When I was 27, my mother told me she was dying of ALS, a fatal neurodegenerative disease with no cure. She died the following summer, and not long after, my father was diagnosed with cancer. He successfully completed treatment, but when the cancer returned, he didn’t survive.

From the moment my mother shared her diagnosis and leading up to my father’s funeral, it felt like my head was being held under water. I could only surface for enough air to survive, but not long enough to understand the enormity of what had occurred. Before I could come to terms with one loss, I was experiencing another.

A prior history of grief can affect the current grieving process. One study found people who lost more than one person in a short time still grieved one loss at a time, and that multiple losses affected various aspects of the bereaved individual’s life, like their health, job, and marriage.

This mental health phenomenon is often referred to as cumulative grief. I spoke to five grief experts about cumulative grief, and how to understand and manage the feelings that may arise from it.

What is cumulative grief?

Cumulative grief is the experience of multiple losses. The challenging aspects of grief can be exacerbated with each new loss, according to Litsa Williams, a licensed social worker and co-author of What’s Your Grief: Lists to Help You Through Any Loss, which can lead to fatigue and overwhelm. There is “the emotional piece, but also the other stressors — coping with the practicalities of settling an estate, sorting through belongings, family conflicts, financial strains,” she says via email. It can be hard to face a new loss when you feel like you’re starting at “half capacity.”

Sometimes after multiple losses, support systems are less engaged than they previously were, Williams adds. An additional loss can make a person feel like they need more support at a time when their support system is weaker than it previously was. “Support system burnout is also a real factor. With the first loss or first couple of losses, a person may have received a lot of support from friends and family. But unfortunately, with multiple losses stacking up, support systems can start to become less engaged,” she says.

While the term “cumulative grief” often refers to deaths that occur in rapid succession, says Cara Mearns-Thompson, the co-founder of the Grief Club of Minnesota and a licensed clinical social worker focused on grieving children, that time frame isn’t an essential component. The term is most often applied to losses in a short amount of time, but losses over any period of time can result in cumulative grief.

The close succession of losses can increase feelings of overwhelm, but the timing is less relevant because grief is a lifelong journey. “Cumulative grief is cumulative over a lifetime because we grieve for our entire lives. The intensity and impact of that grief changes over time, but we still grieve the death of those we love,” says Mearns-Thompson via email.

Grief isn’t limited just to human loss or death

Cumulative grief, like grief in general, isn’t limited to deaths, according to Ajita Robinson, a grief and trauma expert and author of The Gift of Grief: A Practical Guide on Navigating Grief and Loss. “It involves all losses that impact someone,” says Jana DeCristofaro, a grief support facilitator at the Dougy Center, a nonprofit that provides support services to children and young adults who are grieving, and host of the podcast Grief Out Loud, via email. Cumulative grief can refer to the loss of a pet or a symbolic loss, like the end of a relationship, loss of employment, a friendship ending, or a family separation.

“A lot of people have a difficult time naming their losses because our society is geared toward grief being limited to physical loss, and it really negates the impact of symbolic losses that we encounter on a daily basis,” says Robinson.

Secondary and tertiary losses can also result from a single incident. For example, “think of the death of a person as the first circle, and the outer rings would be the secondary losses,” says Mearns-Thompson. If an individual’s parent died, for example, Robinson says that would be a primary loss. The potential secondary loss could be financial instability due to the loss of parental income.

These secondary losses can contribute to a feeling that “everything” has changed. It can be an overwhelming, disorienting experience that can also be invisible to others — which can cause an even larger sense of isolation in the griever.

Grief can be a lifelong journey

Five years after my father died, I miscarried at 13 weeks pregnant, which triggered memories from my parents’ passing. “A death can often trigger the feelings of prior losses,” a therapist I was seeing at the time told me, which I’d never heard before.

It’s not uncommon that a new loss brings up old memories from a prior loss, according to Mearns-Thompson, but those feelings may surprise you. Many people believe that grief won’t have a long-term effect. “We believe that the work of grief just takes time. As time goes on, the impact will be less, but that’s not true,” says Robinson.

Grief is a lifelong journey. “We don’t grieve a death and then lock it up in titanium, never to be gone back to again. We go with our assumption and our belief that grief is non-finite — is something that we take with us for the rest of our lives, that it becomes part of who we are. And every new loss or death that we experience is going to overlap and interweave with our previous losses, and there are lots of different ways that that can show up,” says DeCristofaro.

Some grief therapists, like Mearns-Thompson and Robinson, take an inventory of a client’s prior losses during counseling. This is called a “loss history,” and the practice of recording it enables both the client and counselor to better understand the person’s prior experiences with grief, their coping styles, and to explore any new tools that they may need to manage their current experience.

