While loss affects people in different ways, many people experience the following symptoms when they're grieving. Just remember that almost anything that you experience in the early stages of grief is normal – including feeling like you're "going crazy", feeling like you're in a bad dream, or questioning your religious beliefs.

• Shock and disbelief – Right after a loss, it can be hard to accept what happened. You may feel numb, have trouble believing that the loss really happened, or even deny the truth. If someone you love has died, you may keep expecting them to show up, even though you know they're gone.
• Sadness – Profound sadness is probably the most universally experienced symptom of grief. You may have feelings of emptiness, despair, yearning, or deep loneliness. You may also cry a lot or feel emotionally unstable.
• Guilt – You may regret or feel guilty about things you did or didn't say or do. You may also feel guilty about certain feelings (e.g. feeling relieved when the person died after a long, difficult illness). After a death, you may even feel guilty for not doing something to prevent the death, even if there was nothing more you could have done.
• Anger – Even if the loss was nobody's fault, you may feel angry and resentful. If you lost a loved one, you may be angry at yourself, others, the doctors, or even the person who died for abandoning you. You may feel the need to blame someone for the injustice that was done to you.
• Fear – A significant loss can trigger a host of worries and fears. You may feel anxious, helpless, or insecure. You may even have panic attacks. The death of a loved one can trigger fears about your own mortality, of facing life without that person, or the responsibilities you now face alone.
• Physical symptoms – We often think of grief as a strictly emotional process, but grief often involves physical problems, including fatigue, nausea, lowered immunity, weight loss or weight gain, aches and pains, and insomnia.

If you are experiencing any of these emotions following a loss, it may help to know that your reaction is natural and that you'll heal in time. However, not everyone who is grieving goes through all of these stages – and that's okay. Contrary to popular belief, you do not have to go through each stage in order to heal. In fact, some people resolve their grief without going through any of these stages. And if you do go through these stages of grief, you probably won't experience them in a neat, sequential order, so don't worry about what you "should" be feeling or which stage you're supposed to be in.

Kübler-Ross herself never intended for these stages to be a rigid framework that applies to everyone who mourns. In her last book before her death in 2004, she said of the five stages of grief, "They were never meant to help tuck messy emotions into neat packages. They are responses to loss that many people have, but there is not a typical response to loss, as there is no typical loss. Our grieving is as individual as our lives."

Losing someone or something you love is very painful. After a significant loss, you may experience all kinds of difficult and surprising emotions, such as shock, anger, and guilt.  Sometimes it may feel like the sadness will never let up. While these feelings can be frightening and overwhelming, they are normal reactions to loss. Accepting them as part of the grieving process and allowing yourself to feel what you feel is necessary for healing.

If you recognize any of the above symptoms of complicated grief or clinical depression, talking with a counselor can be helpful. Left untreated, complicated grief and depression can possibly lead to emotional damage, life-threatening health problems, and even suicide. But treatment can help you get better.

Contact the Counseling Center, or professional counselor if you are not on campus, if you:

• Feel like life isn't worth living
• Wish you had died with your loved one
• Blame yourself for the loss or for failing to prevent it
• Feel numb and disconnected from others for more than a few weeks
• Are having difficulty trusting others since your loss
• Are unable to perform your normal daily activities

Tip 1: Get Support

The single most important factor in healing from loss is having the support of other people. Even if you aren't comfortable talking about your feelings under normal circumstances, it's important to express them when you're grieving. Sharing your loss makes the burden of grief easier to carry. Wherever the support comes from, accept it and do not grieve alone. Connecting to others will help you heal.

• Turn to friends and family members – Now is the time to lean on the people who care about you, even if you take pride in being strong and self-sufficient. Draw loved ones close, rather than avoiding them, and accept the assistance that's offered. Oftentimes, people want to help but don't know how, so tell them what you need – whether it's a shoulder to cry on or help with putting together a memorial.
• Draw comfort from your faith – If you follow a spiritual or religious tradition, embrace the comfort its mourning rituals can provide. Spiritual activities that are meaningful to you – such as praying, meditating, or talking with a spiritual/religious leader – can offer solace. If you're questioning your faith in the wake of the loss, talking with others in your religious/spiritual community could be helpful.
• Join a support group – Grief can feel very lonely, even when you have loved ones around. Sharing your sorrow with others who have experienced similar losses can help.
• If your grief feels like too much to bear, call the Counseling Center to schedule a time to speak with a counselor. An experienced therapist can help you work through intense emotions and overcome obstacles to your grieving.

