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Understanding the 5 Stages of Grief: A Comprehensive Guide

stages of grief

Clinically Reviewed by: Charee Marquez, LMFT

The 5 Stages of Grief

Grief is a natural reaction to loss, a journey filled with painful feelings and complex emotions. Most people experience grief differently, whether due to the sudden death of a loved one, the prolonged struggle with a chronic illness, or the terminal illness of a family member. Understanding grief is essential to navigating this challenging period, and the widely recognized five stages of grief model, developed by Elisabeth Kübler-Ross, offers a framework to describe grief and the diverse experiences of those in mourning. These stages—denial, anger, bargaining, depression, and acceptance—help individuals comprehend their emotions and behaviors as they cope with loss. In this blog, we will explore the grief journey, highlighting the unique challenges faced during end-of-life decisions, the support needed from family members and health care professionals, and the importance of acknowledging and addressing each stage to stay healthy during such a difficult time.

What are the 5 Stages of Grief?

The stages of grief, often referred to as the Kübler-Ross model, outline the process people typically go through when experiencing loss or significant life changes. These stages are not necessarily experienced in a linear order, and individuals may go back and forth between them. The five stages of grief are:

  1. Denial: In this stage, individuals may have difficulty accepting the reality of the loss. They might think, “This isn’t happening” or “This can’t be true.” Denial helps people to initially survive the loss.

  2. Anger: As the masking effects of denial begin to wear off, reality and its pain re-emerge. Individuals may feel frustrated and helpless, and these emotions can manifest as anger. They might direct their anger towards other people, themselves, or the situation.

  3. Bargaining: During this stage, individuals may try to regain control or make sense of the loss by making bargains or promises. They might think, “If only I had done this differently” or “I will change if only this can be different.”

  4. Depression: This stage involves deep depression and sadness as the individual begins to understand the extent of the loss. They might feel overwhelmed, helpless, and hopeless. This is a natural and necessary part of the grieving process.

  5. Acceptance: In the final stage, individuals come to terms with the loss. Acceptance does not mean that the individual is okay with the loss, but they begin to find a way to move forward. They might start to find peace and ways to adapt to their new reality.

It’s important to note that these stages are just a framework and that everyone’s grief process is unique. People may experience these stages in different orders, revisit stages, or experience different emotions altogether.


Who was Elisabeth Kübler-Ross?

Elisabeth Kübler-Ross (1926-2004) was a Swiss-American psychiatrist and a pioneer in the field of near-death studies and hospice care. She is best known for her groundbreaking work on the psychological processes of dying and grief, particularly through her seminal book “On Death and Dying,” published in 1969. In this book, she introduced the Kübler-Ross model, which outlines the five stages of grief (denial, anger, bargaining, depression, and acceptance).

Key points about her life and work:

  1. Early Life and Education: Born in Switzerland, Kübler-Ross studied medicine at the University of Zürich. She was deeply influenced by her experiences as a medical student during World War II, where she witnessed the aftermath of the Holocaust.

  2. Career: After moving to the United States in 1958, Kübler-Ross completed her psychiatric residency in New York. Her work in hospitals led her to explore the experiences of terminally ill patients, culminating in her development of the five stages of grief.

  3. Contributions to Hospice and Palliative Care: Kübler-Ross’s advocacy for the humane treatment of terminally ill patients was instrumental in the development of the hospice movement in the United States. She emphasized the importance of providing compassionate care and emotional support to those facing the end of life.

  4. Books and Legacy: In addition to “On Death and Dying,” Kübler-Ross authored more than 20 books on death, dying, and the afterlife. Her work has had a profound impact on how society understands and approaches death and bereavement, and she remains a highly influential figure in psychology, psychiatry, and thanatology.

  5. Awards and Recognition: Over her career, she received numerous awards and honors for her contributions to medicine and psychiatry, including the prestigious American Humanist Association’s Humanist of the Year Award in 1978.

Elisabeth Kübler-Ross’s work continues to be a cornerstone in the fields of grief counseling, palliative care, and the study of death and dying.


How it Feels to Go Through the Grieving Process

Going through the five stages of grief can be a deeply personal and often overwhelming experience. Each stage can bring a unique set of emotions and challenges. Here’s a more detailed look at how it might feel to go through each stage:


  • Feelings: Numbness, shock, and disbelief.

  • Thoughts: “This can’t be happening,” “There must be some mistake,” or “I don’t believe it.”

  • Behaviors: Avoiding talking about the loss, carrying on as if nothing has changed, and sometimes even feeling detached from reality.


  • Feelings: Frustration, rage, irritation, and helplessness.

