How to cope with anticipatory grief

Anticipatory grief is when you experience symptoms of grief before an expected loss. It often affects people facing terminal illness, but it can also come before other life-changing events, like moving or getting a divorce.  

It’s normal to grieve for lost moments, memories, and opportunities, but it’s important to balance those feelings with appreciation for the present. Below, we review the signs and stages of anticipatory grief, as well as healthy ways to prepare yourself for loss. 

Common symptoms of anticipatory grief

Grief is a natural human response to loss. And, for some people, anticipatory grief is part of that process. You might experience anticipatory grief after being diagnosed with a terminal or progressive disease. It can also be triggered by end-of-life planning for a loved one or learning that your child has a congenital condition. 

In other cases, anticipatory grief may relate to the idea of losing an important aspect of who you are. Life-changing events, like divorce or moving out of your childhood home, can cause intense emotional responses. The same goes for medical procedures that affect your sense of self, like a mastectomy. 

Anticipatory grief can involve a range of emotional responses, including sadness, anger, and desperation. It can also cause guilt, denial, and resentment. 

Other symptoms of anticipatory grief include:

• Trouble concentrating and focusing on everyday tasks 

• Sleep troubles, like sleeping too much or too little

• Change in appetite, like eating more or less than usual 

• Increased isolation and social withdrawal

How and why people anticipate loss

Grief isn't linear, and the process can feel different for different people. That said, some experts propose four stages of anticipatory grief that can show up in any order:

1. Acceptance: As you start to acknowledge what’s to come, it’s normal to experience feelings like sadness, shock, or depression.

2. Reflection: You may reflect on how it makes you feel. It’s common to think about memories of the person, place, or thing you’ll be losing. You might feel regret for lost opportunities or grateful for positive experiences. 

3. Rehearsal: At this point, people begin to prepare for their loss. You might imagine what you’ll think, feel, or experience during that time. Depending on your situation, you might even begin to make preparations. For example, you may start planning a funeral or selling your belongings. 

4. Thinking about the future: During this stage, people begin to imagine their lives after the loss. For example, what will life be like without your loved one? 

What happens when you grieve before death?

Loss can have a significant impact on a person's life, so it makes sense that you might start to grieve once you learn about change. In fact, some research suggests that anticipatory grief can cause more intense anger and emotional dysregulation than the grief you experience after an actual loss. 

Anticipating loss can affect your mental health in several ways. You might have trouble concentrating, pull away from family and friends, or become emotionally numb. Grieving at this stage might even make you feel guilty or like you're giving up on a loved one too soon. 

Anticipatory grief can worsen symptoms of mental health conditions like anxiety and depression. It can also be particularly challenging for people with obsessive-compulsive disorder (OCD). Many people with OCD have a low tolerance for uncertainty, which can make it difficult to cope with impending change. 

That said, anticipatory grief may present a few benefits. For some people, it provides a chance to develop a deeper or more meaningful connection with people or places in their lives. You might even feel more empowered to embrace your emotions or express your feelings.

Healthy ways to cope with anticipatory grief

Grief is a personal experience, and everyone deals with it in their own way. Anticipatory grief, in particular, can be difficult to navigate. You may be trying to prepare for what’s to come while enjoying what’s left of the moment. If this resonates with you, here are some healthy ways to cope with anticipatory grief. 

1. Acknowledge your emotions

Grief can cause many different emotions, so give yourself permission to sit with those feelings. Whether you feel sad, guilty, or relieved, recognizing your emotions can help you process what you’re going through. 

2. Focus on the present

It can be difficult to focus on the present when you’re grieving the future. If you find that your thoughts often drift to your future loss, look for ways to slow down and notice what's happening in the present. Mindfulness exercises — like meditation, journaling, and mindful movement — can be a good place to start. 

3. Show yourself compassion

Preparing for change can be difficult, and some days may feel more manageable than others. Remembering to show yourself compassion and kindness is an important skill for navigating these situations. 

You might try reciting a positive affirmation each morning, like, “I’m strong and brave.” You can also focus on treating yourself with kindness, like moving your body and making time for hobbies you enjoy. 

4. Stay connected

Research suggests that social support can help people cope with anticipatory grief — especially when it comes to losing a loved one. Spending time with close family and friends can help you feel safe, supported, and seen during your most vulnerable moments.

5. Speak with a therapist

Working with a therapist can be an effective way to process grief. If you’re finding it difficult to manage your emotions or make sense of your experience, therapy can provide the skills to cope with this difficult period. In some cases, you may even consider meeting with a psychiatric provider to add medication to your treatment plan.

Clinician's take

One insight I share with clients who feel guilty for grieving before a loss is this: Grief isn’t only about death itself. It’s also about the changes, uncertainties, and small losses along the way. Feeling sorrow in advance doesn’t mean you’re giving up hope or ‘failing’ your loved one; it means your heart is already honoring the depth of love you carry.

Ashley Ayala, LMFT

Clinical reviewer

Find care with Rula

Grief can be painful and overwhelming, even before the loss occurs. If you’re having trouble coping with anticipatory grief, consider working with a therapist. Talk therapy can help you process your emotions, focus on the present, and start healing.

At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best. 

Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we're here to help you make progress — wherever you are on your mental health journey.