News Special Report

The Grief Experience: Survey Shows It's Complicated

looking through window grief concept

July 11, 2019 -- People grieve a lost friendship or relationship at a level similar to the death of a close family member or friend -- and no matter what you’re grieving, other people may expect you to bounce back long before you’re ready, a new WebMD survey finds.

WebMD’s survey, “Grief: Beyond the 5 Stages,” sought to discover how people grieve after different life events and how they got through them. It was taken May 16 to May 19, 2019, by 1,084 U.S. respondents. Of those, 780 said they had grieved over a life event in the past 3 years.

“Many of us have the misperception that there’s a right way to grieve, and most people think they’re doing it wrong,” says Donna Schuurman, a family therapist and senior director of advocacy and training and at the Dougy Center, a Portland, OR, nonprofit that helps people deal with the death of a loved one. “We live in a society that wants us to get over it and move on.”

The “five stages” in the survey title refers to Elisabeth Kubler-Ross’s pioneering study of grief, which she unveiled in her 1969 book, On Death and Dying. In it, she lays out five stages mourners pass through on their way to recovery: denial, anger, bargaining, depression, and acceptance. But the survey showed that grieving is not a “one size fits all” experience -- either in what people grieve for or how they experience it.

What Causes Grief?

Although we may think of grief only in terms of death, a deep sense of loss comes in response to many more events, respondents said:

  • Nearly one-third (31%) had faced serious illness -- their own or a family member’s.
  • About another third (32%) had gone through the death of a family member or close friend, and almost as many mourned a lost friendship or relationship (29%).
  • Twenty percent were recovering from the death of a pet.
  • Smaller proportions grieved for divorce or lost jobs, homes, or possessions, among other things.

“What’s surprising is that we don’t recognize all the different aspects of grief more,” says Claire Bidwell Smith, a licensed clinical professional counselor, grief therapist, and the author of Anxiety: The Missing Stage of Grief. “When we don’t, people feel they’re not allowed to grieve. It does a disservice to their recovery.”

The duration of intense grieving varied among those who took the survey, depending on what people had lost. Nearly half of all people (48%) said their most powerful feelings subsided within the first 6 months, and two-thirds (67%) had recovered within 1 year. Pet owners were the most likely to recover quickly. Sixty-six percent of those who lost a pet said their intense grief lasted less than 6 months, compared to 48% of people who lost a close family member or friend to death and 45% who mourned the loss of a friendship/relationship.

Expectations vs. Reality

Grieving is a very personal process, but it can be hard to ignore the expectations of others -- and people often expect mourners to return to regular life before they’re ready.

“You’re in that wilderness, off kilter, feeling unmoored, and people aren’t showing up in the ways you hoped they would,” says Schuurman. “We live in a society that wants us to get over it and move on. ‘It’s been this long, are you dating?’ ”

More than half of all participants (53%) said that they’d encountered people whose sympathy seemed to have an expiration date. Of that sub-group:

  • 58% of the people who were pressured said they felt expected to recover within the first 3 months. A whopping 81% of those mourning a pet, and 75% of those who’d lost a friendship or went through a breakup, said the same.
  • Even for those mourning the death of a close relative or friend, most (91%) felt expected to move on within 1 year.

“It shouldn’t be surprising to see people grieving for longer than we expect,” says Smith. “Clinical texts give you 6 months, but I see it happening for 5 years when it’s the loss of a spouse, child, parent.”

Mental and Physical Effects of Grief

Nearly all (88%) had some type of emotional symptom while grieving, and two-thirds (68%) had physical symptoms.

Just as people needed different amounts of time to recover from their grief, the symptoms they reported varied. Sadness (76%) and depression (43%) were the two main emotions they say they had, while fatigue (59%) and change of appetite (48%) affected the most people physically. But here, too, the symptoms varied, depending on the loss:

  • Death -- of either a close relative or friend (84%) or a pet (81%) -- was more likely to result in sadness.
  • Those who’d lost a friendship or romantic relationship were more likely to have depression (53%) and anger (48%).
  • Nearly half of those mourning a serious illness (47%) reported a hard time sleeping, considerably more than the next largest group: people who’d experienced a close death (33%).

It makes sense that grief can lead to such varied experiences, says Schuurman.

“Life is a process of accumulating losses. How we integrate or ignore, process or push away those losses -- of everything: jobs, friendships, relationships, health, things that matter to us -- starts to become patterns,” she says. “It shapes how we look at the world, who we become, how we’re able to show up for other people.”

