How long does grief last? Coping with the loss of someone you love

Someone you loved is gone, and the world carries on as if nothing has happened. You may find yourself reaching for the phone to call them, or crying over a smell of their cooking. If you are grieving, you may wonder whether what you feel is normal, and when it will end. This article is for you, and for anyone who is trying to understand a grieving person.

What grief is

Grief is the natural reaction to losing someone or something important to you. The NHS notes that it follows the death of a loved one, but also other losses, such as the end of a relationship, losing a job or home, moving to a new place, or someone close becoming seriously ill. Grief on its own is a normal human response, not a sign that something is wrong with you.

What grief can feel like

The NHS describes a wide range of feelings. They include:

• Shock and numbness, like being in a daze
• Overwhelming sadness and a lot of crying
• Tiredness and exhaustion
• Anger, at the person who died, at others, or at what caused the loss
• Guilt about things said or left unsaid, or not being able to prevent the death
• Powerful feelings that appear unexpectedly

A deep wish to have the person back is very common. Grief can also be tiring, and the NHS says regular exercise may help you sleep better and regular meals help keep your energy steady.

What about the five stages?

You may have heard that grief has five stages: denial, anger, bargaining, depression and acceptance. This idea is widely known, but it is not a fixed path that everyone follows. The NHS says that you may not experience all of the stages, they may not happen in a particular order, and you may not move smoothly between them.

Researchers have tested the idea. In a study of 233 bereaved adults in Connecticut, published in JAMA in 2007, people were followed from 1 to 24 months after a death from natural causes. Disbelief was not the first or strongest feeling. Yearning was the strongest painful feeling throughout, acceptance was reported from early on, and acceptance rose over time. The average peaks of the five feelings did come in the order the stage idea predicts (disbelief, yearning, anger, depression, acceptance), and the authors read this as partial support for it. But these were group averages, the feelings overlapped rather than replacing one another, and the study cannot tell us how any one person will grieve.

Another line of research looks at trajectories. A 2004 review by George Bonanno in American Psychologist argued that resilience after loss, meaning only mild and short-lived disruption, is more common than is often believed. In a 2020 study of 282 recently widowed people in Depression and Anxiety, researchers found different paths over about two years, including resilient, moderately improving, and prolonged symptoms. So the best summary is that people take different roads, not one fixed ladder.

Why grief comes in waves

Grief rarely goes in a straight line. Many people describe it as arriving in waves, with calmer stretches in between. The NHS notes that powerful feelings may appear unexpectedly. A song, a festival or an anniversary may bring a wave back. This does not mean you are going backwards.

The dual process model, described by Margaret Stroebe and Henk Schut in 1999, explains part of this. Coping involves two kinds of tasks: facing the loss itself (crying, remembering, missing them) and dealing with the changes it brings (new roles, paperwork, routines, a life without them). The model proposes that coping involves moving back and forth between these, and taking breaks from both. Laughing at a family meal or going to work for a day is not disrespect. It is part of how people cope.

How long does grief last?

There is no set time. The NHS says that for most people grief becomes less intense over time, though it may not ease smoothly. For some people grief lasts many months or years. Prolonged grief disorder is more likely to be prolonged after a sudden, unexpected or traumatic death (NHS).

When grief may need professional help

Some people find that their grief stays as intense and disabling as ever, and does not ease. A professional can assess whether this is prolonged grief disorder. It is a recognised condition in both major diagnostic systems, but only a qualified clinician can assess it, and it is not something to decide on your own.

The American Psychiatric Association states that prolonged grief disorder is included in the DSM-5-TR (released in March 2022). The loss must have happened at least a year ago for adults (at least 6 months ago for children and adolescents). The person may have intense longing for the one who died or be preoccupied with thoughts of them, and has at least 3 of 8 symptoms nearly every day for at least the last month. The symptoms include feeling that part of oneself has died, disbelief about the death, avoiding reminders, intense emotional pain, difficulty re-engaging with life, numbness, feeling that life is meaningless without the person, and intense loneliness. The grief must also last longer than social, cultural or religious norms would expect. The WHO's ICD-11 uses a shorter minimum. In published descriptions of the ICD-11 criteria, the grief must have lasted an abnormally long time, more than 6 months at a minimum, clearly beyond what is expected in the person's culture and context. So the two manuals differ: DSM-5-TR asks for at least 12 months in adults, and ICD-11 for more than 6 months.

The APA estimates that about 4% to 15% of bereaved adults experience it. Treatments exist. A 2024 meta-analysis of 22 trials with 2,602 bereaved adults (Journal of Consulting and Clinical Psychology) found that grief-focused cognitive behavioural therapies reduced prolonged grief symptoms by a medium amount after treatment. The APA says no medicines currently treat grief symptoms specifically. A psychiatrist can also check for depression, which can occur alongside grief and has its own treatments.

What helps

• Talk to someone: a friend, family member, counsellor or doctor. The NHS also suggests peer support, where people help each other using their own experience.
• Let feelings come in their own time. You do not have to be 'strong' for everyone.
• Take breaks. Do something ordinary, such as a walk, a favourite show or a cup of chai, without guilt.
• Set small goals instead of trying to do everything at once (NHS).
• Keep to regular meals and some exercise, which the NHS says can lift mood and may improve sleep.
• Go easy on alcohol, tobacco and other substances. The NHS says they can make mental health worse.
• Many people find it helps to mark the loss in ways that matter to them, such as a ritual, a prayer, a photo or a letter. Families and cultures have their own ways.

Myths and the Indian context

• Myth: 'You should be over it by now.' There is no deadline. The NHS says that for some people grief lasts many months or years.
• Myth: 'Crying means you are weak, and not crying means you did not care.' People grieve differently.
• Myth: 'Talking about the person keeps you stuck.' The NHS suggests talking about your feelings with a friend, family member, healthcare professional or counsellor, or joining peer support.
• Myth: 'Everyone goes through the same five stages.' See above: there is no universal sequence.

Many families have rituals to mark a death. A study on Hindu death rituals in India notes that they depend on the deceased's caste, community, class, gender and age, and that when families could not hold them during the COVID-19 lockdown, mourners lost a source of consolation (Omega, 2024). Rituals, prayers and gatherings can be a real support. Grief can also be harder when you cannot attend them, for example when you live in another city or country, when the death was sudden, or when there was no goodbye.

In some families there is pressure to 'be strong' or 'move on' quickly, or to hide grief from elders or children. It can help to find at least one person with whom you can be honest. If you are supporting someone who is grieving, you can read how to support a friend.