Locations:
Search IconSearch

The 5 Stages of Grief After a Loss

What to expect after the unthinkable happens

man and woman grieving sad

There’s no way around it: Grief is never easy. And though we tend to associate grief with death, other life events can trigger grief, too — from the end of a relationship to the loss of a job to financial hardships.

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

“Grief is a natural response to any kind of loss,” says clinical psychologist Regina Josell, PsyD. “People experience it in different ways, but typically, it includes a variety of intense emotions, like sadness, anger, irritability and guilt.”

Dr. Josell explains the five stages of grief, including what they are, how they manifest and when to seek support from a therapist who can help you cope.

What are the five stages of grief?

Swiss-American psychiatrist and researcher Elisabeth Kübler-Ross first outlined five stages of grief — sometimes called the Kübler-Ross model — in her 1969 book On Death and Dying.

“Dr. Kübler-Ross spent her career studying the dying process and the impact of death on survivors,” Dr. Josell says. “She outlined a five-stage protocol of dying to help us understand the process.” This protocol was later applied to those impacted by someone else’s death.

Keep in mind that these stages are meant to be descriptive and don’t necessarily apply to everyone or happen in the order presented.The five stages of grief can be summarized as:

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

1. Denial

You’re let go from your job, but the next day, you still get up early and start to get ready to head into the office, just in case your boss changes their mind. Your grandmother recently passed away, but you still feel like she might pick up the phone if you call to say hello.

“Denial refers to the difficulty comprehending the reality of a loss,” Dr. Josell explains. “It can take a while to wrap your head around the fact that you’ve experienced a significant loss — that things are different, and they’re not going back to the way they were.”

Symptoms of denial during the grieving process might include:

  • Believing that there’s been a mistake and your loved one isn’t actually gone.
  • Refusing to discuss your loss or acting like everything is OK when you do.
  • Busying yourself with work or other things so you don’t have to confront your feelings of loss.
  • Pretending like your loved one has gone on a vacation or will be back soon.
  • Continuing to speak about your lost loved one in the present tense.

2. Anger

“Anger is a perfectly natural response, and in the case of loss, it can be directed at a variety of sources,” Dr. Josell says. It can also manifest as blame — the feeling that someone else is at fault for your loss.

You might feel angry with yourself for some perceived role in the loss, or even at your loved one for dying. Maybe you’re mad at doctors or first responders for “letting” your loved one die, or at God for letting something so unfair and tragic happen.

Advertisement

As with every other stage of grief, these emotions can be experienced in reaction to non-death losses, too. Say you lost your job and feel angry at the co-worker who took on your workload. Or you couldn’t afford your mortgage and had to sell your family home, leaving you feeling angry with politicians about the state of the economy.

Your anger could also be less targeted, less sensible. “Sometimes, you’re just angry at innocent bystanders, like the guy in the checkout line at the grocery store who looked at you funny,” Dr. Josell says. “It’s not always rational.”

3. Bargaining

The bargaining process sometimes happens before your loss has fully occurred, like when you think, “If I recover from cancer, I promise I’ll start going to go to church every week,” or “If my husband pulls through after his heart attack, I’ll never argue with him again.”

But it can take place afterward, too, in the form of “if only” thinking:

  • “If only we’d gone to a different doctor, maybe she could’ve been treated in time.”
  • “If only we hadn’t gone on vacation, he wouldn’t have contracted this disease.”
  • “If only I’d gotten my dog an electric collar, she wouldn’t have run out into the street.”

This may not look like bargaining, but Dr. Josell says the thinking is similar. “We engage in a type of mental gymnastics to try to undo something that we can’t undo,” she explains.

4. Depression

It’s natural to be sad when someone you love dies or when you’ve experienced another major loss. Symptoms of the depression stage of grief can include:

  • Loss of hope about the future.
  • Feeling directionless, lost or confused about your life.
  • Difficulty concentrating.
  • Difficulty making decisions.

Grief-related depression can cause physical symptoms, too, like aches and pains and changes in sleep patterns. Studies show that it can even cause increased inflammation in your body, which can worsen existing health issues and lead to new ones.

The depression stage of grieving isn’t the same as major depressive disorder (also known as major depression or clinical depression), a mental health condition that combines a number of emotional, cognitive and physical symptoms.

