Grief counselling onlineLive with loss at your own pace.

The NHS describes many common reactions to bereavement: shock and numbness, overwhelming sadness, tiredness, anger, and guilt, sometimes about things said or not said (NHS). Feelings can come and go, and intense ones can arrive unexpectedly, sometimes months later. There is no right or wrong way to feel.

Grief also lives in the body and in daily routines. You may sleep badly or too much, lose your appetite, forget things or struggle to concentrate at work. Familiar places and dates can become painful. Some people feel driven to keep busy; others can barely get out of bed. All of these can be part of an ordinary, if deeply painful, response to loss.

The well-known "five stages" of denial, anger, bargaining, depression and acceptance can be a helpful vocabulary, but they are not a ladder. The NHS notes that people may not go through all of them and may not experience them in a set order (NHS). Acceptance, when it comes, does not mean being fine with what happened. It means being able to live alongside it.

For most people, the sharpest edges of grief soften with time. For some, they do not. The NHS notes that grief can last many months or years and that this is more likely after a traumatic, sudden or unexpected death; it calls this prolonged grief disorder (NHS). Prolonged grief disorder is now included as a distinct condition in the World Health Organization's ICD-11 classification, a change designed to help clinicians recognise people whose grief has become stuck rather than to label ordinary mourning (Killikelly & Maercker, 2017). Signs the NHS mentions include intense feelings that do not ease and thoughts of suicide.

How common is this? A systematic review and meta-analysis of 14 studies of adults bereaved through non-violent deaths estimated a pooled prevalence of prolonged grief disorder of around 9.8%, or roughly one in ten, with higher rates among older people; the authors caution that the studies vary considerably (Lundorff et al., 2017). Most grieving people, in other words, do not develop a disorder, but a meaningful minority need more than time.

Grief counselling does not try to remove the pain of loss, which is bound up with love. It aims to help you carry it in a way that allows life to continue. Our therapists work in an evidence-informed, integrative way and tailor the work to you. Depending on your loss and what you need, counselling may include:

Consider reaching out if:

• months after the loss, the pain is as intense as it was at the start;
• you cannot accept the death, or feel life has lost all meaning;
• you are avoiding anything that reminds you of the person;
• you have had low mood for more than two weeks, or self-help is not working;
• you are drinking more, not eating, or unable to work or look after yourself;
• you are thinking about wanting to be with the person who died, or about ending your life.

The last point needs urgent attention. Please contact emergency services or a crisis line rather than waiting for a session; online counselling is not an emergency service.