Grief and Loss

Convo Africa Mental Health Knowledge Hub

Grief and Loss

Grief is a natural response to losing someone or something important. It can affect emotions, thoughts, the body, relationships, faith and daily life. This guide explains how grief develops, what can help, when symptoms may indicate prolonged grief disorder and how to access appropriate support.

Evidence-informedAfrica-relevantReviewed for clinical safety

Grief can feel like more than sadness

01Yearning and painA deep longing for the person, life or future that was lost.
02DisbeliefDifficulty accepting the loss or understanding who you are now.
03Body and thinkingSleep, appetite, energy and concentration may shift.
04Life narrowsRelationships, routines, meaning and the future may feel harder to access.
Clinically informedAligned with current grief guidance
Africa relevantLocal family, faith and economic realities
Action focusedClear steps for individuals and families
Connected careEducation, screening and therapy
Part one

Understanding grief

Grief is the mind and body’s response to significant loss. It is not automatically a mental disorder. It reflects attachment, identity, meaning and the practical changes created by the loss.

G
Grief

The emotional, physical, cognitive, social and spiritual response to loss.

B
Bereavement

The state of having experienced the death of someone important.

M
Mourning

The personal, cultural, family and religious expression of grief.

What does healthy grieving look like?

There is no single correct pattern. Many people gradually move between confronting the pain and attending to ordinary life. The aim is not to forget, but to adapt while maintaining a meaningful connection to what was lost.

Part two

Types of grief and loss

BE
Bereavement grief

Grief following the death of someone important.

AN
Anticipatory grief

Grief before an expected death or major change.

TR
Traumatic grief

Grief complicated by sudden or frightening circumstances.

DI
Disenfranchised grief

Grief that others do not fully recognise or support.

AM
Ambiguous loss

Loss without clear closure, including disappearance or dementia.

ND
Non-death loss

Grief after divorce, infertility, disability, migration or unemployment.

Important: the Convo PG-13-R screening is specifically for grief following a death.
Clarifying the problem

Grief, depression, trauma and prolonged grief

ExperienceCommon patternTypical focusNext step
Adaptive griefPain often comes in waves and gradually integratesThe person or life lostSupport, rituals and practical care
DepressionPersistent low mood or loss of interestSelf, life and future broadlyClinical assessment
Trauma-related stressIntrusions, avoidance and altered safetyThreat and traumatic memoryTrauma-informed assessment
Prolonged grief disorderPersistent yearning with marked impairmentThe deceased and difficulty adaptingGrief-informed assessment
Do not assume every symptom is grief. New, severe or persistent physical symptoms require medical assessment.
Recognising the signs

Grief symptoms and common reactions

E
Emotional

Sadness, yearning, anger, guilt, relief, numbness or fear.

T
Thinking

Disbelief, poor concentration, memories and “if only” thoughts.

P
Physical

Fatigue, sleep change, appetite change, tension or heaviness.

B
Behavioural

Crying, withdrawal, overworking or avoiding reminders.

S
Social

Changing roles, isolation, conflict or feeling misunderstood.

SP
Spiritual

Questions about God, meaning, fairness, hope or ritual.

CopingStrainedImpairedUrgentPainful, functioningMore support neededDaily life disruptedSafety at risk
Seek urgent support for thoughts of self-harm, inability to remain safe, severe confusion or inability to meet basic needs.
Mind and body

How grief affects the brain and body

Grief involves systems responsible for attachment, memory, threat detection, sleep and stress regulation.

GRIEFattachment + loss responseAttention and memoryStress systemsSleep and restorationBody and appetite
Why grief differs

What shapes the grieving process

R
Relationship

Closeness, dependence and unfinished conflict.

C
Circumstances

Expected, sudden, violent or stigmatised loss.

P
Previous experience

Earlier loss, trauma, health and coping patterns.

S
Support

Family, faith, community and access to care.

L
Life pressures

Finances, caregiving, housing and parenting.

CM
Culture and meaning

Beliefs, rituals and mourning expectations.

Interactive explainer

The grief adaptation process

Grief is rarely linear. Select each area to explore what can happen.

Taking in the reality of the loss may happen gradually, especially after a sudden death. Clear information, rituals and repeated supportive conversations can help.
The five stages are not a rule

Denial, anger, bargaining, depression and acceptance are possible reactions, not a compulsory sequence or a test of whether someone is grieving correctly.

Local context

Grief and bereavement in Kenya and Africa

Grief is shaped by family systems, community expectations, faith, funerals, economic realities and access to care. Many people carry grief while organising transport, fundraising, burial arrangements, hospital bills and support for dependants.

Community can protect and create pressure

Collective mourning may provide belonging, practical help and ritual. Expectations about strength, gender, faith, inheritance or public expression may also silence individual needs.