“However, grief can turn into clinical depression, so it’s really important that you address your grief while you’re experiencing it,” Dr. Josell advises.

5. Acceptance

The sadness and sense of loss of grief may never fully fade. But the acceptance stage represents learning to live with the loss — a newfound ability to acknowledge the reality of your loss and to allow sorrow and joy to live alongside one another.

In this stage of grief, you’re no longer immobilized by your sadness. For example, you can hear a song on the radio that reminds you of your loved one without bursting into tears.

“Acceptance is a sense of understanding that there is a finality to what has happened,” Dr. Josell says. “You can hold onto your sadness while still experiencing good memories of the past and maintaining hope for the future.”

How long does grief last?

There’s no set timeline for grief, and anyone who tells you to “move on” or “get over it” is underestimating and misunderstanding the weight of loss.

Advertisement

That said, the length of your grieving process depends on what kind of grief you’re experiencing.

  • Uncomplicated grief: Sometimes referred to as “normal grief,” most of the symptoms — including the five stages — happen within the first two years of loss.
  • Complicated grief: This type of profound, intense grief extends for a prolonged period of time and can be debilitating.

In some sense, of course, all grief is complicated, stirring a tide of emotions that feel anything but straightforward. And many of the signs and symptoms of complicated grief are the same as those of uncomplicated grief. In uncomplicated grief, though, the intensity of those reactions softens with time. Complicated grief, on the other hand, is more intense, persistent and prolonged, significantly interfering with a return to “normal” life.

When to ask for help

If you’re experiencing intense emotional distress or struggling to return to your regular routine after your loss, consider seeking the help of a therapist. Talking about loss, sharing your distress and having your grief witnessed can significantly facilitate the healing process.

The bottom line, Dr. Josell says, is simple: “If you feel you’re suffering, go talk to somebody.”

Advertisement

Learn more about our editorial process.

Related Articles

Angusihed person sitting by hospital bedside of loved one
April 9, 2024/Mental Health
Anticipatory Grief: Symptoms and How To Cope

This coping mechanism can help you prepare and think through an impending loss

Closeup of person sick with grief staring out rainy window.
January 25, 2023/Mental Health
What To Do When You’re (Literally) Sick With Grief

Like other kinds of stress, grieving a loss can impact you physically and emotionally

sad and depressed woman sitting on bed
April 6, 2020/Mental Health
It’s OK to Feel Grief – and Whatever Else You’re Feeling Right Now

Tips for navigating the emotions of a public health crisis

Woman sad after breakup in relationship
January 22, 2019/Mental Health
Grieving After a Break-Up? 6 Strategies to Help You Heal

A psychologist’s advice: How to cope + move on

Person on phone with boss, pretending to be sick, with germs, stomach, temperature floating around
June 14, 2024/Mental Health
Malingering Explained

Whether it’s playing hooky or faking cancer, malingering behavior is always motivated by personal gain

Older person smiling, taking in the outdoors
June 13, 2024/Mental Health
Put Intention Behind Your Walking Meditation

While walking, be mindful of your body, your mind, your place in the world and all five of your senses as you pave a path forward, one step at a time

Person checking watch at a rail station
June 5, 2024/Mental Health
How To Be Patient: 6 Strategies To Help You Keep Your Cool

In a world where instant gratification is the norm, you can train yourself to be more comfortable waiting patiently

People volunteering at a food drive
June 3, 2024/Mental Health
How To Make — and Nourish — New Friendships When You’re an Adult

Look to activities you enjoy — or try a new hobby — to help foster meeting new people

Trending Topics

Female and friend jogging outside
How To Increase Your Metabolism for Weight Loss

Focus on your body’s metabolic set point by eating healthy foods, making exercise a part of your routine and reducing stress

stovetop with stainless steel cookware and glassware
5 Ways Forever Chemicals (PFAS) May Affect Your Health

PFAS chemicals may make life easier — but they aren’t always so easy on the human body

jar of rice water and brush, with rice scattered around table
Could Rice Water Be the Secret To Healthier Hair?

While there’s little risk in trying this hair care treatment, there isn’t much science to back up the claims

Ad