  • Thoughts: “Why is this happening to me?” “It’s not fair,” or “Who is to blame?”

  • Behaviors: Lashing out at loved ones, becoming easily agitated, and feeling an overwhelming sense of injustice.


  • Feelings: Desperation, guilt, and regret.

  • Thoughts: “If only I had done this differently,” “Please let this be a bad dream,” or “I’ll do anything to change this.”

  • Behaviors: Making promises or trying to negotiate with a higher power, replaying events in the mind, and dwelling on “what if” scenarios.


  • Feelings: Deep sadness, emptiness, hopelessness, and isolation.

  • Thoughts: “What’s the point?” “I can’t go on,” or “I’ll never feel okay again.”

  • Behaviors: Withdrawing from social activities, experiencing changes in sleep and appetite, and struggling with daily tasks.


  • Feelings: Peacefulness, a sense of resolution, and emotional stability.

  • Thoughts: “This is my new reality,” “I can live with this,” or “I’m finding a way to move forward.”

  • Behaviors: Re-engaging with life, finding new routines, and sometimes even experiencing moments of joy and contentment again.

It’s important to note that these descriptions are generalized and that everyone’s experience with grief is unique. People may move through these stages in different orders, revisit stages multiple times, or experience other emotions that aren’t listed here. Grief is a highly individual process, and there is no right or wrong way to go through it. Everyone experiences grief differently, and there is no exact time frame to adhere to. Seeking support from friends, family, or a professional counselor can be very helpful during this time.


Other Stages of the Grief Model

Beyond the five stages of grief proposed by Elisabeth Kübler-Ross, other models and perspectives have been developed to capture the complexity and individuality of the grieving process. Some alternative or additional stages and models include:

Seven Stages of Grief

This model expands on Kübler-Ross’s five stages, adding two more to better encapsulate the range of emotions experienced during grief:

  1. Shock and Disbelief: Immediate reaction to the loss, characterized by numbness and a sense of unreality.

  2. Denial: Inability to accept the loss, often manifesting as a refusal to believe what has happened.

  3. Anger: Frustration and resentment directed towards oneself, others, or the situation.

  4. Bargaining: Attempts to negotiate or make deals to reverse or mitigate the loss.

  5. Guilt: Feelings of regret and self-blame for perceived shortcomings or actions taken/not taken.

  6. Depression: Deep sadness, hopelessness, and withdrawal from life activities.

  7. Acceptance and Hope: Coming to terms with the loss and beginning to move forward, finding ways to adapt.


Four Tasks of Mourning (William Worden)

Worden proposed a task-based approach to grieving, suggesting that individuals must work through specific tasks to adapt to a loss:

  1. To Accept the Reality of the Loss: Recognizing and acknowledging the loss as real and irreversible.

  2. To Process the Pain of Grief: Allowing oneself to experience and express the emotional pain associated with the loss.

  3. To Adjust to a World Without the Deceased: Adapting to the changes in daily life and identity that the loss brings.

  4. To Find an Enduring Connection with the Deceased While Embarking on a New Life: Creating a lasting bond or memory of the deceased while continuing to live a meaningful life.


Dual Process Model (Margaret Stroebe and Henk Schut)

This model emphasizes the dynamic nature of grief, proposing that individuals oscillate between two types of coping:

  1. Loss-Oriented Activities: Focusing on the grief and pain of the loss, such as crying, reminiscing, and feeling the emotional impact.

  2. Restoration-Oriented Activities: Engaging in activities that help rebuild and re-engage with life, such as learning new skills, forming new relationships, and finding new roles.


Continuing Bonds (Dennis Klass, Phyllis Silverman, Steven Nickman)

This perspective suggests that maintaining an ongoing relationship with the deceased can be a healthy and integral part of the grieving process:

  • Maintaining Connection: Finding ways to keep the memory and influence of the deceased present in one’s life, such as through rituals, memories, and personal growth influenced by the deceased.


Six R’s of Mourning (Therese Rando)

Rando outlines six processes that individuals go through as they mourn:

  1. Recognize the Loss: Acknowledging the death and understanding the full impact of the loss.

  2. React to the Separation: Experiencing the emotional response to the loss, including feelings of pain, sadness, and anger.

  3. Recollect and Re-experience the Deceased: Remembering the deceased and reflecting on shared experiences.

  4. Relinquish Old Attachments: Letting go of previous roles, routines, and expectations tied to the deceased.

  5. Readjust to a New World: Adapting to life without the deceased, developing new relationships, and forming a new identity.

