Delayed Grief: Causes, Symptoms, and How to Cope

In short, delayed grief is a reaction to a loss that is often experienced months or even years after the event occurs.

“Grief does not occur in formulaic orders,” explains Dr. Bryan Bruno, psychiatrist and medical director at MidCity TMS in New York City. “Grief is not a linear process.”

Delayed grief can affect everyone, including those who do not seem to be grieving initially after loss, as well as people who began to grieve after loss but thought they were starting to heal.

“Although time has passed since the loss, the grief can still affect you as though it happened yesterday,” Bruno explains.

Grief can take many different forms. There are six common types, aside from delayed grief.

Anticipatory grief

This type of grief starts before, rather than after, a death or loss occurs.

Anticipatory grief is commonly experienced by:

• caregivers, individuals, or families with a loved one in hospice
• adolescents with a parent who has a terminal illness
• people who have cancer

Like delayed grief, there is no exact timeframe for when anticipatory grief can affect someone. Anticipatory grief can start years before a loss, just like delayed grief can start years after.

Uncomplicated, or simple grief

This is the type of grief that most people think of when they talk about grief. It is the response to a loss after it occurs that can include symptoms such as:

• crying
• sleep changes
• appetite changes
• difficulty concentrating
• anger
• depression

Symptoms are generally strongest at the beginning and lessen with time as someone learns to cope with the loss and adjust to their “new normal.”

Disenfranchised grief

When someone is experiencing grief but feels like they cannot openly acknowledge or talk about it, it is known as disenfranchised grief.

It can occur when people may feel the pressure to “move on” or hide their grief due to:

• family pressures
• cultural or religious beliefs
• societal expectations

Parents who experience a miscarriage or stillbirth often characterize their feelings as disenfranchised grief because people expect them to return to work or hide their loss.

Disenfranchised grief is often a risk factor for causing delayed grief later.

Traumatic grief

Grief that follows a violent or sudden, unexpected loss is known as traumatic grief.

Traumatic grief is considered a risk factor for developing post-traumatic stress disorder (PTSD) as well as delayed grief.

Compounded grief

“Compounded grief [is] experienced when several losses [experienced] back-to-back culminate into an acute sorrow,” explains Alexia Smith, a licensed general professional counselor in Maryland and grief and bereavement counselor for Mercy Hospital/Stella Hospice in Maryland.

Prolonged grief

Prolonged grief is also known as complicated grief or chronic grief. It is a type of persistent, pervasive, and severe grief that doesn’t ease with time.

If unaddressed, prolonged grief can severely disrupt everyday life and can lead to suicidal thoughts or actions.

Grief that lasts for a very long time or is experienced this intensely may require treatment by a mental health professional.

Prolonged grief has been recognized as a new diagnosis by the World Health Organization (WHO) and as a disorder in the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5).

Prolonged grief disorder is believed to affect about 7% of bereaved people.

Anyone can develop prolonged grief, but delayed grief — as well as disenfranchised grief and traumatic grief — can be risk factors for developing prolonged grief.

“Delayed grief is caused by the inability of the individual to process the shock of loss at the time it occurs,” explains Bruno.

Obligations and ‘busyness’ after loss

This is often due to social or professional obligations at the time of the loss, which could force you to hold back your emotions to function and “get through it.”

“Delayed grief often occurs after the busyness and responsibility of the surviving family member slows down,” Smith explains.

For example, someone may not be able to process the loss of their spouse or parent at first because they’re busy handling funeral arrangements or feeling anxious over sudden financial pressures.

Your body has time and space

Delayed grief often emerges when you have the time, stillness, and space to confront the loss and feelings you’ve been repressing.

“Delayed grief is your body finally processing emotions you’ve been needing to express,” Bruno explains. “The body finally feels safe enough to experience and feel these emotions fully.”

Sudden reminders of loss

Delayed grief can also be triggered by a sudden reminder of the loss, which causes the feelings to reemerge.

For example, researchers expect that the pandemic might lead many people to experience delayed grief because they were unable to be at their loved one’s deathbeds or hold funerals right away.

As with grief in general, delayed grief is a powerful, multifaceted reaction, not a single reaction. So it doesn’t affect everyone in the exact same way.

Bruno explains, “delayed grief is a reaction to unprocessed emotions, that stress can come out in different ways.”

Delayed grief can also lead to both emotional and physical symptoms, including:

• recurring memories of the loss
• frequent dreams and nightmares about the person you lost
• trouble sleeping
• strong feelings of sadness
• feelings of longing
• loneliness
• anger, which is often easily triggered
• trouble concentrating
• low energy levels
• fatigue
• difficulty concentrating
• aches and pains
• anxiousness
• mood swings
• changes in appetite
• feelings of apathy

In many ways, coping with delayed grief is similar to coping with other forms of grief — you’re just learning to manage those feelings at a later time.

There’s no timeline

According to Bruno, giving yourself some time to feel what you’re feeling may be the best thing you can do. “There is no timeline to follow or deadline to ‘get over it,’” Bruno says.

“Giving yourself time and space to experience these emotions is the best way to begin healing from loss,” Bruno continues.

You might also want to consider postponing major life decisions while you’re dealing with your feelings of loss, such as:

• moving
• changing jobs
• having another child

Remember that your feelings might come in waves. Just because you feel better for a bit, then worse, doesn’t mean something’s wrong. It’s just the nature of how grief can affect people.

Self-care and wellness

Trying to be kind and patient with yourself and doing your best to take care of your health while you grieve can be important steps on your path to healing.

Consider building a self-care routine into your day while you cope with how you’re feeling.

Support from others

Remember that it’s OK to think and talk about the person you lost.

Some people might also find it helpful to:

• connect with friends and family who share the loss
• start a grief journal
• join a bereavement support group

“With my delayed grief clients, I often encourage them to recall stories, experiences, meals, and music they had or enjoyed with the deceased as a way to honor their memory and increase positive emotions,” says Smith.

Therapy

If you continue to be challenged by feelings of grief, you might want to consider reaching out to a therapist or other mental health professional.

“If your mood has been persistently impaired for 2 weeks or more, you may be experiencing depression,” Bruno says. Or you may have prolonged grief disorder.

A therapist can help you determine if you could benefit from additional treatment, such as individual psychotherapy or medication.

Contrary to how it is often portrayed in popular culture and media, grief does not have a “normal” timeline. It can start at any time and reemerge when you least expect it — including years after the initial loss.

If you’re dealing with delayed grief, it’s not your fault, and it is possible to feel better — but it may take time. There are no shortcuts through grief, but with time and space, you may find it becomes less challenging to cope with your loss.

If you’re looking for a support group near you, consider using GriefShare.org’s search page for a local group. You can also get help finding a therapist by checking out Psych Central’s resource guide for more information.