What is Grief?
Grief is a natural response to the experience of psychological trauma due to a loss.
Unlike physical trauma, it is not always outwardly visible but the emotional suffering we feel when something or someone we love is taken away is one of the most stressful experiences in life.
The more significant the loss, the more intense the stress will be.
You may associate grieving with the death of a loved one—which is often the cause of the most intense type of grief—but any loss can cause grief, even subtle losses in life can trigger a sense of grief, including
1. A divorce, a relationship breakup or the loss of a friendship.
2. A difficult diagnosis or a trauma that involves the loss of your physical health.
3. Retirement, losing a job or financial stability.
4. A miscarriage.
5. The death of a beloved pet.
6. The loss of a cherished dream.
Whatever your loss, it’s normal to grieve the loss you’re experiencing because it’s personal to you and with the loss you are not only grieving the person, the animal, the relationship, or the situation that was significant to you, you are also grieving the part of yourself that the lost relationship represented for you.
Learning to let go of that part of you that is lost as well is an important part of the grieving process and it is part of the ways you practice authentic self-care that brings you growth.
The Stages of Grief
In 1969, psychiatrist Elisabeth Kübler-Ross introduced what became known as the “five stages of grief.”
These five stages were described as
1. Denial, when we think “This can’t be happening to me.”
2. Anger, where we question “Why is this happening?” and “Who is to blame?” Unfortunately, oftentimes we tend to blame ourselves and enter a vicious cycle of rumination and self-blame that creates an insane amount of stress for our brain in a moment of our life that we are already very vulnerable emotionally, making the healing process longer and more difficult.
3. Bargaining, when we start negotiating with ourselves and life “Make this not happen, and in return, I will….” or we start contemplating the “what-ifs” of life.
4. Depression, when a deep sense of sorrow takes over and we are too sad to do anything.
5. Acceptance, when somehow we find ways of coping with the loss and we are at peace with what happened.
If you are experiencing any of these emotions following a loss your reaction is natural. However, not everyone who grieves goes through all of these stages or in this sequential order. Also, you do not have to go through each stage in order to heal.
Some people resolve their grief without going through any of these stages.
As Kübler-Ross herself said of the five stages of grief “They are responses to loss that many people have, but there is not a typical response to loss, as there is no typical loss. Our grieving is as individual as our lives.”
The Grieving Process
The psychological process of healing from a loss is called mourning or grieving. There is no right or wrong way to grieve. Grieving is a highly individual experience. How you grieve depends on many factors, including your personality and coping style, your life experience, your faith, and how significant the loss was to you.
It takes time to work through a loss. Even years after a loss we may still experience a strong sense of grief.
Healing happens gradually and it can’t be forced or hurried. Some people start to feel better in weeks or months. For others, the grieving process is measured in years. Whatever your grief experience, it’s important to be patient with yourself and allow the process to naturally unfold.
Even if we all mourn in different ways there are some similarities and in particular, there are four phases that are part of the mourning process.
1. Acceptance of the reality of the loss.
2. Experiencing the pain of grief.
3. Adjusting to the environment in which the loss is missing.
4. Withdrawal of emotional energy and reinvestment in new relationships or priorities.
Grief and Stress
There’s no guide to grieving, however almost every loss, no matter how expected, will be accompanied by an activation of our stress response. In fact, the National Mental Health Association describes the loss of a loved one as “life’s most stressful event.”
This happens because when we experience a loss, at some deep level we fear for our very own survival, therefore our stress response is triggered in our brain and the fight, flight or freeze response is activated. Our brain is ready to take action, but since we cannot undo the loss, we have no control over the situation and there is no action we can take. We experience a profound sense of powerlessness and helplessness that put our bodies under enormous stress. This type of stress is particularly harmful to your body and brain because it includes both a major traumatic life event and ongoing chronic stress experienced after the loss.
This chronic stress after the death of a loved one is a combination of many different stressors involved in the process of grieving.
These stressors can increase our levels of stress as each presents different degrees of physical, mental, spiritual and emotional challenge and often make us question our fundamental beliefs about ourselves and our world. They may include
1. The changes that we have to adjust to after the loss.
2. The intense emotions that the loss generates, including the sense of lack of control and frustration. Also sometimes how the loved one dies will have a powerful effect on how we grieve. Sudden deaths, especially violent or accidental deaths, provoke our greatest shock and anxiety. Violent deaths may make us feel vulnerable and fearful or provoke our rage. Suicide may arouse guilt among the survivors. On the other hand, if the death involved having to make end-of-life decisions for our loved one, the levels of stress skyrocket. A study conducted by researchers at the Oregon Health Sciences University found that families who had to make end-of-life decisions for dying patients faced immense stress after the patient died.
3. Interpersonal stressors. A common source of stress and pain after the death of a loved one is conflict, regret and hurt feelings among family members and friends.
4. External pressure. It would be wonderful if, after the death of a loved one, we were given a grace period to grieve. Unfortunately, we often experience the total opposite because we need to take care of a series of tasks that require decisions that we might not be able to make in that vulnerable state.
The Symptoms of Grief
The death of someone you love can affect both the mind and body. During a period of grief, we can experience emotional, mental and physical symptoms.
The emotional symptoms of grief are often a mixture of raw feelings such as sorrow, anguish, anger, regret, longing, fear, disappointment, blame and deprivation, frustration, guilt, shock, and numbness.
The physical symptoms of grief can include fatigue, generalized weakness, shortness of breath or tightness in your chest, and/or dry mouth, exhaustion, emptiness, tension, sleeplessness, and loss of appetite, or a hollowness in your stomach, nausea, lowered immunity, weight loss or weight gain, aches and pains.
