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Understanding Compounded Grief and Mental Health

May 2, 2025

Loss is an inevitable part of life, and feeling and expressing our grief is a sign of our humanness. We mourn and grieve the death of a loved one or the end of a marriage because it illustrates their value to us and the void their absence creates.

Grieving over the loss of one person or thing — the myriad of emotional waves that may ebb and flow, surface and disappear — can be life-changing enough for most of us. When multiple losses occur in near succession, finding yourself facing a new loss before you’ve had a chance to recover from the last, the waves of grief can be difficult to chart.

This type of compounded grief builds upon itself, making it harder and more challenging to cope with each loss all at once. Not only can it affect how you grieve, but it can also weigh heavily on your mental health.

How do you make sense of compounded grief when the pain of multiple losses at once has piled up faster than you can process? Becoming aware of how compounded grief takes shape can help you begin the grieving journey, and treatment can help.

What Is Compounded Grief?

Typical grief normally heals when we’ve had time to reflect, mourn, and reconcile the emotions we’ve felt after losing something or someone important. When it’s one loss in a single instance, we’re more likely to have the space to focus on our grief without it affecting other parts of life.

On the other hand, compounded grief, also known as cumulative grief, happens when someone experiences multiple losses or traumas over a somewhat brief period of time. It can create a layered and complex grieving process, making it harder to mourn the losses individually since each one overlaps with each other.

“Research shows that while the losses may relate to various causes, intensities, and areas of your life, they can be harder to cope with than individual losses because of the compounding effect,” notes a study by the National Healthcare for the Homeless Council.

Cumulative and compounded grief and loss are types of grief that can arrive in many forms:

Losing multiple family members or friends within a short timeframe

Facing a major loss — like the death of a parent or a beloved pet — while also dealing simultaneously with significant life changes, like a divorce or the end of a meaningful relationship, a job loss, or getting diagnosed with health issues

Losing contact with former in-laws, stepchildren, or friends of a spouse/romantic partner after a breakup

Mourning the loss of a relationship, but also a future you anticipated with your former partner

Experiencing compound loss during a collective traumatic event, like losing a loved one during COVID-19

A spouse’s death can cause financial troubles — and even home displacement — if they were the primary earner

Losing your home and personal possessions to a natural disaster

Having a traumatic loss triggers unresolved past grief

A singular loss on its own can create grief that may feel insurmountable. A combination of losses together or in succession lessens the opportunity to give each loss the time and emotional bandwidth it needs.

“With cumulative grief, you’re working through multiple losses at once. For example, you’re not only grieving the loss of a child. You’re grieving the ending of a marriage that followed that loss,” notes the Cleveland Clinic. “Grieving multiple losses simultaneously makes the process difficult and complex in unexpected ways.”

Studies show that certain demographics are more vulnerable to suffering from compounded grief than others, like those who struggle with mental health or substance abuse issues; people with few to no social support systems; those exposed to situational trauma (such as public health workers); people exposed to environmental losses, like living in a war-afflicted area; and elderly people losing friends and acquaintances of a similar age.

Compounded Grief vs Normal Grief

Grief is universal. We’re all capable of experiencing profound, painful grief, even more deeply than we might have expected over potential losses we once thought minor. These feelings gradually diminish and become less acute — your pain, less frequent — as the body and mind, built to seek out a default state of calm and clarity, cause grief to eventually dissipate.

There are some ways in which compounded grief vs normal grief differ:

Intensity and duration: Normal grief often follows a general trajectory — initial shock, deep sadness, anger, guilt and gradual adjustment — whereas compounded grief is a cumulative combination of emotions. Greater in intensity, they may prolong the grieving period.

Emotional overload: Bereavement experts call it “grief overload.” “The losses can come from various sectors, but put together, it’s a big pile of grief and loss to deal with,” says funeral planning organization Funeral Basics. This emotional turbulence often feels disproportionate to any one single loss, where, unlike regular grief, none can be given the focused attention they deserve.

Compromised grieving and coping: Unlike normal grief, compounded grief can also make one feel conflicted in how to cope and mourn losses, especially when both losses are unrelated and bring about different emotional responses (i.e., the death of one’s mother or father and being laid off from work within the same month). “Individuals may experience conflicting emotions or difficulty in expressing their grief, leading to a sense of disorientation or emotional numbness,” notes Willowbrook Cemetery’s website. “This complexity may interfere with the natural progression of mourning.”

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What Are the Signs and Symptoms of Grief?