  6. Reinvest in the Future: Finding new interests and goals, and engaging in life with renewed purpose.

These models offer different perspectives and tools for understanding and navigating grief, recognizing that it is a multifaceted and deeply personal experience.


Common Grief Misconceptions

Grief is a complex and deeply personal experience, and many misconceptions about it can lead to misunderstandings and unrealistic expectations. Here are some common misconceptions about grief:

  1. Grief Follows a Linear Path:

    • Misconception: People often believe that grief follows a predictable, linear progression through stages.

    • Reality: Grief is unique to each individual and can be non-linear. People may move back and forth between different emotions and stages.

  2. You Should Be Over It by Now:

    • Misconception: There is a specific timeline for how long grief should last.

    • Reality: Grief has no set timeline. It can take months, years, or even a lifetime, and the intensity can vary over time.

  3. Staying Busy Will Make It Go Away:

    • Misconception: Keeping oneself constantly busy will help avoid or expedite the grieving process.

    • Reality: While staying occupied can provide temporary distraction, avoiding the emotions associated with grief can delay healing.

  4. Talking About the Deceased Makes It Worse:

    • Misconception: Bringing up the deceased will only cause more pain.

    • Reality: Talking about the deceased can be a crucial part of the healing process, helping to keep their memory alive and providing comfort.

  5. Grief Only Involves Sadness:

    • Misconception: Grief is solely about feeling sad and crying.

    • Reality: Grief can involve a wide range of emotions, including anger, guilt, relief, anxiety, and even numbness.

  6. You Must Be Strong for Others:

    • Misconception: People grieving should hide their emotions to support others.

    • Reality: It’s important for everyone to express their emotions and seek support. Being open about grief can help others feel more comfortable sharing their feelings too.

  7. Grief Is the Same for Everyone:

    • Misconception: Everyone grieves in the same way.

    • Reality: Grief is highly individual. Cultural, personal, and situational factors influence how someone experiences and expresses grief.

  8. Moving On Means Forgetting:

    • Misconception: Finding happiness again means forgetting the deceased.

    • Reality: Moving forward does not mean forgetting the loved one. People can find ways to honor and remember the deceased while continuing to live their lives.

  9. Children Don’t Grieve Like Adults:

    • Misconception: Children either don’t understand or are less affected by loss.

    • Reality: Children do grieve, but they may express it differently than adults. They need support and understanding to process their emotions.

  10. Grief Is a Sign of Weakness:

    • Misconception: Showing grief indicates weakness or a lack of resilience.

    • Reality: Grief is a natural response to loss and does not reflect one’s strength or character. Allowing oneself to grieve is a healthy part of the healing process.

  11. You Can Get Over Grief Completely:

    • Misconception: Eventually, you will completely get over the loss.

    • Reality: While the intensity of grief can lessen over time, the loss of a loved one can leave a lasting impact. People often learn to live with the loss rather than getting over it completely.


Side Effects and Risks

Short-Term Side Effects and Risks of Grief

  1. Emotional Distress: Intense sadness, anger, anxiety, and mood swings.

  2. Physical Symptoms: Fatigue, headaches, stomach issues, and changes in appetite or sleep.

  3. Cognitive Impairment: Difficulty concentrating, making decisions, and memory problems.

  4. Social Withdrawal: Isolation from friends and family, reduced interest in activities.

  5. Behavioral Changes: Increased risk of substance abuse, impulsive behaviors, or neglect of personal responsibilities.

Long-Term Side Effects and Risks of Prolonged Grief Disorder

  1. Prolonged Grief Disorder: Persistent and intense grief that interferes with daily life for an extended period.

  2. Mental Health Issues: Increased risk of depression, anxiety disorders, and post-traumatic stress disorder (PTSD).

  3. Chronic Health Problems: Potential exacerbation of existing conditions or development of new issues, such as heart disease or weakened immune system.

  4. Relationship Strain: Ongoing difficulties in maintaining relationships with friends, family, and partners.

  5. Impaired Functioning: Long-term difficulties in work or school performance, and overall daily functioning.


Signs and Symptoms that You Need Help

Recognizing when you need help during the grieving process is important. Here are some signs and symptoms that indicate you may benefit from professional support:

  1. Persistent Intense Sadness: Constant deep sadness that doesn’t improve over time.

  2. Withdrawal: Isolating yourself from friends, family, and social activities.

  3. Trouble Functioning: Difficulty performing daily tasks at home, work, or school.

  4. Physical Symptoms: Ongoing physical issues like fatigue, headaches, or stomach problems.

  5. Substance Abuse: Increased use of alcohol, drugs, or other substances.

  6. Prolonged Denial: Refusing to accept the reality of the loss for an extended period.

  7. Severe Anger or Irritability: Persistent anger or irritability that affects relationships.

  8. Hopelessness: Feeling that life is meaningless or hopeless.

  9. Guilt or Self-Blame: Excessive feelings of guilt or blaming yourself for the loss.

  10. Thoughts of Self-Harm: Thoughts of hurting yourself or suicide.


What to Do if a Loved One is Grieving

Supporting a grieving loved one involves offering compassion, patience, and understanding. Here are some ways to help:

