Anticipatory Grief: Signs, Causes, & Coping Tips

Published on: 23 Aug 2022
Clinically Reviewed by Elizabeth Keohan, LCSW-C

Whether it is disenfranchised grief, prolonged grief disorder, or even pet grief, everyone experiences grief at some point in their life. It’s a normal emotion, often in response to the death of a loved one or another significant loss. What happens, though, if you’re experiencing grief before you’ve gone through a loss? 

Anticipatory grief is the term used to describe when someone feels like they’re grieving even before they’ve actually faced any sort of loss. As the name suggests, anticipating future grief happens, and it can be a difficult part of the process when you know that a loss is looming or inevitable. 

It’s important to understand that anticipatory grief is a normal response when we’re expecting to have to grieve in the near future. Sometimes, even just the anticipation of losing someone or something important to you can have a significant impact. It can take a hefty toll on your psyche and mental well-being. 

Read on to learn more about anticipatory grief, including what signs to look for, what might cause it, and how you can cope if you’re experiencing it.   

Regular Grief vs. Anticipatory Grief

There are many parallels between regular and anticipatory grief, but also some key differences.

“Anticipatory grief is similar to regular grief in a few ways. Both invoke similar kinds of emotions but anticipatory grief can cause more emotional instability. This is usually because there might be times when a person feels more sad or alternatively more hopeful about not losing the person. Both types of grief can be coped with through therapeutic interventions.”

Talkspace Therapist Bisma Anwar, LMHC 

What is anticipatory grief?

Anticipatory grief means a caregiver or loved one is aware of someone’s terminal prognosis and has time to prepare for the loss. That said, while they may have time to prepare, the feeling of the upcoming loss can still be overwhelming. People with preparatory grief often have the same symptoms as normal grief.

It’s generally assumed that it’s the caregivers who are most affected by anticipatory grieving, but according to some research, an estimated 25% of patients themselves might also experience it. 

Anticipatory grief is the entire combination of all the reactions — affective, cognitive, social, and cultural — that both patients and families might feel as they are expecting loss.

What is normal grief?

Normal grief or conventional grief is what we go through once a loved one has passed away or another loss is experienced. Grief occurs in an estimated 50 to 85% of people who have a loss. As we heal from grief, we go through stages that can often include emotional distress, shock, numbness, and denial (and eventually, acceptance), especially if the loss was unexpected or sudden.

Dr. Mary-Frances O’Connor, an associate professor of psychology at the University of Arizona, points out that grief is natural and something we all go through – our minds and our bodies can react when we’re grieving. The majority of people are able to move through the process, recover, and eventually heal. Grief can be thought of as a healthy response to loss.  

Signs of Anticipatory Grief

Another way of further understanding anticipatory grief is to know the signs beforehand. Someone with signs of anticipatory mourning may feel some or all of the following:

  • Anger and irritability
  • Uncontrollable emotion
  • Anxiety, fear, or dread
  • Denial
  • Desperation
  • Guilt
  • Lethargy, lack of motivation, anti-social
  • Loneliness
  • Sadness, tearfulness

Stages of Anticipatory Grief

While most people are familiar with stages of the traditional grieving process, going through preparatory grief is unique. The University of Rochester Medical Center introduced the following stages of anticipatory grief to explain what someone may go through as they prepare for loss. 

Stage I: Death is inevitable

The first stage is realizing that your loved one is facing death and that a cure is impossible. Overwhelming feelings of depression and sadness are typical in this stage.

Stage II: Concern for the dying individual

Stage II involves extreme concern for a dying loved one. A spouse, family caregiver, family member, or significant other may reminisce about previous interactions and experience guilt or regret. The family caregiver is worried about their loved one, while the dying person can also experience preparatory grief.

Stage III: Rehearsal of death

While the name of this phase sounds ominous, it’s actually a necessary part of the anticipatory grieving process. Rehearsing the loved one’s death includes communicating with a loved one about their wishes (funeral plans, finances, family, etc.). In addition, most people say their goodbyes at some point during this phase.

Stage IV: Imagine life without your loved one

Stage IIII includes caregivers imagining what life will one day be like without their loved ones. For example, they may visualize significant holidays, life events, or special occasions without the dying person’s presence.

What Causes Anticipatory Grief?

Caregivers who have loved ones with a terminal illness are the most likely to experience preparatory grief. However, any significant change can cause someone to experience this form of grief — sometimes even if the change is exciting. 

