Grief is a universal human experience, yet it remains one of the most misunderstood aspects of mental health. The concept of grief stages — popularized by Elisabeth Kübler-Ross in her 1969 book On Death and Dying — provides a framework for understanding the emotional journey after loss, but it is not a rigid roadmap. Understanding how grief works can help you recognize what you are experiencing and know when professional support might be needed.
The Kübler-Ross model identifies five stages: denial (a temporary defense mechanism that buffers the immediate shock), anger (as the masking effects of denial fade, pain re-emerges as frustration directed at others, oneself, or the situation), bargaining (dwelling on "what if" and "if only" statements as the mind tries to negotiate its way out of pain), depression (deep sadness as the full weight of the loss settles in — this is not clinical depression but profound grief-related sadness), and acceptance (not "being okay" with the loss, but acknowledging the reality and learning to live with it). Kübler-Ross herself later emphasized that these stages are not linear, not experienced by everyone, and not meant to tuck messy emotions into neat packages.
Modern grief research has moved beyond the stage model. David Kessler, who co-authored with Kübler-Ross, added a sixth stage: finding meaning. The dual process model (Stroebe and Schut) describes grieving as oscillating between loss-oriented coping (confronting the pain) and restoration-oriented coping (attending to life changes and new roles). The continuing bonds model recognizes that maintaining a connection to the deceased through memories, rituals, or internal dialogue is healthy and normal — not a failure to "move on." These perspectives acknowledge that grief is more fluid and individual than any single model can capture.
Most people navigate grief without professional intervention, though the process can take months or years and varies widely. However, approximately 7-10% of bereaved individuals develop prolonged grief disorder (also called complicated grief), recognized as a clinical diagnosis in the DSM-5-TR. Warning signs include intense longing that does not diminish after 12 months, difficulty reengaging with life, emotional numbness or detachment, persistent bitterness or anger about the loss, avoidance of reminders, and feeling that life is meaningless without the deceased. Complicated grief differs from major depression in that the distress is specifically centered on the loss rather than being a generalized mood state, though both conditions can co-occur.
You should consider seeking help from a psychiatrist or therapist if grief is interfering with your ability to function at work or in relationships for an extended period, you are using alcohol or substances to cope, you are having thoughts of self-harm or feeling you cannot go on, your anxiety or sleep disruption has become severe, or you notice symptoms that suggest a co-occurring condition like PTSD or depression. Treatment for complicated grief may include grief-focused CBT, medication for co-occurring depression or anxiety, and supportive therapy. A psychiatric evaluation can determine whether what you are experiencing falls within normal grief or has crossed into territory that warrants clinical intervention.
Mood cycling can complicate the grief process — if you notice periods of unusual energy alongside depression, bipolar 2 screening may be warranted.
Grief can intensify codependent tendencies as loss disrupts the attachment dynamics that codependent relationships are built around.
This content is for informational purposes only and should not replace professional medical advice, diagnosis, or treatment. If you are struggling with grief, contact Elevate Psychiatry for compassionate support. We serve adults 18 and older through our Miami offices in Coconut Grove and Doral, as well as virtually throughout Florida.