The behavioral symptoms may include appetite loss or overeating to soothe anxiety, nightmares or insomnia or you may feel like retreating socially, and sleeping and crying all day long.
The brain is particularly sensitive to the stress of grief. The stress caused by the loss of an attachment to a loved person or of some other significant attachment is usually associated with:
1. reduction in cognitive effectiveness and problem-solving capacity,
2. reduced access to memory
3. deterioration in the clarity of our sense of identity and in our capacity to assess our ability to persevere in the face of the struggle.
How to Cope with the Stress of Grief
Though a necessary step for healing, grief is not easy. Research shows that when people don’t deal with the emotions of grief, the pain remains and the stress can become chronic and emerge in unrecognizable and sometimes destructive ways in an attempt to “numb the pain”.
This happens because we are not well prepared to deal with loss.
From a cultural perspective, this happens because we’re taught to acquire things not to lose them and that acquiring things will help us feel happy or complete.
From a social perspective, we live in a society that is not really centered on promoting mental and emotional health, therefore, we often don’t know how to prioritize or manage our mental and emotional wellbeing.
However, it is important to learn and cultivate positive and constructive ways to cope with the chronic stress of grief to prevent mental and physical health problems in the future. Some suggestions include
1. Deal with the emotions of grief.
• Acknowledge your pain. Thinking that the pain will go away faster if you ignore it will only make it worse in the long run. It is necessary to face your grief and actively deal with it. Accept that grief can trigger many different and unexpected emotions.
• Forgive yourself for things you didn’t say or do.
• Seek out face-to-face support from people who care about you.
• Find ways to express your feelings in a tangible or creative way.
2. Balance yourself with rituals of wellbeing. While you take time for the natural process of healing to occur, remember to support yourself emotionally by taking care of your body, your heart, your mind, and your brain.
3. Practice relaxation and yoga, tai chi, or qigong. Not only these mind-body activities help you relax but they can reverse the effects of stress and anxiety on a molecular level, according to a study in the June 2017 Frontiers in Immunology Journal. In people who regularly engaged in these practices, researchers found less activity of genes that create inflammation in the body.
4. Maintain a healthy diet. Stress triggers cravings for sugar and fat, which is why you reach for feel-good, high-calorie and high-fat processed food. Instead, focus on keeping up a well-balanced diet. That means eating plenty of vegetables, fruits, and lean proteins, and drinking plenty of water.
5. Follow good sleep hygiene. Grief is emotionally exhausting. After a loss, people often find that their sleep is disrupted — they have trouble falling asleep, or sleep too much. Try following a bedtime routine.
6. Keep moving. A simple daily walk can help ease depression, agitation, and sorrow related to grief.
7. Practice appreciation. In our hearts, we all know that death is a part of life. In fact, death gives meaning to our existence because it reminds us of how precious life is. Being grateful for what you have will help you renew your priorities.
8. Overcome isolation. Try to surround yourself with life: plants, animals, friends, and family.
9. Take on new responsibilities. The loss of a spouse or family member may mean you have to take over certain routine jobs.
10. Reach out to your social circle. While it can be painful to see people, it is important to maintain connections with others. Make an effort to communicate with someone every day, either by phone or email.
11. Spiritual Deepening. If you follow a religious tradition, embrace the comfort its mourning rituals can provide. Spiritual activities that are meaningful to you—such as praying, meditating, or going to church—can offer solace. If you’re questioning your faith in the wake of the loss, talk to a clergy member or others in your religious community.
12. Join a support group. Grief can feel very lonely, even when you have loved ones around. Sharing your sorrow with others who have experienced similar losses can help. To find a bereavement support group in your area, contact local hospitals, hospices, funeral homes, and counseling centers, or see the Resources section below.
13. Talk to a therapist or grief counselor that will help you recognize the difference between grief and depression. Distinguishing between grief and depression isn’t always easy as they share many symptoms.
If your grieving process continues beyond a few months, you might consider seeking professional assistance. Doctors classify grief into two types: acute and persistent. Most people experience acute grief, which occurs in the first six to 12 months after a loss and gradually resolves. Some, however, experience persistent grief, which is defined as grief that lasts longer than 12 months. Sometimes grief can become associated with behavioral and mental health disorders like depression, anxiety and panic attacks. In this case, it is called complicated grief.
Symptoms of complicated grief include:
• Intense longing
• Intrusive thoughts or images of your loved one
• Denial of the death or disbelief
• Avoiding things that remind you of your loved one
• Extreme anger or bitterness over your loss
• Feeling that life is empty or meaningless
People who experience persistent or “complicated grief” or constant symptoms of emptiness and despair more similar to depression, should talk to a doctor or a mental health professional to help them work through the grieving process.
This may include focused treatments like cognitive behavioral therapy and grief therapy or the use of antidepressants and antianxiety medications.
Left untreated, complicated grief and depression can lead to significant emotional damage, life-threatening health problems, and even suicide.
If you’re feeling suicidal, seek professional help immediately.
What can you do for a grieving person?
If someone you care about has lost a loved one, you can help them through the grieving process by sharing the sorrow and allowing them to talk about their feelings of loss or by offering practical help. Be patient. Remember that it can take a long time to recover from a major loss. Make yourself available to talk and encourage professional help when you feel someone is experiencing too much pain to cope alone.
No matter what path your grief takes, I am here to remind you to be patient and kind to yourself.
It can take months or even years to absorb a major loss and accept your changed life but keep alive in your heart the hope that you have the power to transform any stress in growth, health and renewed happiness.
I hope this helps in your path to growth and health.