The following scenarios are more likely to cause anticipatory grief for the caregiver, as the loved one may not be as likely to have the capacity to understand the circumstances: 

  • A loved one has been diagnosed with a degenerative disease, such as Alzheimer’s, dementia, or Parkinson’s
  • A child is diagnosed with a chronic (or possibly terminal) disease
  • The impending loss of a pet

However, the situations below can affect both the individual and their loved ones, as each can understandably have concerns about impending death.

  • End-of-life care for a loved one with a terminal illness
  • An impending organ transplant
  • A loved one facing amputation or another major medical procedure
  • A new job, new relationship, geographic move, or a teen leaving home for college
  • In-utero complications or premature birth

How to Cope with Anticipatory Grief

There are several ways you can learn to cope with anticipatory grief. Understanding what you’re feeling is the first step — then you can implement any of the following coping skills into your life so you can heal and survive. 

“There are a few helpful ways to cope with anticipatory grief such as seeking support from family and friends, connecting with the person they are going to lose and spending quality time with them, and engaging in therapy.”

Talkspace Therapist Bisma Anwar, LMHC 

Educate yourself about what to expect

Learn all you can about your loved one’s condition — understand the symptoms, the side effects, and the prognosis.

Share feelings with someone else experiencing anticipatory grief

There are many resources for support groups — online, in-person, or on the phone. A support group is a safe place for you to vent your frustrations and feelings. You can lean on others who might be going through a similar experience and can relate. 

Ask for help from family and friends

People are eager to help, so don’t hesitate to ask friends or family for love, understanding, and support if you need it. It’s important not to put your life on hold. You cannot take care of your loved one if you’re not taking care of yourself.

Create memories your family members can enjoy

Even though your loved one isn’t able to do the activities they once enjoyed, try to involve them as much as possible in small, simple joys. In the end, you might cherish these innocent, often mundane memories the most. 

Talk about unresolved feelings

It’s so important to resolve any issues between you and your loved one while you have the time. If they can, try to settle any financial or legal matters and discuss their end-of-life wishes. Have the tough conversations, hash things out, make amends, or just let them know how special they are. You won’t have regrets by sharing more with them. 

Get Professional Help with Talkspace

If you’ve ever wondered what anticipatory grief is, or you think you might be experiencing it, it’s a good idea to talk about it with a professional. Finding someone who focuses on grief therapy, whether that’s a counselor or therapist, social worker, psychiatrist, or psychologist, is a good idea and can be very beneficial.

Counseling may include:

Narrative therapists view people as separate from their problems and thus can help you look at your problems similarly. Through this therapy technique, you can begin to learn how to reframe loss.

Active listening may be helpful for those who want to talk about their feelings. This method can help you work through grief and prepare for the upcoming loss you’re going to need to navigate. 

Cognitive behavioral therapy helps you reframe evaluations of yourself, your world, and your future. It focuses on managing painful emotions and learning to change negative thought and behavior patterns into healthier ones.

For someone nearing the end, therapy might be a useful way to improve their quality of life and alleviate depression during the time they have left. 

If you’re interested in therapy and want to learn more, but aren’t sure where to start, you might want to consider Talkspace online therapy. Talkspace is an online therapy platform that makes the process of getting therapy simple and streamlined. Best of all, because it’s online grief counseling, you can get therapy wherever you are — at home, or anywhere that’s convenient. If you’re struggling with anticipatory grief and looking for support, reach out to Talkspace today.


1. Toyama H, Honda A. Using Narrative Approach for Anticipatory Grief Among Family Caregivers at Home. Glob Qual Nurs Res. 2016;3:233339361668254. doi:10.1177/2333393616682549. Accessed June 26, 2022.

2. Board P. Grief, Bereavement, and Coping With Loss (PDQ®). Published 2020. Accessed June 26, 2022. 

3. Speaking of Psychology: How grieving changes the brain, with Mary-Frances O’Connor, PhD. Published 2022. Accessed June 26, 2022.

Talkspace articles are written by experienced mental health-wellness contributors; they are grounded in scientific research and evidence-based practices. Articles are extensively reviewed by our team of clinical experts (therapists and psychiatrists of various specialties) to ensure content is accurate and on par with current industry standards.

Our goal at Talkspace is to provide the most up-to-date, valuable, and objective information on mental health-related topics in order to help readers make informed decisions.

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