Grief takes many forms. From lost loved ones to life-changing injuries, it can make us feel numbly — even agonizingly — frozen in place. For anyone grieving, one question often lingers: How long will this last?
The answer is complicated. Mental health experts are still uncovering how grief reshapes the body and mind.
Grief doesn’t come in five stages
Denial, anger, bargaining, depression and acceptance — the five stages of grief have been around for over 55 years. There’s a problem, though. Many mental health experts think they’re wrong.
Psychiatrist Elisabeth Kubler-Ross introduced the concept in her 1969 book “On Death and Dying.” The stages, however, were used to specifically describe the experience of patients coming to terms with terminal illness, not general bereavement. The theory’s use to describe grief has been criticized by mental health experts ever since.
Professor Charles A. Corr, Ph.D., a former chairperson of the International Work Group on Death, Dying, and Bereavement, wrote in 2018 that it “can actually do damage when misapplied to individuals or applied too rigidly, and should be set aside as an unreliable guide to both education and practice.”
In 2023, psychologist Deborah Davis, Ph.D., penned her thoughts on the theory as “the harmful myth that refuses to die” when titling her article on the subject for Psychology Today.
Despite its popularity, the five stages may oversimplify an experience that’s deeply personal. Grief doesn’t follow a script, and neither does healing.
The ‘fight or flight’ of grieving
Grief may not play out in five specific stages, but it does have a significant effect on our mind and bodies. Speaking to the American Brain Foundation, neurologist Dr. Lisa Shulman explained how our bodies process grief from an evolutionary perspective.
“Grief is a normal protective process,” Shulman said. “This process is an evolutionary adaptation to promote survival in the face of emotional trauma.”
The doctor explained that traumatic loss is perceived as a threat to our survival, forcing our bodies to activate defense mechanisms. This is when our “fight or flight” response can become active, leading to increased blood pressure, heart rate and a release of hormones. These can lead to further changes in memory, behavior, sleep and immune response.
It can rewire the brain based on the new norms of its stress-based functions.
“When a circuit fires repeatedly, it’s reinforced and becomes a default setting,” Shulman said.
How long does grief last?
So how long does grieving last? It’s different for everyone, and mental health experts are still figuring it out.
In a 2017 study of 771 bereaved that were 55 or older, around 25% of participants still experienced “persistent” grief after six years. Others eventually experienced less or no grief symptoms within that time frame. But what makes grief “persistent” or “prolonged,” as compared to, well, typical?
Four years ago, in the wake of the pandemic, the American Psychiatric Association published a new diagnosis for the bereaved: prolonged grief disorder.
Some mental health experts have since criticized the new diagnosis, calling it a misstep. Speaking to The New York Times in 2022, Arizona State University associate professor of social work and grief expert Joanne Cacciatore, Ph.D., offered her thoughts.
“I completely, utterly disagree that grief is a mental illness,” she said.
“When someone who is a quote-unquote expert tells us we are disordered and we are feeling very vulnerable and feeling overwhelmed, we no longer trust ourselves and our emotions. To me, that is an incredibly dangerous move, and short sighted.”
Living with loss long term isn’t something we overcome. It’s something we learn to carry. And how we choose to lift that profound weight throughout our lives is something experts will be studying for many years to come.
