The difference is that the bereaved experiences predominant feelings of loss and emptiness, which are linked to memories and thoughts. Low mood and the inability to experience joy or pleasure are central to depression. They are not linked to memories. Instead, they are a general experience (Bahou, 2023).
Grief has an identifiable cause, while depression has various causes that are often interlinked (Peña-Vargas et al., 2021).
Even though depression is a stage of the grieving process, the bereaved doesn’t suffer from clinical depression, even though maladaptive grieving could turn into depression (Peña-Vargas et al., 2021; Bonanno, 2009).
Bereavement doesn’t have a set timeline, and everyone goes through it in their own way. Yet over time, its impact on the daily life of the bereaved lessens.
The 5 Stages of Grief: The Kübler-Ross Model Explained
The five stages of grief were first introduced in 1969 by Elisabeth Kübler-Ross in her book On Death and Dying.
Kübler-Ross (1969) originally developed the stages to describe the emotional journey of terminally ill patients. Since then, the model has evolved and been applied broadly to anyone experiencing any form of loss.
These stages are not a strict sequence that needs to be followed during grieving (Hall, 2014). Instead, they should be considered a helpful framework that brings language to the often confusing and difficult experience of grief (Kübler-Ross & Kessler, 2005).
Also, these stages are not specific to everyone, nor do they necessarily follow a chronological order. Individuals may experience the stages in a different order or even experience multiple at the same time, and sometimes some might experience the stages over again (Kübler-Ross & Kessler, 2005).
Denial
During the initial shock, denial functions as a protective buffer between the strong emotions and the mind. It helps the person experiencing loss to process the new, painful reality.
This isn’t about refusing to accept the new reality. Instead, it is a way for the individual to not become overwhelmed by the pain. Kessler (2019, p.1) describes this stage as “shock and disbelief that the loss has occurred.”
Anger
Anger is a common emotion that often surfaces when reality sets in during the healing process. It is a necessary, protective, and frequently misunderstood part of the grieving journey because it functions as a bridge between emotional numbness and deeper emotions (Kübler-Ross & Kessler, 2005). Anger provides the bereaved something to hold on to (LeDoux, 1996; Greenberg, 2002).
The sense of injustice, abandonment, sorrow, disappointment, longing, or powerlessness can be the trigger for anger (Harris & Winokuer, 2019). While navigating grief, the bereaved may direct their anger outward toward others, including therapists and other professionals (Harris & Winokuer, 2019).
Anger surfaces once the bereaved feels safe enough to know that they will probably survive whatever comes (Kübler-Ross & Kessler, 2004).
Bargaining
Bargaining is the stage of grief where the brain tries to cling to hope and the idea that death could be reversed. It is a psychological negotiation with fate, for some with God and others with themselves or their beliefs (Kübler-Ross & Kessler, 2005).
This process is not just an imaginative pleading. This stage is the brain’s attempt to restore predictability and coherence after the event. Emotionally charged memories activate the amygdala and can intensify mental ruminations — a characteristic of the bargaining stage (LeDoux, 1996).
Bargaining often occurs when cognitive and emotional systems are recalibrating to a new, overwhelming reality. This can provide a sense of agency in a situation that feels hopeless (O’Connor, 2019).
Not everyone goes through the bargaining stage or experiences prolonged distress. Ultimately, there is a wide variability in the process of grief (Bonanno et al., 2002; Bonanno 2009).
What our readers think
This is very insightful. I work in behavioral health and addiction treatment and this topic is important in recovery. Many people do not understand grief or how to cope and heal from it. In turn, this often leads to serious mental health and behavioral issues. I’ve learned through my work that grief is often the result of deep rooted trauma, which manifests as addiction. Thank you for your efforts on educating people to the importance of understanding grief.
I received an email from Seph with resources, articles on 13 Types of Grief, and the 10 Grief Counseling Therapy Techniques. Thank you, I will be trying them out. I am open to any other resources.
Dear Dr. Celestine,
I run a program for the VA, a weekly Zoom meeting group for Vietnam Veterans with PTSD. For this aging population this article is very relevant. Unfortunately they are not eager to read longer partly-scientific articles, however beneficial or relevant, but prefer talks, videos, etc. Do you know of any videos, TEDtalks, or other presentations which provide (even parts of) this information?
Thank you,
Jon
I am the founder and senior consultant of Optimum Practice Solutions. My focus is on providing organizational management tools and techniques as well as other solutions to support the veterinary and medical professions.
I write educational articles 3-4 times a month which are sent to my subscriber list via email. With a high rate of mental illness and suicide in veterinary medicine and the healthcare profession, I’d like to reprint this article with the author as a Guest in one of my upcoming articles. You’ll find me on LinkedIn https://www.linkedin.com/in/marylemalloy/
Let me know as soon as possible if I have your permission.
Hi Maryle,
Thanks for your interest. Could you please send a few details about your organization, the purpose for which you’d like to republish this article, and the contact for your publishing manager via our contact form here, and we will be in touch 🙂
Thank you.
– Nicole | Community Manager
Thank you so much for the wonderful , detailed information. These resources help in supporting the clients. These kind of resources help the therapist to connect with the clients and help them in their journey.