Tip 2: Take Care of Yourself

When you're grieving, it's more important than ever to take care of yourself. The stress of a major loss can quickly deplete your energy and emotional reserves. Looking after your physical and emotional needs will help you get through this difficult time.

• Face your feelings. You can try to suppress your grief, but you can't avoid it forever. In order to heal, you have to acknowledge the pain. Trying to avoid feelings of sadness and loss only prolongs the grieving process. Unresolved grief can also lead to complications such as depression, anxiety, substance abuse, and health problems.
• Express your feelings in a tangible or creative way. Write about your loss in a journal. If you've lost a loved one, write a letter saying the things you never got to say; make a scrapbook or photo album celebrating the person's life; or get involved in a cause or organization that was important to him or her.
• Look after your physical health. The mind and body are connected. When you feel good physically, you'll also feel better emotionally. Combat stress and fatigue by getting enough sleep, eating right, and exercising. Don't use alcohol or drugs to numb the pain of grief or lift your mood artificially.
• Don't let anyone tell you how to feel, and don't tell yourself how to feel either. Your grief is your own, and no one else can tell you when it's time to "move on" or "get over it." Let yourself feel whatever you feel without embarrassment or judgment. It's okay to be angry, to yell at the heavens, to cry or not to cry. It's also okay to laugh, to find moments of joy, and to let go when you're ready.
• Plan ahead for grief "triggers". Anniversaries, holidays, and milestones can reawaken memories and feelings. Be prepared for an emotional wallop, and know that it's completely normal. If you're sharing a holiday or lifecycle event with other relatives, talk to them ahead of time about their expectations and agree on strategies to honor the person you loved.

Distinguishing between grief and clinical depression isn't always easy since they share many symptoms. However, there are ways to tell the difference. Remember, grief is a roller coaster. It involves a wide variety of emotions and a mix of good and bad days. Even when you're in the middle of the grieving process, you will have moments of pleasure or happiness. With depression, on the other hand, the feelings of emptiness and despair are constant.

When grief doesn't go away

It's normal to feel sad, numb, or angry following a loss. But as time passes, these emotions should become less intense as you accept the loss and start to move forward. If you aren't feeling better over time, or your grief is getting worse, it may be a sign that your grief has developed into a more serious problem, such as complicated grief or major depression.

MYTH: The pain will go away faster if you ignore it.

Fact: Trying to ignore your pain or keep it from surfacing will only make it worse in the long run. For real healing it is necessary to face your grief and actively deal with it.

MYTH: It's important to be "be strong" in the face of loss.

Fact: Feeling sad, frightened, or lonely is a normal reaction to loss. Crying doesn't mean you are weak. You don't need to "protect" your family or friends by putting on a brave front. Showing your true feelings can help them and you.

MYTH: If you don't cry, it means you aren't sorry about the loss.

Fact: Crying is a normal response to sadness, but it's not the only one. Those who don't cry may feel the pain just as deeply as others. They may simply have other ways of showing it.

MYTH: Grief should last about a year.

Fact: There is no right or wrong time frame for grieving. How long it takes can differ from person to person.

Source: Tulane University Campus Health Services

Students are reminded of the campus resources to turn to for support. These include, but are not limited to:

• Counseling Center (603-646-9442). After hours On-Call Counselor (603-646-4000).
• Tucker Center (603-646-3780)
• Safety & Security (603-646-4000)
• Division of Student Affairs (603-646-2243)

Additional information for graduate students:

• Graduate Studies (603-646-2107)
• Geisel School of Medicine (603-650-1111)
• Thayer School of Engineering (603-646-3483)
• Tuck School of Business (603-646-2190)

Faculty and Staff

Faculty and Staff are reminded that the Faculty/Employee Assistance Program (F/EAP) is available for support. There are two ways to access the Faculty/Employee Assistance Program (F/EAP):

• Call 844.216.8308: You'll speak to a counseling professional who will listen to your concerns and can guide you to the appropriate services you require, including local providers for in-personal counseling. 
• Visit GuidanceResources® Online at, click on Register and enter your company ID: Dartmouth and then follow the registration prompts. You will find timely, expert information on thousands of topics, including relationships, work, school, children, wellness, legal, and financial. You can search for qualified child care and elder care, attorneys and financial planners as well as ask questions, take self-assessments and more.

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