There is no expiration date on grief. “A loss that happened five years ago, 10 years ago, 20 years ago, even 40 years ago, can continue to affect us throughout the course of our lives, but can also affect the way that we come to future losses,” says Joanne Cacciatore, professor at Arizona State University and founder of the MISS Foundation, an organization that provides support to families struggling with traumatic grief.

Prioritize taking care of yourself when you’re grieving

If you’re feeling overwhelmed by your grief, take the time and space you need to take care of yourself. “Treat it like a psychological wound that deserves care and attention,” says Robinson.

The same tactics that work to help grieving individuals through one loss can be applied to multiple-loss grief. Taking care of your physical body through nutrition, sleep, and movement, making time to journal or join a support group, and trying out remembrance activities like sorting through pictures or sharing stories are just some ways to help yourself work through your feelings, says DeCristofaro.

A counselor or therapist can also be an important part of the healing process. While support and community are extremely important when dealing with cumulative losses, sometimes you’ll find that your support system isn’t showing up for you or is stretched thin. Still, you should try to find independent and community-based ways to heal, and seek support through a counselor or therapist.

On a daily basis, exercise and sleep have helped me the most. And longer-term, speaking with a therapist, writing about my experience, and opening up more to my closest friends have also made it more manageable. With time, I’ve also learned to show myself more compassion when my grief arises, which has helped.

Don’t judge yourself for your feelings of loss

Multiple experiences of loss can be destabilizing and can lead to internal judgment, according to DeCristofaro. “Each time we experience a new loss, we experience ourselves grieving in a new way, and that can lead to judgment or criticism about how we have or haven’t grieved in the past, or what does it mean about the person and what they meant to us in our lives if we are responding really differently,” says DeCristofaro.

Sometimes we don’t grieve someone the way we anticipate, which can be confusing. If you lost someone as a teenager and then lose someone later as an adult, those grief experiences likely won’t be the same. As an adult, you’ve had years to mature and it’s easy to reflect on your younger self grieving with nostalgia, or at times criticism, says DeCristofaro. You may feel hit harder emotionally by the death of someone you had a complicated relationship with, or feel that you should grieve “more” for a current loss, says DeCrisotfaro.

These reactions are normal, and the more we understand that we can grieve each loss differently, the more we can give ourselves permission to do just that.

There isn’t just one way to grieve

You need to be compassionate with yourself, your grief, and how you’re feeling, says Robinson. “We often discount what our experiences are and tell ourselves that we shouldn’t feel that way. There is a lot of feedback that we receive about what we should do that often impacts our ability to just feel and grieve.”

Remember that there isn’t one way to grieve. You’re going to feel your grief in your own way and time, says DeCristofaro. “It is probably not going to fall on the same timeline as other people.”

Our reactions will be impacted by a variety of factors, such as how supported we feel by the people in our life, the relationship we had with the person we lost, and the context of what is going on in our life and in the world, according to DeCristofaro.

Whatever your reaction, it is important to allow yourself to feel the emotions that arise. “It’s when we’re shut down and we pretend that it didn’t happen and we suppress and inhibit our own emotional experiences, and the emotional experiences associated with traumatic loss, that we suffer — in my experience — even more,” says Cacciatore.

In instances of multiple loss, be aware of whether your grief and life stressors exceed your capacity to cope, says Williams. Williams prefers the term “grief overload” over cumulative grief or bereavement overload, which are often used interchangeably, because she believes that this is the central issue for multiple losses.

“‘Cumulative grief’ as a term suggests that the issue is simply the number of losses that is the challenge. In reality, the real issue is the overload that occurs when someone’s stressors exceed their coping capacity, and when, why, and how that happens varies dramatically from griever to griever,” she says.

Learn from prior losses

Multiple losses can be devastating. In the early period of grieving, it’s hard to see past that period of intense sadness. But prior experiences of loss can also serve “as a way to draw on hope and healing and a belief in a positive future,” says Mearns-Thompson.

We need to remind “people that they have survived and they have made it through” grief before, says DeCristofaro. “They know more than they think they do about how they navigate grief and what they value, and that they can use those skills in facing the same loss.”

The losses that I have experienced devastated me, and I can’t change that. But those experiences have also become a source of pride for the obstacles I have faced and learned to live with (and still do today). If you experience grief overload, don’t be afraid to ask for help or reach out for support. It can be hard to do, but you’ll never regret giving yourself the care you deserve when facing a difficult time.

Katie Reilly is a freelance journalist based in the San Francisco Bay Area.

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