Dealing with grief can manifest itself in a host of ways and touch every aspect of your being:

Physical Symptoms of Grief

Grief is often mistaken as affecting only your emotional and mental states. But compounded grief can weigh heavily on your body, including:

Fatigue and low, lethargic energy

Restlessness

Sleeping too little (insomnia) or too much (hypersomnia)

Chest or throat tightness

Heart palpitations

Changes in appetite or weight

Headaches

Nausea and upset stomach

Weakened immune responses risk more frequent illness

Mental Symptoms of Grief

Compounded grief can have a significant impact on your cognitive functioning, affecting your mental health, which can result in behavioral changes:

“Mental fog” — difficulty concentrating or focusing

Memory problems or forgetfulness

Having trouble making decisions

Preoccupied thoughts of the loss you’re grieving

Feeling hopeless and questioning your beliefs or purpose following a loss

Emotional Symptoms of Grief

Grief’s emotional impact can be unpredictable in many ways. You may be feeling better months after a divorce or breakup, but then return to feeling sad after seeing something reminding you of a former partner or memories you shared. “One minute, life may feel as if it were back to normal, and the next, you may find yourself in tears,” states the Cleveland Clinic. Here’s how the landscape of grief’s emotional symptoms can take hold:

Persistent and profound sadness and crying spells

Feeling angry, irritable, or resentful — at yourself or toward others

Guilt, regret, or shame

Anxiety and a subsequent sense of constant worry

A sense of emotional detachment or numbness

Feeling a mix of conflicting emotions is also common in compounded grief. For instance, you might express sadness over a loved one dying, yet relief that they’re no longer suffering. The sadness may also be mixed with feelings of guilt or regret that you didn’t get to say goodbye to them one last time or spend more time with them in their final days. A difficult breakup or divorce may leave you angry at an ex-partner or spouse while also missing them and hoping for reconciliation. While these types of feelings may seem contrasting and almost counterintuitive, they speak to the complexity of how we deal with grief.

How Does Grief Affect Mental Health?  

While grief itself isn’t a mental illness, the totality of compounded grief and loss can trigger or exacerbate mental health conditions. “You may not be prepared for the intensity and duration of your emotions or how swiftly your moods may change,” states the organization Mental Health America. “You may even begin to doubt the stability of your mental health.”

Consider some of the common symptoms of grief. When grief from a single loss remains unresolved or is compounded by new losses, one’s mental health may worsen.

You may find yourself feeling hopeless, consistently sad, unable to sleep, withdrawing from friends and family, losing interest in activities you once enjoyed, or struggling to maintain daily routines — common symptoms of the onset of depressive disorder. And in some cases, compounded grief can lead to substance use as a means of self-medicating and coping with painful emotions.

The weight of compounded grief may also lead to the development and diagnosis of prolonged grief disorder, when a person’s failure to move on after the loss of a loved one more than one year ago affects their mental health and well-being.

“An individual with prolonged grief disorder may experience intense longing for the person who has died or preoccupation with thoughts of that person,” says the American Psychiatric Association. “(They) may experience significant distress or problems performing daily activities at home, work, or other important areas. The persistent grief is disabling and affects everyday functioning in a way that typical grieving does not.”

The Importance of Professional Help for Compound Grief  

We might often believe that dealing with grief on our own is a sign of strength, but pursuing help is a sign of weakness or defeat — that you’re unable to cope with loss and manage your emotions on your own.

But this couldn’t be further from the truth. Consider the invaluable benefits that grief counseling can provide for compounded grief. One-on-one with a counselor, or in a group setting, you’re in a supportive, non-judgmental environment where you can openly and freely talk about your experiences and the journey of emotions you’ve been on.

Through therapy, you can start to process multiple losses with an intentional path to healing mapped out. How has your grief impacted your day-to-day functioning? Are the losses you’ve experienced related, or do the feelings you hold overlap or conflict?

Treatment helps you to find solace in grief — to process multiple losses without feeling overwhelmed, to integrate them into your life without letting them define you and to reconnect with meaning and purpose in your life when grieving and mourning have become all-consuming. A therapist will also be able to help you if substance abuse or other mental health symptoms are part of your story.

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How Long Does Grief Last?

Dealing with grief doesn’t ever follow a set timeline. Society pressures us into mourning quickly and move on from loss as soon as possible, but the truth is that grief takes shape and follows a different course and timetable for everyone. For some people, grief may begin to subside within weeks or months. For others with compounded grief or complicated grief, the grieving process may take longer.

“Although there is no clear agreement on any specific time period needed for recovery, most bereaved persons experiencing normal grief will note a lessening of symptoms after about six months,” notes a 2024 study.

“Multiple factors may influence how an individual or a social network adjusts to a death,” the study continues. “How people grieve depends on the personality of the grieving individual and his or her relationship with the person who died.”

It’s common to wonder if you are grieving too long or not long enough. The key is recognizing when grief is interfering with your ability to live fully. Keep in mind that it’s not wrong if your bereavement takes time — it’s a sign that the loss is important to you and something worth honoring.

