Symptoms and CourseWhile grief is not the same for every person, there are certain commonalities. During the initial phase, the bereaved (sad or lonely due to a loss or death) person is preoccupied with the deceased, preoccupied with feelings of yearning and longing, and with searching for him or her. While grieving, most people withdraw from the world and turn inward, often reviewing the course of the relationship, including positive and negative thoughts and feelings. People often also review the meaning the relationship had in their lives. Grief entails a host of painful emotions that can sometimes be very strong and persistent. Strong feelings of sadness and loneliness almost always occur following the death of a close friend or family member. Fear and anxiety are also common. Difficult feelings of resentment, anger, and guilt can occur. Experiencing any or all of these emotions following the loss of a friend or family member is perfectly normal.
As the transition to life without a friend or family member progresses, the intensity of grief subsides. The bereaved person accepts the death and begins to take some comfort in positive memories, establishing a permanent sense of connection to the person who died. It becomes possible to reengage in activities and relationships while still having memories of and maintaining a sense of closeness to the deceased.
The period over which this adjustment occurs is variable, depending on the circumstances of the death, the characteristics of the bereaved, and the nature of the relationship. In some circumstances, intense grief persists for many months or even years. Intrusive images and disturbing ideas inhibit the healing process, and there is a sense that the death is unacceptable and unfair. For some who have difficulty coping with the death, grief sometimes seems to be all that is left of the relationship. Also, a decrease in the intensity of the grief may feel like a betrayal of the person who died. Some people also have persistent feelings of guilt.
When a death is sudden, violent, and untimely, the bereaved will most likely also face other difficulties. The condition in which unmanageably intense and/or persistent grief symptoms occur is called Traumatic Grief. Work is underway to establish diagnostic criteria and to develop treatments for this condition. Traumatic Grief may predispose to other psychiatric, medical, and behavioral problems that can complicate bereavement. These are generally treatable conditions and need to be recognized by professionals and by the bereaved individuals themselves.