When Grief Becomes More Than Sadness: How Loss Can Increase Risk for Psychosis
- Alison Arias
- Sep 17, 2025
- 2 min read
Grief is something we all go through, whether from the loss of a loved one, the end of a
relationship, or even life transitions we didn’t choose. But when grief is left unprocessed or
happens during vulnerable stages of development, it can show up later in more complex ways. In
some cases, especially for those with added stressors or trauma, grief may become a risk factor
for more severe mental health challenges, like psychosis.
What We Know About Grief and Mental Health
Grieving is not a linear process. Some people begin to feel emotionally lighter after a few weeks
or months. Others feel “stuck” in their pain for years. When grief is prolonged, complicated, or
tied to an especially traumatic event, it can overwhelm a person’s ability to cope.
A recent 2024 systematic review by Del Pozo-Herce and colleagues found that losing a close
loved one—particularly a parent or sibling—during childhood significantly increases the risk of
developing psychotic symptoms later in life. The risk was even higher when the death was
unexpected or when the grieving individual had limited emotional or social support.
Why Grief Sometimes Becomes a Deeper Vulnerability
Grief itself doesn’t “cause” psychosis. But it can interact with other risk factors, including:
Past trauma or emotional neglect
Social isolation or economic hardship
Medical or mental health conditions
Loss of a secure attachment figure (especially during childhood)
When someone is grieving and lacks emotional safety or tools to process their pain, the brain
may begin to misinterpret thoughts, sounds, or beliefs—especially under prolonged stress. This
is when grief-related psychotic symptoms may come, such as hearing the voice of the deceased
or feeling watched. While this doesn’t always indicate a full psychotic disorder, it’s a flag that
the grieving process has become more complicated and needs support.
What This Means in a Therapy Setting
As a therapist, we often see clients who feel ashamed or scared about the intensity of their grief.
They may say things like:
“I still hear their voice sometimes.”
“I feel like I never came back to myself after they passed away.”
“No one ever helped me talk about it—so I just moved on.”
When we take time to explore these experiences in therapy, what often emerges is deep,
unacknowledged pain that never had a safe space to land.
Therapy can help by:
Creating room to tell the full story of the loss
Exploring confusing or frightening emotions in a safe, validating environment
Connecting the dots between unresolved grief and current symptoms
Offering practical tools to restore emotional balance
Healing Is Still Possible
If you're struggling with grief that feels heavy, confusing, or like it's affecting your mental
clarity, you’re not alone and you’re not “going crazy.” You're human. And sometimes, our most
human moments need the most compassionate support.
Understanding grief as a potential risk factor doesn't mean you’re destined to develop psychosis
it means that by tending to your loss with care and support, you can protect your emotional well-
being in the long run.
Therapy provides a nonjudgmental space to process, integrate, and eventually soften the weight
of grief—before it becomes something harder to carry.
References:
Del Pozo-Herce, P., Gonçalves-Bradley, D. C., Landon, K., & Castelpietra, G. (2024). Grief as a
risk factor for psychosis: A systematic review. Schizophrenia
