Management of Loss and Grief

Bereavement is a common and emotionally challenging experience encountered by both patients and clinicians. Most individuals adapt to the death of a loved one without requiring a psychiatric intervention, while others develop prolonged grief disorder (PGD), major depressive disorder (MDD), an anxiety disorder, or the worsening of a medical illness. Because psychiatrists evaluate bereaved individuals across diverse care settings, they should recognize the normal trajectory of grief and its deviations. This review summarizes contemporary concepts of grief and mourning, differentiates adaptive grief from PGD and MDD, reviews the risk factors for persistent distress, discusses psychotherapeutic and pharmacologic treatments, and addresses the emotional impact of a patient's death on clinicians. Understanding the natural course of bereavement allows psychiatrists to normalize expected grief, while identifying individuals who require evaluation and treatment. Thoughtful assessment, supportive interventions, and timely referral can reduce suffering and improve adaptation following a loss.