Physical reactions.
While physical manifestations of grief such as fatigue, aches, and pains may very well be related to the stress we experience in grief, any persistent physical complaints ought to be evaluated by a physician. Be sure your physician knows that you are grieving a significant loss.

Grief that is disabling.
Seek counseling if grief is critically interfering with key roles in work, school, or at home, especially if you cannot seem to minimally function in those roles.

Extreme anxiety or sadness.
While anxiety and sadness are normal reactions to loss, seek help if they seem severe or disabling. If you have a history of anxiety or depression, it might be worthwhile to be proactive and seek help.

An intense inability to speak of the person who died or an extreme unwillingness to make any changes in his or her room.
If these or other minor events trigger intense reactions, they should still be evaluated.

Destructive behaviors.
While anger is a natural part of grief, intense anger or thoughts of hurting others should be a sign to seek help.

Self-destructive behaviors.
Thoughts of suicide, excessive drinking, or excessive use of dependence upon prescription medications or illegal drugs are signs that one should seek immediate help.

If you feel you need to speak to a counselor, you should do so. 

Developed from Journeys with Grief: A Collection of Articles about Love, Life and Loss, edited by Kenneth J. Doka, Ph.D., MDiv., copyright Hospice Foundation of America, 2012.