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Grief is a natural, emotional response to a major loss, such as the death of a loved one. It is often characterized by extreme mental anguish. Other losses, such as divorce, miscarriage or the loss of a home or job, are also sources of grief. Grief is an important and necessary reaction that eventually leads to emotional healing. However, it can be a prolonged and intensely painful experience, and can result in significant emotional distress. Social function and productivity at work or school may be impaired, although most people who are grieving continue to work and socialize.

People grieve for different periods of time. The grief reaction may last for months or years. Intense symptoms of emotional distress generally last between six and 12 months, with less intense grieving continuing for one to three years.

The grieving process may occur in several stages.  Early stages may involve numbness or denial of the loss, followed by anger. Some people may then experience deep yearning followed by despair. The final stages include acceptance of the loss.

The stages of grief are not linear. Some people go through the stages quickly or even skip some stages entirely. Other people seem to linger or return to certain stages after a period of feeling better. For example, a person who has been widowed may experience anger at the loss of the spouse soon after the spouse’s death. The anger may diminish but return months later, when the surviving spouse is confronted with a chore formerly performed by the deceased person (e.g., handling finances).

People grieve differently at different ages. Children may not understand the concept of death and may take more time to grieve. Preschool-aged children typically view death as temporary and may need to have it explained repeatedly. Children between the ages of 5 and 9 years generally begin to understand death better. They comprehend that the dead person is not returning and may ask questions or invent games about dying. Adolescents understand death as adults do, but may grieve differently. They often seek help within their own peer groups and may engage in more impulsive or risk-taking behaviors, such as drug or alcohol use or impulsive sexual behavior.

Different types of grief include:

• Normal grief. Also called uncomplicated grief. The normal, healthy response to a major loss.
  
  
• Anticipatory grief. Grief that begins before (in anticipation of) the loss, such as the initiation of divorce proceedings or when a loved one is diagnosed with a terminal illness.
  
  
• Anniversary reactions. Grief responses that occur following reminders of the loss, such as on anniversaries, holidays or other special days throughout the year. These can last for days or weeks, and are not necessarily a setback in the grieving process.
  
  
• Complicated grief. Also called traumatic grief. Occurs when grief becomes chronic, disabling and more intense. This is often seen as a progression of grief into major depression, with some features of post-traumatic stress disorder, such as nightmares and flashbacks. Complicated grief is not recognized by the American Psychiatric Association. According to the National Institute of Mental Health (NIMH), about 10 percent to 20 percent of people grieving the loss of a loved one experience complicated grief.