The Lingering Pain of Lost Friendships and Relationships

The loss of a friendship or a breakup seems to pose particular challenges. Relationships end for complicated reasons, and social media makes it easy to see how the friend has gone on without you.

  • Those who mourned lost relationships were the most likely to have extended grief, with 20% saying it had lasted more than a year.
  • Emotionally, this group was more likely to have depression (53%) and anger (48%) than any other group.
  • They were also likely to have changes in appetite (54%) and more likely to have stomachaches (41%).
  • And after the loss, they were more likely to have social fallout like lack of trust or isolation (53%), bitterness (41%), and self-blame (36%).
  • Sixty-percent of people reported they felt expectations from people to get over their grief. The majority (75%) of them felt they had up to 3 months to move on.

“I think it’s because there isn’t the same kind of finality. With loss of friendship, that person’s still out there. It can be hard to reconcile the idea you’ll never talk to them again,” says Smith. “Also, because the grief isn’t as recognized, it’s not dealt with. And when it’s not dealt with, it sticks around longer.”

Coping Mechanisms, Good and Bad

In response to the life-changing event, most participants said they came up with some strategy to deal with their grief -- only 14% said otherwise. The most common tactic: spending more time with friends and family. Forty-four percent of all participants turned to other people for help.

But again, when you consider the individual types of loss, the picture changes:

  • After the death of a loved one, people were more likely to spend more time with others (53%). They were also the group most likely to turn to religion or spiritual practices (31%).
  • Both those dealing with a serious illness (50%) and those who lost a relationship (58%) found music to be a comfort.
  • People who’d lost a pet were least likely to seek any kind of help, with 21% saying they muddled through on their own. Among those who did have coping mechanisms, they were more likely (37%) to focus on work to get over their loss.

“When you’re grieving death, it’s helpful to connect with others, because they’re either grieving themselves or can support you,” says Smith. “But lost friendship is a grief not a lot of people understand, which is why you’d turn towards more self-soothing exercises like music.”

Not all coping mechanisms were positive, though. Half of all participants (51%) engaged in some kind of behavior that can be harmful.

“When we look at all the micro-losses we have as people, from childhood up through your life, it’s not an understatement to say that unaddressed losses are directly responsible for a lot of the problems we get ourselves into,” says Schuurman. “We turn to things like substance misuse, rash relationships we know aren’t healthy, and other numbing behaviors.”

  • Many experienced a a change in their eating -- 38% overate, while 23% didn’t eat enough. Isolation affected 47% of participants.
  • Other common negative behaviors include drinking too much alcohol (26%) and excessive spending (23%).
  • Those dealing with a serious illness were most likely to indulge in negative behaviors (67%).
  • Among those grieving a friendship, self-medicating or over-indulging with food or alcohol were the most common activities, with 42% doing each.

Effective Ways to Help Someone Who’s Grieving

When someone you know is grieving, it can be hard to know what to say -- and how it is interpreted. Not surprisingly, according to the participants, some approaches are more helpful than others. However, at best, only half will say any of these approaches are helpful. 

  • Most participants (76%) said someone had tried to cheer them up -- and most of the time (54%), it worked. But, many others (36%) said it was ineffective. 
  • Sharing your own experience with loss had a similar effect: 74% said someone had done that, and 53% felt better afterward. However, 37% said it was ineffective.

The survey also uncovered some approaches that often do more harm than good.

  • Saying, “It could be worse” made people feel worse almost three times as often as it helped (46% to 16%).
  • Recommending that the mourner move on or seek closure had a similar effect, with 42% saying it made things worse and 16% saying it improved the situation.
  • Unsolicited advice also had a tendency to make things worse, with 33% saying it hurt and 19% saying it helped.

“I often hear that the people who were the most helpful were the ones who just sat with me, and didn’t want me to tell them how to help,” says Schuurman. “They just showed up, cut the lawn, brought coffee. And they didn’t give advice about how to get over it.”

WebMD News Special Report Reviewed by Neha Pathak, MD on July 11, 2019

Sources

WebMD survey completed May 16 to May 19, 2019, by 1,084 respondents drawn from AmeriSpeak, a probability-based panel designed to represent the U.S. household population. The margin of error is +/- 2.98 percentage points.

Donna Schuurman, EdD, family therapist; senior director of advocacy and training, executive director emeritus, the Dougy Center, Portland, OR.

Claire Bidwell Smith, licensed clinical professional counselor, author of Anxiety: The Missing Stage of Grief, Los Angeles.

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