Until recently, the physical and mental symptoms of grief were underacknowledged and underdiscussed. That left people who had experienced significant loss wondering why they weren’t feeling better a year later, why their feelings became more intense at unexpected times, and how joy and grief could coexist.

Amanda Kloots, author, entrepreneur, and host of the Good Grief podcast, has asked these questions in the years since her 41-year-old husband, Nick Cordero, died of Covid-19 complications in 2020. She has shared with millions the story of how she navigated the grief, trauma, and unexpected anxiety that followed, and how therapy helped her cope with these complex emotions and symptoms.

“I thought after a year I’d be much better than I was,” she said. “I thought I’d get a grief certificate, like you graduate from it. But that’s not how it happened.”

The reality, according to Thea Gallagher, PsyD, a clinical psychologist at NYU Langone Health, is much more individual. “Grief is a normal human experience that looks different for everyone,” she said.

Here’s what Dr. Gallagher and Kloots want you to know about what grief actually looks like, how it overlaps with anxiety and depression, and what anyone moving through loss can do to support their own healing.

What Are the Symptoms of Grief?

Grief is much more than an emotional experience—the physical symptoms of grief affect how people sleep, eat, move, socialize, and find meaning in daily life. Common symptoms include:

• Anxiety, including panic attacks, racing thoughts, or waking at night in fear
• Depression, with low energy, withdrawal from preferred activities, loss of motivation, and difficulty experiencing joy
• Sleeping too much or too little
• Difficulty concentrating, including brain fog, forgetfulness, and trouble making decisions
• Other physical symptoms, such as fatigue, changes in appetite, headaches, or body tension

Kloots experienced many of these, including one that surprised her the most. “It changed everything about me,” she said. “During the second year, I had the worst anxiety of my life—it came out of the blue and I could barely breathe.”

What Are the 5 Stages of Grief—and Do You Experience Them in Order?

The five-stage model of grief—denial, anger, bargaining, depression, and acceptance—is one of the most widely recognized frameworks in psychology. It’s also widely misunderstood.

“The stages suggest that you’ll feel this and then this, in order,” said Kloots. “But that’s not how it happened for me.”

Dr. Gallagher noted that while the stages are helpful in reminding us that grief carries a wide range of emotional experiences, grief doesn’t follow a linear pattern.  “Symptoms resurface, intensity fluctuates, and it looks different for everyone,” she said. “Someone might feel something like acceptance for a period, then be blindsided by an acute wave of loss months or even years later.”

How Long Does Grief Last?

Just as symptoms evolve over time and vary for each individual, there is no universal timeline for grief—and that uncertainty can be difficult for many grieving people to accept.

Now six years out from Nick’s death, Kloots described grief not as something she has moved past, but as something that has evolved alongside her. “As we grow and evolve and change, so does our grief,” she said. “It lives with me for the rest of my life.”

Dr. Gallagher said that what mental health providers hope to see over time is not the absence of grief but a bittersweet quality: the ability to mourn a loved one while also recalling the good things about them with a spark of joy. “That is when people no longer feel stuck in their grief, when they can hold those two feelings together,” she said.

Can Grief Cause Anxiety and Depression?

One of the most important clinical questions around grief is how it relates to anxiety and depression. The answer is that the three can and often do exist together, so understanding the relationship between the symptoms and the loss is an important part of evaluation and care. “Grief generally has an identifiable connection to loss, while anxiety and depression can arise more organically,” said Dr. Gallagher.

Kloots’s experience of severe anxiety two years after her loss illustrates how grief and anxiety can become intertwined in ways that aren’t always predictable. Her anxiety was real and disruptive, and it needed to be addressed on its own, rather than dismissed because she was “still grieving.”

What Is Prolonged Grief Disorder?

When people remain overwhelmed by feelings of grief after about one year following a loss, they may be experiencing prolonged grief disorder. “It’s when people remain stuck and unable to adequately process their grief after a prolonged period of time,” said Dr. Gallagher.

Signs of this condition include withdrawal from life, a persistent inability to reengage with meaningful activities, and an inability to access positive memories of the person who died. This is a recognized clinical condition that usually responds well to treatment, including specialized forms of therapy.

How to Cope With Grief

While there is no single “right” way to grieve, there are approaches that research and treatment consistently support.

Pay attention to changes in how you’re feeling and functioning. Dr. Gallagher recommends starting with self-monitoring: Are you enjoying things the way you used to? What has changed in how you’re sleeping, exercising, or socializing? Has anything drastically changed in a significant period of time? Noticing these changes is the first step toward addressing them.

Move your body. The grief process changed Kloots’s relationship with movement forever. “It is a privilege to move my body every single day,” she said. “I don’t go a day without doing something.” Dr. Gallagher confirmed that exercise, combined with healthy nutrition and sleep habits, is one of the most evidence-supported tools for mental health. “Even 5,000 to 7,000 steps per day has huge benefits,” she said.

Find community and connection. Kloots walks regularly with other widows, and described that combination of movement, conversation, and connection as deeply sustaining. Dr. Gallagher recommends finding grief groups specifically, since being around people who understand the experience firsthand can be immensely helpful.

Consider therapy—and find the right fit. Dr. Gallagher suggests seeing a provider who uses evidence-based treatment and collaborates with you to find an approach that works for you. Kloots cycled through therapists for years before finding one she truly connected with. “If I leave a therapy session feeling 1 percent better, it’s worth it,” she said.

Take small steps toward what matters to you. For people feeling guilty about reengaging with life, whether it’s dating again, experiencing joy, or returning to activities they once loved, Dr. Gallagher recommends focusing on personal values rather than fear. “It’s about taking small steps to reach your goals, not doing it all at once,” she said.

When Should You Seek Help for Grief?

Professional support is worth seeking when grief, anxiety, or depression significantly interfere with your ability to socialize, care for yourself, experience positive emotions, or reengage with life or work.

Grief groups can offer a valuable first resource for people who aren’t sure whether they need formal therapy. For others, an important next step is to connect with a provider who offers evidence-based treatments and can coordinate with a psychiatrist if medications are needed.

The Future of Grief and Mental Health Treatment

Mental health treatment is evolving, with developments like precision medicine leading the way. “We are working to use a deeper understanding of a person’s biology, history, experiences, and needs to determine what therapies are most likely to work for them,” said Dr. Gallagher.

She also pointed to a broader cultural shift, with the stigma around mental health becoming less powerful. “We used to think people were either sick or well,” she said. “Now there’s a new space of well-being and wellness where we think about our mental health like we do our physical health.”

For Kloots, the question of what grief teaches has become a central one. “Death taught me how to live,” she said. “It’s not just about surviving—it’s about how to live with grief.”

At NYU Langone, a team of psychologists and psychiatrists can help you understand what you’re experiencing with grief and connect you with the support you need. “If you’re asking whether it’s time to get help, that question alone is reason enough to reach out,” said Dr. Gallagher.