“There is no ‘right’ length of time for a person to grieve,” notes the American Cancer Society. “It’s important for the person who has lost a loved one to be allowed the time they need to work through their grief.”

Stages of Grief

Pioneering psychologist Elisabeth Kübler-Ross, through her work with terminally ill people, realized that there are five stages of grief that define the emotional journey after loss:

Denial

When someone close to you passes away or a relationship ends, we don’t want to believe it. Initially, we may struggle to accept the reality of the situation. Disbelieving and denying the loss — even flatly refusing it to be true — becomes a protective mechanism. “Denial and shock help us to cope and make survival possible,” says Grief.com. “Denial helps us to pace our feelings of grief. There is a grace in denial. It is nature’s way of letting in only as much as we can handle.”

Anger

Why do we feel anger when dealing with grief? After suffering a loss, we may become angry at the unfairness of being robbed of someone close to us. You might blame a doctor for not trying hard enough to save the life of a loved one; a former partner for ending a relationship; or even God for not intervening and letting someone live. “It is natural to feel deserted and abandoned, but we live in a society that fears anger,” says the site. “Anger is strength, and it can be an anchor, giving temporary structure to the nothingness of loss.”

Bargaining

“It is common to be overcome by statements of ‘what if’ and ‘if only,’ as we experience a loss of control over what is happening,” notes Harvard Medical School. And during the bargaining phase of grief, we might feel like we’d do anything to reverse the loss and bring a person back to life or into our lives, even praying to and pleading with God to make it real. “We may even bargain with the pain,” states Grief.com. “We will do anything not to feel the pain of this loss. We remain in the past, trying to negotiate our way out of the hurt.”

Depression

The bargaining stage is a way of negotiating how we feel about suffering a loss. It’s a mental and emotional ploy to wish a situation was different. But over time, the magnitude of loss sinks in along with the realization that there is no going back in time or bringing someone back. This can lead to deep sadness, emptiness and despair taking hold in many cases. “Feelings of depression are a natural reaction to grief,” notes the Harvard Health study. “Following the loss of a loved one, acute grief can impact your functioning for a limited time.”

Acceptance

After navigating some or all of the other stages of grief, acceptance is when we’re finally able to accept the reality of a loss for what it is, with no illusions or pretentions. “Acceptance is often confused with the notion of being ‘all right’ or ‘OK’ with what has happened. This is not the case,” notes Grief.com. “Most people don’t ever feel OK or all right about the loss of a loved one. This stage is about accepting the reality that our loved one is physically gone and recognizing that this new reality is the permanent reality.”

The stages of grief are not linear, meaning that you may move back and forth between them, experience them in a different order, or experience just a few of them.

Mental Health Treatment for Compounded Grief   

Though grief, compounded grief and complicated grief are natural, that doesn’t mean it needs to adversely impact your mental health. Help for grief is available, and help is effective. Through talk therapy and other approaches, the goal isn’t to “get over” your losses but to help you integrate them into your life in a way that allows for healing and moving on. There are two primary types of treatment offered at our locations:

Evidence-Based Psychotherapy for Compounded Grief

Psychotherapy is a type of talk therapy designed to recognize, understand and change the underlying nature of a mental health issue. When it’s evidence-based, it means that it has strong research support for being effective in treating conditions in a clinical setting.

For compounded grief and loss, a number of different approaches may work well for you. One is Cognitive Behavioral Therapy, or CBT, designed to help you identify and challenge unhelpful thoughts related to grief and reframe your mental narrative — both to help you mourn and grieve more genuinely but also to arrive more readily at a place of healing and acceptance.

There’s also group therapy to hear from others who are experiencing compounded grief in their own way, plus a chance to speak to your own experiences and learn new coping skills while showing support for each other. Additionally, specialized grief counseling focuses specifically on the process of mourning, helping you understand and express complex emotions while developing strategies for moving forward.

Holistic Treatment for Compounded Grief

Holistic can be translated to mean “whole,” and holistic treatment is meant to address how issues like severe grief impact our wellness. Grief weighs heavily on each of them, creating imbalances in our mind-body-spirit connection — when your mind is weighed down and preoccupied with grief, it can affect our physical and spiritual health.

Holistic treatments like yoga, mindfulness meditation, tai chi and expressive arts therapy are just a few of the ways to help you stay grounded in the present, process and express your emotions and promote healing from bereavement.

Where to Find Professional Treatment for Grief    

Creating a mental health recovery action plan and finding professional grief counseling — compassionate care with a therapist committed to your healing — is just a click away on this site. Explore the Aliya site to see the different therapies and treatment plans we offer and read some of our other blogs on grief and mental health treatment.

Treatment can help you move forward if you’re dealing with compounded grief. If you have questions about treatment, we’re here to help answer any questions you have. Contact us today.

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