a deal with fate to gain more time with the one who was lost, the depression stage as the period when the bereaved person gets in touch with how very sad they are about losing their loved one, and acceptance as feeling some resolution to their grief and more ability to go on with their own life.

Kübler-Ross apparently felt these phases can be applied to any significant personal loss (for example, of a job, relationship, one's own health, anticipating one's own death), as well as the death of a loved one. It also seems that she believed these stages don't all have to occur, can take place in different order, and can reoccur many times as part of an individual's specific grief process.

In addition to the emotional pain already discussed, symptoms of grief can be physical, social, cultural, or religious in nature. Physical symptoms can range from mild sleep or appetite problems to heart attack. Social symptoms of bereavement include isolation from other loved ones and difficulty functioning at home, school, and/or at work.

For children and adolescents, reactions to the death of a parent or other loved one tend to be consistent with their reaction to any severe stress. Such reactions usually reflect the particular developmental stage of the child or adolescent. For example, since infants up to about 2 years of age cannot yet talk, their reaction to the loss of a loved one tends to involve crying and being more irritable. They further show physical symptoms of sleep or appetite problems, changes in activity level, and being more watchful of (vigilant toward) their surroundings.

Since preschoolers from 3 to 5 years of age begin to be able to remember the one who died but have not yet developed the ability to understand the permanence of death, they may believe they somehow magically caused the death and can make the person come back. In addition to showing signs of grief that are similar to infants, they may have more difficulty separating from caregivers.

Early school-aged children, from 6 to 8 years of age, more likely understand that death is permanent compared to younger children, often feel guilt about the death of the loved one, become preoccupied with memories about the departed, and try to master the loss they have suffered by talking about it frequently. 

In keeping with their budding need for independence, young adolescents 12 to 14 years of age may experience mixed feelings about the deceased individual and exhibit a wide range of emotions. They may avoid talking about the loss. Older teens usually experience grief similarly to adults, enduring sadness, anxiety, and anger. They tend to deny their feelings of loss to parents but discuss them in detail with peers. For children, adolescents, and adults, as with any major stress, grief may cause a person to regress emotionally, in that they go back to former, often less mature ways of thinking, behaving, and coping.

Regardless of age, individuals who lose a loved one from suicide are more at risk for becoming preoccupied with the reason for the suicide while wanting to deny or hide the cause of death, wondering if they could have prevented it, feeling blamed for the problems that preceded the suicide, feeling rejected by their loved one, and stigmatized by others.

This answer should not be considered medical advice...down arrowThis answer should not be considered medical advice and should not take the place of a doctor’s visit. Please see the bottom of the page for more information or visit our Terms and Conditions.up arrow

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Archived: March 20, 2014

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Read the Original Article: Grief: Loss of a Loved One