Although grief responses, in general, differ from one person to another, there are many predictable expressions of grief. These expressions occur on physical, intellectual, emotional, social, and spiritual levels. Before, during, and after loss, grief may appear in several of the following forms.
Physical: crying, sobbing, wailing, shock and numbness, dry mouth, a lump in the throat, shortness of breath, stomach ache or nausea, tightness in the chest, restlessness, fatigue, exhaustion, sleep disturbance, appetite disturbance, body aches, stiffness of joints or muscles, dizziness or fainting
Intellectual: denial, sense of unreality, confusion, inability to concentrate, feeling preoccupied by the loss, experiencing hallucinations concerning the loss (visual, auditory, and olfactory,) a need to reminisce about the loved one and to talk about the circumstances of the loss, a sense that time is passing very slowly, a desire to rationalize or intellectualize feelings about the loss, thoughts or fantasies about suicide (not accompanied by concrete plans or behaviors)
Emotional: sadness, anger, depression, guilt, anxiety, relief, loneliness, irritability, a desire to blame others for the loss, resentment, embarrassment, self-doubt, lowered self-esteem, feelings of being overwhelmed or out of control, feelings of hopelessness and helplessness, feelings of victimization, giddiness, affect that is inappropriate for the situation (nervous smiles and laughter)
Social: feelings of withdrawal, isolation and alienation, a greater dependency on others, a rejection of others, rejection by others, a reluctance to ask others for help, change in friends or in living arrangements, a desire to re-locate or move, a need to find distractions from the intensity of grief (to stay busy or to over-commit to activities)
Spiritual: bargaining with God in an attempt to prevent loss, feeling angry at God when loss occurs, renewed or shaken religious beliefs, feelings of being either blessed or punished, searching for a meaningful interpretation of a loved one’s death, paranormal visions or dreams concerning a dead loved one, questioning whether or not souls exist and wondering what happens to loved ones after death, the need to “finish business” with a purposeful ending or closure to the relationship (a funeral, memorial service, last rites ceremony, good-bye ritual)