Grief and Loss: When to See a Psychologist

Grief isn’t a mental illness, and most people who are grieving don’t need therapy. It’s a normal response to loss, it’s supposed to hurt, and it generally softens over time with the support of the people around you. That said, grief sometimes gets stuck, or arrives alongside trauma or depression, and in those situations working with a psychologist can help. This article covers what ordinary grief looks like, what makes it more complicated, and what therapy can and can’t offer.

What ordinary grief looks like

Grief isn’t only sadness. It commonly shows up as exhaustion, difficulty concentrating, disrupted sleep and appetite, irritability, guilt, and physical symptoms like chest tightness or a heavy feeling. Some people feel numb rather than sad, particularly early on, and then worry that something is wrong with them.

It also isn’t linear. The stages model that most people have heard of was drawn from work with people facing their own death, not with the bereaved, and it was never intended as a sequence to move through. Grief comes in waves, and a bad week eight months in doesn’t mean you’ve gone backwards.

Anniversaries, birthdays, and ordinary triggers like a song or a smell can bring it back sharply years later. That’s normal and it doesn’t mean the grief is unresolved.

All of us, at times, find that other people expect us to be further along than we are. There’s no schedule, and the timeframe varies enormously between people and between losses.

When grief becomes something more

For a minority of people, grief stays at full intensity and keeps interfering with daily life well beyond the early period. This is recognised clinically as prolonged grief disorder, which appears in both the ICD-11 and the DSM-5-TR.

The features that distinguish it are persistent intense yearning or preoccupation with the person who died, alongside significant difficulty functioning, continuing well past what’s expected given the person’s culture and context. The diagnostic timeframes differ slightly between the two classification systems, and diagnosis is a clinical judgement rather than a calendar calculation.

Some things make a complicated course more likely. Sudden, violent or traumatic deaths. The death of a child. Losses where the relationship was difficult or unresolved. Situations where you couldn’t be there, or where there was no funeral. Multiple losses close together. Grief alongside an existing mental health condition or limited support.

Grief can also sit alongside depression or post-traumatic stress rather than instead of them, and those need identifying because they respond to different treatment. If the death was traumatic, the intrusive memories may need addressing before the grieving itself can move.

Signs it’s worth talking to someone

There’s no threshold you have to cross before you’re allowed to seek support. Some practical markers that professional support may help:

• You’re not able to function at work or at home months after the death, and it isn’t shifting.
• You’re avoiding reminders so thoroughly that your life has narrowed.
• You’re using alcohol or other substances to get through.
• The death was traumatic and you’re getting intrusive images or nightmares.
• You feel persistently that life has no purpose without the person, or you’re having thoughts of not wanting to be here.
• You have nobody to talk to about it, which is a common situation and a real risk factor on its own.

If you’re having thoughts of suicide, contact your GP, or call Lifeline on 13 11 14 at any hour.

What therapy for grief actually involves

Grief therapy isn’t about getting over the loss or moving on from the person. It’s about being able to carry it in a way that lets you live.

In practice that involves telling the story of the loss to someone who won’t rush you, working out which parts feel stuck, and identifying whether something specific is holding it in place. That might be guilt about a decision, anger with someone involved, or an unfinished conversation.

Where the death was traumatic, trauma-focused work may come first, because intrusive memories interfere with grieving. EMDR is one approach used in that situation. Where avoidance has taken over, the work is often gradual re-engagement with what’s been avoided.

Therapy can’t shorten grief, and it isn’t meant to. What it can do is address the parts that have jammed.

Getting support

Bereavement support in Australia isn’t only clinical. Griefline offers a national phone and online service, and Beyond Blue has information and a support line. Many hospitals and palliative care services run bereavement groups, and for some people a group with others who’ve had similar losses is more useful than individual therapy.

If you’d like to work with a psychologist, a Mental Health Treatment Plan from your GP gives you rebated sessions. There’s more in how to get a mental health treatment plan.

Veronica works with grief and loss, including where it overlaps with trauma. More detail is on the grief and loss page.

Frequently asked questions

How long does grief normally last?

There’s no set timeframe, and it varies with the relationship, the circumstances and the person. Most people find the intensity softens over the first year or two while the grief itself remains. Clinicians look at whether it’s still preventing you functioning, rather than at the calendar alone.

Is grief a mental illness?

No. Grief is a normal response to loss. A small proportion of people develop prolonged grief disorder, which is a recognised condition in the ICD-11 and DSM-5-TR, but ordinary grief is not a disorder and doesn’t need treating.

Should I see a psychologist or a grief counsellor?

Either can help. A psychologist is worth considering where grief overlaps with trauma, depression or an existing mental health condition, where formal assessment would be useful, or where you want Medicare rebated sessions.

Can therapy help if the death was years ago?

Yes. Grief that has stayed stuck for years responds to the same work, and delayed grief is common where someone had to hold things together at the time.

What are the stages of grief?

The five-stage model is widely known but was developed from work with people facing their own death rather than with bereaved people, and grief doesn’t move through fixed stages. Most current models describe it as coming in waves that gradually change in intensity.

Working with Veronica

If you’re grieving and want to talk it through with a psychologist, you can read more on the grief and loss page or get in touch. Sessions are available across Australia by telehealth. If you need support right now, Lifeline is on 13 11 14.

About the author

Veronica West is a registered psychologist (BPsychSc(Hons), MPH, MPsych) and Board-approved supervisor based on the Sunshine Coast, Queensland. She works with adults and adolescents across Australia by telehealth and provides clinical supervision to provisional psychologists, registrars and fully registered psychologists. More about Veronica.