What Is Anticipatory Grief, and How Can You Cope With It?

We often hear about grief, a feeling of intense sadness or sorrow, in connection with death. But grief isn't something you only experience when someone you love has died. It's also perfectly normal to grieve in response to a sudden or drastic change in your daily routine, or a life event that disrupts your feelings of comfort and stability. While feeling grief, people may experience symptoms including shock, disbelief, and denial. Anxiety, distress, anger, periodic sadness, and a loss of sleep or appetite can also be indicators of grief.

The way grief interacts with time is complex. Grief can begin upon hearing the news that someone has died, but it can also manifest in the period of time before someone actually passes away — a process known as anticipatory grief. "Anticipatory grief is the distress people feel in the days, weeks, months, years before an impending loss," Ashwini Bapat, MD, a palliative care doctor and founder of EpioneMD, tells POPSUGAR. "It is a completely normal and human response to a predicted loss." Although it might be difficult to navigate through, it's important to understand what anticipatory grief is, when it can occur, its symptoms, and the best ways to cope with anticipatory grief.

What Is Anticipatory Grief?

"Anticipatory grief is the normal grief process you begin when you know a living loved one will be dying soon," Ani Mirasol, LCSW, CGP, a grief and trauma therapist and owner of Rooted Rising therapy practice, tells POPSUGAR. Anticipatory grief can occur in a number of situations in the days, weeks, or months leading up to someone's death. "Some situations that can incite anticipatory grief include caring for an ageing parent with Alzheimer's, receiving a life-threatening diagnosis for a child, or in-utero complications when an unborn baby may not survive," explains Annia Palacios, LPC, owner of Tightrope Therapy.

Anticipatory grief can be just as painful as grief that occurs after death. "The time period in which it happens is the main difference," Dr. Bapat tells POPSUGAR. Despite the intense sadness one may feel, there can be some silver linings in that "anticipatory grief helps people create an advance care plan, and open up conversations about future medical care," she says. "Anticipatory grief can also help an individual proactively find meaning and closure."

However, people experiencing anticipatory grief may not receive the same level of support as those grieving after a loss. "An increased sense of isolation can be common in anticipatory grief," Palacios tells POPSUGAR. "The usual stream of casseroles, flowers, condolences, cards, and support may be absent, so we feel alone in our grief." This might be why certain symptoms are more common in anticipatory grief. "This can contribute to increased irritability, loneliness, and resentment as others continue on with their lives, while we are in an active stage of grief with little support," Palacios says.

What Are the Signs and Symptoms of Grief?

Symptoms of grief can be experienced in various ways, and they can be both emotional and physical. These include "anxiety, sadness, anger, guilt, relief, denial, withdrawing from others, dread, isolation, tearfulness, and preoccupation with the dying person or pet," Dr. Bapat explains.

On the physical side, "common body manifestations of grief include headaches, joint pain, muscle aches, fatigue, digestive troubles, and appetite changes," Mirasol says. "It is common to have difficulty concentrating, trouble with memory, and a general feeling of being spacey or out of it."

There are also myriad ways to recognise grief in someone else. Oftentimes, signs of grief tend to be behavioural. "Signs of grief include isolation and withdrawal, or an increased desire to talk about the situation," Mirasol tells POPSUGAR. "Trouble performing tasks, difficulty focusing, memory impairment, and emotional numbness are also signs of grief." Overly consuming alcohol or drugs, or developing new eating patterns, can also be signs of grief. "Substance use and disordered eating may occur as people seek ways to manage their intense and painful emotions," says Mirasol.

Whether someone is experiencing traditional grief or anticipatory grief, there are signs that can make it easier to recognise. "All grief involves similar elements of shock or denial, bargaining, sadness or depression, anger, and eventual acceptance of reality and integration of the loss into your life," Mirasol explains, adding that the signs and symptoms of anticipatory grief are influenced and affected by waiting for a loss to take place. "Anticipatory grief may be filled with more anger, irritability, frustration, or helplessness than typical grief, as you wait and watch for the loss to occur."

How Can You Cope With Anticipatory Grief?

Coping with anticipatory grief starts with speaking about it to someone you can confide in. "It is important to share your experience with a trusted friend, partner, or family member," Dr. Bapat tells POPSUGAR. "This is actually how you begin processing the grief and making sense of it."

It may be hard, but leaning on and accepting help from friends and family is crucial when you're experiencing symptoms of anticipatory grief. "This is a time to let yourself receive help and support from others," Mirasol says. "If your friends are offering to organise a meal train, provide childcare, or clean your home, let them."

Support groups can also be helpful to those awaiting a loss. "Local illness-specific or caregiver support groups can be a great source of strength," Dr. Bapat says. Mirasol adds that "you may want to talk or just listen, but being with others who understand is indescribable." Additionally, you might turn to your culture, faith, or another type of community. "Many folks find solace in spiritual counsel or community during times of grief," Mirasol says.

Most importantly, you should speak with a professional who is trained to assist those experiencing anticipatory grief. "Talking about this with a professional, such as a palliative care clinician, a therapist, or a counselor can help," Dr. Bapat says. "It is critical to seek professional help particularly if the anticipatory grief starts to interfere with your daily responsibilities."

Can Anticipatory Grief Be Treated?

Although it's important to seek counseling for anticipatory grief, it might not be something that can ever fully go away. "Grief is described in counseling as cycling, or coming and going in waves," Jared Heathman, MD, of Your Family Psychiatrist, tells POPSUGAR. "Grief is not something that one is 'cured' from, or can even be fully processed. Rather, it is processed in waves that could last for the remainder of one's life."

Even though anticipatory grief might not be fully treatable, speaking with a therapist can help. "Talk with a licenced therapist who specialises in grief or trauma, who can help you make sense of your thoughts, feelings, and actions," Mirasol tells POPSUGAR. "A therapist will help you accept reality, provide coping tools and strategies, and help you make meaning of your loss."