  1. Listen: Be there to listen without judgment or giving advice. Let them express their feelings.

  2. Offer Presence: Spend time with them, even if it means sitting in silence. Your presence can be comforting.

  3. Acknowledge Their Pain: Validate their feelings and acknowledge their loss. Avoid clichés like “They’re in a better place.”

  4. Provide Practical Help: Offer assistance with daily tasks like cooking, cleaning, or running errands.

  5. Be Patient: Grief has no timeline. Allow them to grieve at their own pace without pushing them to move on.

  6. Stay in Touch: Regularly check in with them, even after the initial shock has passed. Grief can be a long process.

  7. Encourage Professional Help: Gently suggest seeking support from a therapist or grief counselor if needed.

  8. Respect Their Needs: Sometimes they might need space or solitude. Respect their wishes and let them know you’re there when they’re ready.

Your consistent support and understanding can make a significant difference in their healing journey.


Can physical symptoms occur during the five stages of grief?

  • Yes, grief can manifest in physical symptoms such as headaches, fatigue, nausea, and changes in appetite or sleep patterns.

Do the five stages of grief apply to non-death losses?

  • Yes, the stages can apply to various types of loss, including divorce, job loss, and other significant life changes.

Is it possible to experience multiple stages of grief simultaneously?

  • Yes, individuals can experience overlapping emotions and may feel several stages at the same time.

How does culture influence the experience of the five stages of grief?

  • Cultural background can significantly affect how people experience and express grief, with different cultures having various rituals, customs, and beliefs about mourning.

Do children go through the five stages of grief the same way adults do?

  • Children experience grief differently, often in a more sporadic and less predictable manner. Their understanding and expression of grief can vary significantly depending on their age and developmental stage.

Treatment Options for Grief

Several treatment options can help individuals navigate the grieving process. These treatments provide emotional support, coping strategies, and avenues for expressing grief. Here are some common treatment options:

  1. Therapy:

    • Grief Counseling: Specialized counseling focused on helping individuals process their grief.

    • Cognitive Behavioral Therapy (CBT): Helps change negative thought patterns and behaviors associated with grief.

    • Trauma-Focused Therapy: For those experiencing complicated or traumatic grief.

  2. Support Groups:

    • Grief Support Groups: Groups where individuals share their experiences and provide mutual support.

    • Online Support Groups: Virtual groups that offer support and connection with others who are grieving.

  3. Medication:

    • Antidepressants or Anti-Anxiety Medications: Prescribed in some cases to help manage severe depression or anxiety related to grief.

  4. Complementary Therapies:

    • Art Therapy: Using creative expression to process emotions.

    • Music Therapy: Utilizing music to explore and express feelings.

    • Mindfulness and Meditation: Techniques to help individuals stay present and manage overwhelming emotions.

  5. Self-Care Practices:

    • Physical Activity: Regular exercise can improve mood and overall well-being.

    • Healthy Eating: Maintaining a balanced diet to support physical and emotional health.

    • Adequate Sleep: Ensuring sufficient rest to help manage stress and fatigue.

  6. Journaling:

    • Writing: Expressing thoughts and feelings through writing can provide a therapeutic outlet.

  7. Faith and Spirituality:

    • Religious Practices: Engaging in religious rituals or seeking guidance from faith leaders.

    • Spiritual Counseling: Support from spiritual advisors or chaplains.

Choosing the right treatment option depends on individual preferences and the nature of the grief. Often, a combination of these approaches provides the best support for navigating the grieving process.


Common Prescription Medications for Grief Symptoms

  1. Antidepressants:

    • SSRIs: Fluoxetine (Prozac), Sertraline (Zoloft)

    • SNRIs: Venlafaxine (Effexor), Duloxetine (Cymbalta)

    • Use: Treats depression and anxiety.

  2. Anti-Anxiety Medications:

    • Benzodiazepines: Lorazepam (Ativan), Alprazolam (Xanax)

    • Buspirone: Treats generalized anxiety disorder.

    • Use: Provides short-term relief for severe anxiety.

