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Meaning-making is a stage of grief that helps us integrate grief into life purposefully.

Grief and depression may coincide but may be mutually exclusive; clinicians need to be sensitive to this.

Dr. Kübler-Ross, in her 1969 book, On Death and Dying, offered for the first time a framework for understanding grief, based on her research with terminal patients. Her model is not linear, and individuals may cycle through or revisit as needed.

Kübler-Ross, a psychiatrist, describes denial, the first stage of grief, as a defense mechanism where our minds numb us to the immediacy of the loss. The next stage is anger, where the denial gives way to feelings of anger at the pain experienced from the loss or at external circumstances brought about by the loss. The third stage is bargaining, where we might try to negotiate the pain of the loss away by perhaps imagining different outcomes. Then we may experience feelings of depression characterized by the weight of what has occurred, expressed with sadness, isolation, or hopelessness. The final stage is acceptance, which might be best described as learning to live with the permanent pain and changes it brings to how life was.

Dr. David Kessler, a grief expert, has added another stage he describes as meaning, which allows a person to move forward, honor the loss in some way, and find a way to integrate the experience into a purposeful life.

The DSM-5-TR pathologizes grief by calling it Prolonged Grief Disorder, and it adheres to a caveat of more days........

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