Unraveling the Neurobiology of Grief: Insights into Brain and Behavior–Narrative Review

Abstract

Grief is a universal yet multifaceted emotional response to loss, profoundly affecting psychological and biological systems. This review aims to examine the neurobiological mechanisms underlying grief, with a particular focus on prolonged grief disorder, a condition characterized by persistent, maladaptive grief symptoms that extend beyond culturally normative grieving periods. This narrative review synthesizes recent findings on the neurobiology of grief. Hormonal dysregulation, such as elevated oxytocin and cortisol levels, plays a significant role in the physiological response to grief. Epigenetic modifications of stress-related genes further contribute to individual variability in grief responses. Neural alterations are observed in key brain regions associated with memory, emotion regulation, and attachment, including the amygdala, hippocampus, and prefrontal cortex. Dysfunction of the hypothalamic-pituitary-adrenal axis, coupled with disruptions in the default mode network and reward systems, have been implicated in the persistence of pathological grief symptoms. These neurobiological disruptions reflect the interplay among emotional processing, cognitive regulation, and the stress response during grief. By improving our understanding of the biological basis of maladaptive grief responses, these findings provide a foundation for developing targeted therapeutic interventions and guiding future research to better address the needs of individuals experiencing prolonged grief.