In recent years, new ways of understanding grief and the healing process have emerged, including care for the bereaved, a deeper understanding of the brain mechanisms involved in grief, and an evolving view of the so-called stages of grief.

As doctors have learned more about the psychological and physical states of grief and their adverse effect on health and mortality, they have focused attention on those left behind, says Maisha T. Robinson, MD, FAAN, a neuropalliative care physician in Jacksonville, FL. “Recognizing that grief is not a brief, temporary response to loss, counselors from hospice care can follow survivors throughout the first year after the death and provide support.”

For some people, grief can become a serious mental health problem characterized by anger, depression, isolation, and other symptoms, says Dr. Robinson. “If the grief is prolonged or complicated and emotions are debilitating and don't improve over time, I refer people to their primary care physicians, who may recommend nonpharmacologic and pharmacologic therapies,” Dr. Robinson says.

“The brain's response to traumatic loss can result in disorientation and heightened anxiety that can disrupt sleep and increase disturbing dreams by night and intrusive thoughts, such as flashbacks, by day,” says Lisa M. Shulman, MD, FAAN, professor of neurology at the University of Maryland School of Medicine and author of Before and After Loss: A Neurologist's Perspective on Loss, Grief, and Our Brain. “Understanding these brain mechanisms has led to interventions such as journaling and art therapy that help reconnect emotional and cognitive memories.”

For more severe and chronic grief that disrupts daily function, research is underway on the use of psychedelic agents like MDMA, a synthetic psychoactive chemical, under the guidance of a psychiatrist or trained counselor, Dr. Shulman says. “The FDA designated this as a breakthrough therapy for posttraumatic stress disorder in 2017, and recent phase 2 and phase 3 trials have shown efficacy.”

“Uncomfortable feelings like grief are normal and serve a purpose as people move forward with their lives after a loss,” says Farrah N. Daly, MD, a neurologist at EvenBeam Neuropalliative Care in Leesburg, VA. “It is not something that should be ignored or rushed, and everyone's experience can be different.”

The traditional “stages of grief” model that suggested that people move in a linear fashion through denial, anger, bargaining, and depression to acceptance has been supplanted by an understanding that there's no right way to grieve. “The many ways to explore grief include art, journaling, creative writing, listening to podcasts, reading books, talking with friends, developing advocacy efforts, and speaking with a professional bereavement counselor,” says Dr. Daly. “I encourage people to explore ways that work best for them.”

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