Anticipatory grief: Causes, symptoms & treatment

Anticipatory grief is the feeling of foreboding, overwhelm, and sadness that we might feel before experiencing a significant loss. Although our worries about the future may never come to fruition, that doesn’t mean that our emotions aren’t real.

Anticipatory grief symptoms can be difficult to manage, though, especially when they’re attached to an expected loss that we know is almost guaranteed to occur. And even though our feelings of helplessness may feel overwhelming at times, there are ways and modes of coping that can offer relief in the face of anticipatory grief.

What Is the Difference Between Grief and Anticipatory Grief?

As explained above, anticipatory grief occurs when there is an almost guarantee or significant likelihood that an individual will experience a significant loss in their life. While similar in symptoms, the forehand knowledge of an impending significant loss (anticipatory grief) is different from “traditional grief,” which occurs after the loss has already occurred.

What Causes Anticipatory Grief?

Waiting for the impending emotional consequences of a significant loss causes anticipatory grief. A significant loss might be: 

• The loss of a loved one
• A terminal illness diagnosis (for oneself or a loved one)
• The death of a pet
• Saying goodbye to a child who’s leaving to attend college
• Losing a child due to custody rights
• Caretaking for an ailing parent 
• And many other unique circumstances and situations

Anticipatory grief may feel like a massive wave of impending doom—and waiting for the consequences of the unpleasant changes ahead can be extraordinarily difficult to cope with. 

What Is an Example of Anticipatory Grief?

Two possible examples of situations that might create anticipatory grief include: 

• A husband receives the news that his partner has a terminal cancer diagnosis and will most likely die within 6 months. Hearing and processing this news, the non-sick partner notices that he is distancing himself from his husband as a way to “detach” before he dies. 
• A young woman plans to leave her hometown in order to attend a university hundreds of miles away. After receiving her acceptance letter, she begins to dread saying her goodbyes to the friends and family she must leave behind. 

Someone who is experiencing anticipatory grief may notice an increase in anxiety, worrying, impulsive behavior, depressive symptoms, and fatigue. Learn more about the signs of anticipatory grief symptoms below. 

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How Do I Know If I’m Dealing with Anticipatory Grief? Signs and Symptoms

Here are some questions you can ask yourself to help identify if you are experiencing anticipatory grief symptoms: 

Have I received notice or knowledge of an impending situation that will cause significant loss in my life?

• Have I noticed any changes in my thought patterns?
• Have I noticed any changes in my moods or experienced emotions?
• Have I been engaging less with my friends, family, or partner?
• Have I been self-isolating?
• Have I been over-indulging with food, drugs, sex, or shopping in order to cope with anxiety or depressive thoughts? 
• Am I noticing any disruptions in my daily life, work, school, job, or relationships?

If these self-check questions are getting answered “yes,” it’s possible that you’re grappling with anticipatory grief. 

How Long Does Anticipatory Grief Last?

There’s no timeline on how long anticipatory grief symptoms will last, as they develop from the pent-up anticipation of losing something or someone important. Anticipatory grief lasts from the moment you have knowledge of the incident to when the incident occurs, and anticipatory grief may transform into “traditional” grief.

With “traditional” grief, there are usually 5-7 stages that mental health professionals recognize. But with anticipatory grief, the process is far less linear. The individual’s mind attempts to understand and resolve the potential impact of a loss before it has actually happened. 

Processing anticipatory grief might involve: 

• Accepting that the loss is unavoidable. This might involve acceptance of a breakup, divorce, custody loss, friendship, or even the death of oneself or a loved one.
• Battling feelings of regret. The individual may look back on past arguments, failures, mistakes, and more, wishing that they had done something differently. 
• Preparing for the loss. The individual may prep for their own funeral or that of a loved one, or begin packing in order to move to a new location. They may begin saying goodbye to an ailing loved one or partner which they’re leaving far in advance of actually losing them. 
• Imagining the future. This stage is highly dependent on the circumstances involved but could entail picturing life without their loved one, a romantic partner—or even life after death itself. 

Depending on the circumstances, this process may last only a few days, or perhaps a few years, or longer. 

How to Deal with Anticipatory Grief and Find Treatment 

Here are some common coping strategies recommended to clients dealing with anticipatory grief: 

• Get connected. Tell at least one person in your life who you use as support about your anticipatory grief. This helps you have someone with whom you can regularly check-in.
• Get involved. While the anticipation of a grief event can be daunting, making sure you’re engaging in your hobbies and activities that are energizing is important. This also could be a great time to channel your increased emotional energy into something healthy, like learning a new hobby.
• Cover the basics. Drink water, eat regularly, and get 7-9 hours of sleep a night.

But these are just the basics. Receiving grief counseling from a therapist and additional mental health support from a psychiatric provider could make all the difference in dealing with anticipatory grief symptoms. Common counseling methods used to treat anticipatory grief include:

• Cognitive behavioral therapy (CBT) can help someone who is experiencing anticipatory grief to reevaluate the situation that is causing them distress. CBT can help identify distress, depression, and anxiety related to the grieving process—and offer realistic and nurturing coping skills to prevent suffering in the short and long-term. 
• Acceptance and commitment therapy (ACT) focuses on creating manageable, actionable steps that the individual can take during the anticipatory grief process. ACT can assist by inviting the individual to accept the negative feelings they’re struggling with, rather than running from them—and through that process, help the individual to commit to making positive changes. 
• Narrative therapy offers the chance to develop an increased sense of self-worth and confidence in the face of anticipatory grief. Narrative therapy allows the individual to talk through their “story,” reflecting on the events and outcomes that led to the impending loss they’re facing. Through re-telling their journey to their therapist, the individual will have the opportunity to highlight their strength and resiliency in the face of adversity. 

Ultimately, anticipatory grief can be better managed with help from a professional—but reaching out is up to the individual experiencing the symptoms. With time, improved coping skills, and the resolve to face the unknown, those who are at grips with anticipatory grief can become more empowered, ready to face life’s changes.