  3. Sleep Aids:

    • Non-Benzodiazepine Hypnotics: Zolpidem (Ambien), Eszopiclone (Lunesta)

    • Melatonin Receptor Agonists: Ramelteon (Rozerem)

    • Use: Helps with sleep disturbances.

  4. Mood Stabilizers:

    • Examples: Lithium, Valproate (Depakote)

    • Use: Manages severe mood swings, especially with co-occurring conditions.

  5. Atypical Antipsychotics (For severe cases):

    • Examples: Quetiapine (Seroquel), Aripiprazole (Abilify)

    • Use: Treats severe depression or anxiety not responding to other treatments.


Does Insurance Cover Treatment for Grief?

Insurance coverage for grief treatment can vary based on the insurance provider and the specific policy. Here are some general points to consider:

  1. Therapy and Counseling: Many insurance plans cover mental health services, including grief counseling and therapy. Check with your provider for details on coverage and copayments.

  2. Support Groups: Insurance typically does not cover support groups, but some community or nonprofit organizations offer free or low-cost options.

  3. Medication: If prescribed, medications for depression or anxiety related to grief are often covered, though there may be copayments or deductibles.

  4. Complementary Therapies: Coverage for alternative treatments like art or music therapy varies widely and is less commonly covered.

It’s important to review your insurance policy or contact your insurance provider to understand the specifics of your coverage for grief treatment.


Common Insurance Options for Treatment

Common insurance options for grief treatment include:

  1. Employer-Sponsored Health Insurance:

    • Typically covers therapy, counseling, and medication for mental health.

    • Check with HR for specific details.

  2. Private Health Insurance:

    • Generally includes mental health services.

    • Review your policy or contact your provider for specifics.

  3. Medicaid:

    • Covers mental health services for eligible low-income individuals.

    • Coverage varies by state; check your state’s Medicaid office.

  4. Medicare:

  5. Employee Assistance Programs (EAPs):

    • Often provide limited free counseling sessions.

    • Check with your employer’s HR department.

  6. Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs):

    • Can be used to pay for therapy and counseling.

    • Check eligible expenses with your HSA/FSA administrator.

  7. Community Health Centers:

    • Offer mental health services on a sliding scale based on income.

    • Find centers through the Health Resources and Services Administration (HRSA) website.


Addiction and Grief: Understanding the Connection

Grief and addiction are closely linked, as intense emotions from grief can lead to substance abuse as a coping mechanism.

How Grief Can Lead to Addiction

  1. Emotional Escape:

    • Description: Individuals may use alcohol or drugs to numb painful feelings.

    • Example: Turning to substances to avoid dealing with depression and sadness.

  2. Increased Vulnerability:

    • Description: Emotional turmoil lowers resilience, increasing the risk of addiction.

    • Example: Heavy drinking after the sudden death of a loved one.

  3. Social Withdrawal:

    • Description: Isolation from support systems can lead to increased substance use.

    • Example: Using drugs or alcohol when feeling alone and unsupported.


Seeking Help

Combining therapy and support groups with addiction treatment can provide the necessary tools to cope with both grief and addiction.



Grief, whether stemming from the loss due to sudden death, chronic illness, or terminal illness, is a deeply personal and often tumultuous experience. By understanding and accepting the five stages of grief—denial, anger, bargaining, depression, and acceptance—we can better support ourselves and others through this natural part of life. Each person’s journey is unique, influenced by their relationships, beliefs, and circumstances. Whether you’re experiencing magical thinking in the bargaining stage or feeling an overwhelming sadness and depression, it is crucial to recognize that these emotions are a normal part of grieving. Seeking support from family members, health care professionals, and a strong support system can provide the necessary help to navigate this difficult time. Remember, reaching out to a doctor sooner rather than later can offer additional resources and support to stay healthy. Grief is not a set of stages to be conquered but a journey to be understood and experienced with compassion and care.


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If you or a loved one are struggling with mental health challenges or substance abuse, reach out to California Prime Recovery today. Our team of compassionate professionals is here to support your journey towards lasting well-being. Give us a call at 866-208-2390


The five stages of grief, according to Elisabeth Kübler-Ross, are Denial, Anger, Bargaining, Depression, and Acceptance.
No, people do not necessarily experience the stages in a linear order. They can move back and forth between stages or experience them in different sequences.
There is no set timeline for each stage. The duration varies for each individual and can depend on various factors, including the nature of the loss and personal coping mechanisms.
Yes, it is normal. Not everyone experiences all five stages, and some people may skip stages or experience different emotions that are not part of the Kübler-Ross model.
Yes, it’s possible for someone to feel stuck in a particular stage, such as prolonged depression or anger. If this happens, seeking professional help may be beneficial.

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