Dr Tariq Jagnarine
Family Medicine, Endocrinology/Diabetes

Grief is universal. People often describe grief as passing through 5 or 7 stages. The 5 stages are: denial, anger, bargaining, depression, and acceptance.
At some point, everyone will have at least one encounter with grief. It may be from the death of a loved one, the loss of a job, the end of a relationship, or any other change that alters life as they know it.
Grief is also very personal. It’s not very neat or linear. It doesn’t follow any timelines or schedules. Persons may cry, become angry, withdraw, or feel empty. None of these things is unusual or wrong.

According to Kübler-Ross, the five stages of grief are:
* Denial
* Anger
* Bargaining
* Depression
* Acceptance

Grief is an overwhelming emotion. It’s not unusual to respond to strong and often sudden feelings by pretending the loss or change isn’t happening. Denying it gives people time to absorb the news and begin to process it. This is a common defense mechanism, and it helps to numb people to the intensity of the situation.
As people move out of the denial stage, however, the emotions they’ve been hiding will begin to rise. They will be confronted with a lot of sorrow they’ve denied. That is also part of the journey of grief, but it can be difficult.

Whereas denial may be considered a coping mechanism, anger is a masking effect. Anger is hiding many of the emotions and pain that people carry.
This anger may be redirected at other people, such as the person who died, an ex, an old boss, or even inanimate objects.
Anger may mask itself in feelings like bitterness or resentment. It may not be clear-cut fury or rage. Not everyone will experience this stage of grief. Others may linger here. As the anger subsides, however, people may begin to think more rationally about what’s happening, and feel the emotions they’ve been pushing aside.

During grief, persons may feel vulnerable and helpless. In those moments of intense emotions, it’s not uncommon to look for ways to regain control, or to want to feel like the outcome can be affected by an event.
In the bargaining stage of grief, people may find themselves creating a lot of “what if” and “if only” statements.
It’s also not uncommon for religious individuals to try to make a deal or promise to God or a higher power in return for healing or relief from grief and pain.
Bargaining is a line of defense against the emotions of grief. It helps to postpone sadness, confusion, or hurt.

Whereas anger and bargaining can feel very active, depression may feel like a quiet stage of grief.
In the early stages of loss, people may be running from the emotions, trying to stay a step ahead of them. By this point, however, they may be able to embrace and work through them in a more healthful manner. They may also choose to isolate themselves from others in order to fully cope with the loss.
That, however, doesn’t mean that depression is easy or well-defined. Like the other stages of grief, depression can be difficult and messy. It can feel overwhelming. People may feel foggy, heavy, and confused.
Depression may feel like the inevitable landing point of any loss. However, if there is a feeling of being stuck, or seemingly being unable to move past this stage of grief, talk with a mental health expert.

Acceptance is not necessarily a happy or uplifting stage of grief. It doesn’t mean people moved past the grief or loss. It does, however, mean that they accept it and have come to understand what it means in their life now.

Grief is different for every person. There’s no exact time frame to adhere to. People may remain in one of the stages of grief for months, but skip other stages entirely. This is typical. It takes time to go through the grieving process.

Not everyone goes through the stages of grief in a linear way. They may have ups and downs, and go from one stage to another, then circle back.
Additionally, not everyone would experience all stages of grief, and may not go through them in order. For example, they may begin coping with loss in the bargaining stage, and find themselves in anger or denial next.
Avoiding, ignoring, or denying ourselves the ability to express our grief may help us dissociate from the pain of the loss we’re going through. But holding it in won’t make it disappear. And we can’t avoid grief forever.
Over time, unresolved grief can turn into physical or emotional manifestations that affect our health. To heal from a loss and move on, grief needs to be addressed.
The key to understanding grief is realizing that no one experiences the same thing. Grief is very personal, and you may feel something different every time. You may need several weeks, or grief may be years long.