Life is unpredictable, and it’s not often that we know exactly what to expect. However, sometimes there are instances where you know that something unfortunate and upsetting is going to happen — you’re just not sure when. That anticipation can be incredibly distressing and can impact your mental health, leading to anticipatory grief.

While grief is the response to a loss, anticipatory grief refers to the emotions that occur from an impending loss. Even though anticipatory grief occurs before the loss, it can still result in negative thoughts, emotions and behaviors that interfere with your overall quality of life. Anticipatory grief can be just as intense as grief after a loss. Along with negative emotions that often come with grief, anticipatory grief can also involve positive emotions, such as relief or preparedness.

Causes of anticipatory grief

When you think of grief, you’re likely thinking about the death of a loved one. Anticipatory grief often develops when you have a friend or family member who has a life-threatening disease or they’ve entered hospice. It can also occur if the person has been in an accident that caused severe injuries.

Anticipatory grief is not limited to negative events. It can develop for many types of loss and significant life changes that involve a perceived loss, including:

• Amputation
• Pending divorce
• Moving
• A child going off to college
• Retiring from a beloved career

Symptoms of anticipatory grief

Everyone handles significant changes or losses differently, though sadness tends to be the most common experience. By learning about the symptoms of anticipatory grief, you can gain a better understanding of your own grief and determine if you need further support.

Anticipatory grief can impact your emotional, psychological and physical health. Here are a few symptoms to be aware of:

Emotional symptoms of anticipatory grief, besides sadness:

• Feelings of guilt 
• Overwhelming feelings of anger
• Denial or disbelief of the impending loss
• Belief that you can prevent the loss
• Imagining different potential scenarios
• Trouble concentrating on your everyday tasks and obligations
• Withdrawal and isolation from others
• Anxiety

Physical symptoms of anticipatory grief:

• Loss of appetite
• Difficulty falling or staying asleep
• Exhaustion
• Digestive issues

Since anticipatory grief involves symptoms of anxiety and depression, it’s important to talk to your health care provider about a potential generalized anxiety disorder or major depressive disorder diagnosis if those feelings are persistent or worsening.

Stages of anticipatory grief

Just like typical grief, people often go through phases of the anticipatory grieving process. The symptoms that we’ve discussed may come and go throughout the different stages. It’s important to note that the stages of anticipatory grief aren’t linear and can be different for everyone. You may start at the second phase before going to the first. And that’s OK.

• Stage 1: Acceptance — You’ve come to terms with the reality that the loss is inevitable.
• Stage 2: Concern — You may reflect on the negative aspects of your relationship with the person, such as past arguments, and feel concerned about the person and your regrets.
• Stage 3: Rehearsal — You think about what will happen after the loss, likely resulting in saying goodbyes and becoming preoccupied with required arrangements.
• Stage 4: Picturing the future — You start to think about what your life will look like following the loss, such as holidays. 

How to cope with anticipatory grief

Coping with anticipatory grief can help you maintain your everyday routines while still being able to process the impending loss and changes. Here are some ways that you can alleviate the symptoms of anticipatory grief:

• Prioritize self-care — When you’re anticipating a loss, especially a loss that involves another person, it can feel like it’s taking over every aspect of your life. Taking care of yourself is essential for dealing with the distress and negative emotions. That’s why it’s important to integrate self-care into your everyday routines. Self-care can include meditation, spending time in nature and journaling about your emotions.
• Don’t hide — It’s not always easy to acknowledge your feelings, especially when it feels like you’re too busy to process them due to the responsibilities that can come from an impending loss. Even so, it’s important not to ignore your emotions or hide them away. By allowing yourself to feel sad or angry, you’re validating your feelings while also helping to ease them away. When you push them down, it can be difficult to move along the grieving journey.
• Lean on a support system — Similar to the previous point, it’s not easy to be vulnerable with your feelings out of fear that you’ll be seen as “weak” or “too emotional.” Having a support system of people you can trust is essential for anticipatory grief. By opening up about your fears, you can find comfort in others and reduce the sense of loneliness that can come from an impending loss.

• Seek therapy — When you’re struggling to cope with anticipatory grief, it can be beneficial to talk to a mental health professional, such as a psychotherapist. A therapist can help you work through the phases of your grief, understand the underlying issues behind the symptoms, and develop the coping mechanisms you need to deal with the impending loss, such as stress management techniques. They can also help you address symptoms of co-occurring conditions, such as anxiety and depression.

At Lightfully Behavioral Health, our levels of care can help you gain a better understanding of your anticipatory grief and the coping mechanisms needed to manage it. Our Intensive Outpatient Program (IOP), as well as our virtual IOP, can help people with anticipatory grief that’s impacting their overall quality of life. It can also help you manage potential depression and anxiety symptoms that may come along with it.

When you’re ready to take the first step to coping with anticipatory grief, reach out to our Admissions Concierge Team. We’ll take the next steps together, toward the fullest, brightest version of you.