Faith can be a resource, not a substitute for care. Prayer, spiritual counsel and community can work alongside therapy, medical care and practical support.
Understanding your situation

How grief is assessed

Assessment explores the loss, symptoms, duration, cultural context, functioning, safety and possible overlapping conditions.

1The loss and relationship

Who died, when and the circumstances.

2Symptoms and functioning

Yearning, pain, identity, avoidance and daily life.

3Context and culture

Family, faith, rituals, finances and responsibilities.

4Other explanations

Depression, trauma, anxiety, substance use and health.

Start with a private adult screening

The Convo PG-13-R tool is for adults when at least 12 months have passed since the death.

When grief remains disabling

Prolonged grief disorder

Prolonged grief disorder involves persistent yearning or preoccupation with the deceased, additional grief symptoms and significant impairment beyond expected cultural, social or religious norms.

ADAPTING GRIEFPOSSIBLE PGD• Pain often comes in waves• Function gradually returns• Positive memories remain accessible• Persistent yearning or preoccupation• Severe difficulty adapting• Daily functioning is impaired
Timing matters. For adults, DSM-5-TR considers prolonged grief disorder after at least 12 months. Duration or a screening score alone is not enough for diagnosis.
Moving through grief

Coping and adaptation

1Stabilise basic needs

Protect food, water, medication, sleep and safety.

2Make room for grief

Use prayer, writing, tears, memory or conversation.

3Stay connected

Tell safe people what kind of support helps.

4Use rituals and memory

Carry stories, values and connection forward.

5Reduce pressure

Break tasks down and ask for practical help.

6Watch harmful coping

Alcohol, drugs and isolation may deepen distress.

Professional support

Treatment and therapy for grief

GT
Grief-focused therapy

Supports adaptation, emotional processing and re-engagement.

CB
CBT approaches

May address guilt, avoidance and disrupted routines.

TF
Trauma-focused care

For frightening memories or traumatic circumstances.

FM
Family support

Helps with roles, communication and different grieving styles.

MD
Medical care

Assesses sleep, pain and co-occurring conditions.

PC
Peer and faith care

Can reduce isolation and restore belonging.

Medication does not erase grief. A clinician may treat a co-occurring diagnosed condition. Do not self-medicate with alcohol or unprescribed drugs.

Speak with a qualified professional

Choose a therapist and attend securely through video, audio or chat.

Children and adolescents

How children experience grief

Children often move in and out of grief. They may cry and then play. This does not mean they have forgotten.

  • Use truthful, concrete language such as “died”.
  • Repeat explanations calmly and allow questions.
  • Protect routines and reliable caregiving.
  • Offer age-appropriate choices about rituals.
  • Seek assessment for persistent distress, self-harm or severe decline.
The adult PG-13-R screening is not for children.
For friends and families

How to support someone who is grieving

HelpfulAvoid
“I am sorry. I am here with you.”“Everything happens for a reason.”
Offer one specific task“Let me know if you need anything.”
Use the deceased person’s nameAvoiding the person because it feels awkward
Check in after the funeralPressuring them to move on
Respect culture, faith and silenceComparing losses
A useful message

“I have been thinking about you and about [name]. You do not need to reply. I can bring dinner on Thursday or help with errands on Saturday. Which would be easier?”

Connected support

Explore the Convo Africa ecosystem

Frequently asked questions

Questions about grief and loss

How long does grief last?

There is no universal timetable. Grief usually changes over time, and waves may return around anniversaries and milestones.

Are the five stages required?

No. They are possible reactions, not a fixed sequence.

How is grief different from depression?

Grief often centres on the loss and comes in waves. Depression more often involves persistent low mood or loss of interest across most areas.

Can grief cause physical symptoms?

Yes, but severe or persistent symptoms still need medical assessment.

What is prolonged grief disorder?

Persistent yearning or preoccupation with additional symptoms and significant impairment beyond expected cultural norms.

When should I take the screening?

For adults aged 18 or older when at least 12 months have passed since the death.

Evidence base

References and further reading

  1. American Psychiatric Association. DSM-5-TR.
  2. World Health Organization. ICD-11: Prolonged Grief Disorder.
  3. Prigerson HG and colleagues. Validation of DSM-5-TR criteria and the PG-13-R.
  4. Stroebe M, Schut H. Dual Process Model of coping with bereavement.
  5. National and international bereavement and mental-health guidance.
Clinical review

Reviewed for safety, clarity and clinical accuracy by Dr Fridah Wachira, Clinical Reviewer, Convo Africa. This page provides general education and does not replace individual assessment, diagnosis or treatment. Content owner: Convo Africa. Next review: July 2027, or earlier when guidance or local support information changes.