Grief and bereavement are responses to loss due to death. They are also felt when one experiences other losses including loss of loved ones due to divorce or other separation or transition, loss of work, school or other opportunity, loss of self-esteem or self-concept, or loss of physical or mental capabilities.
There is no one right way to grieve. People are unique in how they navigate the grief process. Some prefer to grieve quietly on their own while other individuals benefit from an outpouring of emotion in community with others. One may experience the grief process in linear stages whereas someone else may not have that same experience.
Features of grief and bereavement include preoccupation with, and persistent yearning for, the individual or situation that has been lost; emotional numbness; intense feelings such as sadness, anger, or guilt; difficulty accepting the loss; feeling that part of them has been lost, inability to experience positive emotions and difficulty with social engagement.
Individuals who exhibit signs of complex grief may be supported through early intervention. Research findings show that complicated grief is a condition that differs from grief process norms.
Diagnostic Considerations:
Clinicians treat people who describe their experiences with grief and bereavement. In the last revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) the bereavement exclusion for major depressive disorder was lifted due to little or no evidence of differences between depression due to grief compared to other stressors (APA, 2013). In addition to major depressive disorder as a diagnosis for individuals struggling with grief or bereavement, a condition under further study for possible future recognition by the American Psychiatric Association is persistent complex bereavement disorder.
Grief and bereavement disorders are included in the international Classification of Diseases, 11th Revision (ICD-11; World Health Organization, 2018); there is the recent addition of prolonged grief disorder with passive yearning as a prominent feature.
Treatment:
Treatment for grief and bereavement vary dependent on factors including any co-occurring disorders. Common psychotherapeutic approaches support conscious awareness of feelings, emotion regulation enhancement, coping and calming strategies, communication and other skills that increase social support and relationships, and appropriate responses to physical and psychological cues of the loss that trigger depression, and reengagement in life activities and relationships when there has been withdrawal.
References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Author.
World Health Organization. (2019). International statistical classification of diseases and related health problems (11th ed.). https://icd.who.int/