What is grief?
Grief is a natural human response to any significant loss. People often use words like "sorrow" and "heartache" to describe feelings of grief. When you experience a significant loss --whether you lose a beloved person, animal, place, or object, or a valued way of life (such as your job, marriage, or good health) -- you will likely feel some level of grief. It is important to acknowledge such losses and allow yourself the time and space to grieve and heal.
Anticipatory grief can come in advance of an impending loss. For example, you may feel anticipatory grief for a loved one who is seriously ill, or near death, or you and your children might grieve while contemplating an upcoming move or divorce. Anticipatory grief, while it may help us prepare for losses, can also be an obstacle to fully enjoying the time we have with loved ones. Your emotional well-being is best served by focusing on the present moment and appreciating any gratitude or joy available to you right now.
What is grieving?
Grieving is a process of emotional and life adjustment experienced after a loss. Every person's grief is unique, yet grief is a universal human emotion. The period of grieving after the death of a loved one is also known as bereavement, which in many traditions is a deeply respected time when friends and family come to offer comfort to the bereaved. People coming together in this way, to share mutual love and appreciation for someone they miss, is one of the oldest and most universal human spiritual traditions, irrespective of religion or ethnicity. This opportunity to be together, and connect with family and friends, can be profoundly healing for everyone involved.
Grieving is a personal experience. Depending on who you are and the nature of your loss, your process of grieving will be different from another person's experience. There is no "normal" or "expected" period of time for grieving. Some people adjust to a new life within weeks or months. Others take at least a year, or more, particularly when their daily life has been radically changed or their loss was traumatic and unexpected. Grief unfolds in its own time, sometimes remaining even after the initial period of acute sorrow has passed, such as a dream that recurs, especially on significant anniversaries.
What are common feelings during grief and grieving?
A wide range of feelings and emotions are common to grieving people throughout the world. Feelings of shock, numbness, sadness, anger, guilt, or fear are often relieved by intermittent moments of relief, peace, gratitude, or even happiness. Sadness, "the blues," depression, sleeplessness, and anxiety are very common during the grieving process. It can be very helpful to remember that "this, too shall pass." Seek out a trusted friend, therapist, or clergy to safely share your feelings, which will help you heal.
Although it is possible, and sometimes practical, to postpone grieving, it is not advisable to avoid or repress your grief altogether. Sometimes life circumstances make it difficult to stop, feel, and live through the grieving process. This is understandable and sometimes unavoidable. However, it is vitally important that, at some point, you consciously choose to find a quiet moment to simply feel and be present with whatever you are experiencing. Create opportunities to talk with trusted friends and family. Unresolved grief can affect your quality of life and relationships with others, whereas sharing your feelings can lead to deeper and more meaningful relationships.
How is grieving treated?
Social support, good self-care, and the passage of time are some of the best medicines for grief. As the old saying goes, "Time heals all wounds." It is normal for a grieving person to have trouble functioning for days, weeks, or even a few months. For most people who are grieving, one of the most helpful things is to share their feelings with other people who have experienced similar losses. Your emotional well-being will be vastly enhanced by finding support and sharing with others who are "in the same boat." It is not a sign of weakness, but of strength and courage. Don't hesitate to contact a grief counselor or bereavement support group for help.
If feelings of depression or anxiety are making it difficult for you to function, especially immediately after your loss, there are useful medications that can help relieve short-term symptoms. Talk to your health professional about medication if you feel you need additional support to help speed your recovery.
Causes of Grief
Grief and grieving are the natural response to a major loss, especially if the loss is sudden, traumatic, or unanticipated. Common causes of grief include:
- Death or loss of a loved one.
- Being diagnosed with a chronic or terminal disease.
- Disability from a severe accident or illness.
- Divorce.
- Death or loss of friends or colleagues for any reason.
- Loss of independence.
Grief can also, ironically, be triggered by a loss related to a normal, seemingly positive life change. Examples of such life events include:
- Starting school (loss of the comfort of home and familiar surroundings)
- Gaining increasing independence and self-responsibility in the late childhood and teen years (loss of dependence on parents)
- Marriage (loss of independent decision-making)
- Birth of a child (loss of independence)
- Retirement (loss of income, work-related identity, and daily social contact)
- Aging and maturing (loss of physical strength and youthful appearance)
- Completing a planned course of treatment for cancer (loss of contact with caregivers and healthcare team)
You may find that old feelings of grief from past loss can be triggered by current experiences or anniversaries of that loss. Sometimes these feelings can seem to "sneak up on you," and to come out of nowhere. This is normal and understandable. Be kind and compassionate to yourself if these kinds of thoughts, memories, or feelings arise. Seek guidance and support if you feel it would be comforting and helpful to you.
Symptoms of Grief
Your experience of grief is likely to be different from another person's. Similarly, you will probably grieve somewhat differently each time you experience a significant loss. Your reaction to loss is influenced by the relationship you had with the lost person, object, or situation, and by your general coping style, personality, and life experiences. How you express grief is influenced in part by the cultural, religious, and social norms of your community.
Grief can be experienced and expressed on many levels, including physically, emotionally, socially, and spiritually.
- Physical expressions of grief often include crying and sighing, headaches, loss of appetite, difficulty sleeping, weakness, fatigue, feelings of heaviness, aches, pains, and other stress-related ailments.
- Emotional expressions of grief include feelings of sadness and yearning. Feelings of worry, anxiety, frustration, anger, or guilt are also normal.
- Social expressions of grief may include feeling detached from others, isolating yourself from social contact, and behaving in ways that are not normal for you.
- Spiritual expressions of grief may include questioning the reason for your loss, the purpose of pain and suffering, the purpose of life, and the meaning of death. After a death, your grieving process is influenced by how you view death.
Grief can sometimes cause serious symptoms, including depression, anxiety, suicidal thoughts and actions, physical illness, and posttraumatic stress disorder. After a death, you may have vivid dreams about your loved one, develop his or her behaviors or mannerisms, or even feel you are seeing or hearing your loved one. If you feel fearful or stressed by any of these experiences, talk to your physician, a mental health professional, or a clergy person experienced in grief counseling.
Age and emotional development influence the way a person grieves a death.
- Children younger than age 7 usually perceive death as separation. They may feel abandoned and scared, and fear being alone or leaving people they love. Grieving young children may not want to sleep alone at night, or they may refuse to go to day care or school. Children under age 7 usually are not fully able to verbally express their feelings; instead, they tend to act out their feelings through behaviors, such as refusing to obey adults, having temper tantrums, or role-playing their lives in pretend play. Children younger than age 2 may refuse to talk and be generally irritable. Children between the ages of 2 and 5 may develop eating, sleeping, or toileting and bed-wetting problems. See Helping Children Who Are Grieving.
- Children between the ages of 7 and 12 often perceive death as a threat to their personal safety. They may fear that they will die as well and try to protect themselves from death. While some grieving children want to stay close to someone they think can protect them, others withdraw. Some children try to be very brave or behave extremely well; others behave terribly. A grieving child may have problems concentrating on schoolwork, following directions, and doing daily tasks. Children in this age group often need reassurance that they aren't somehow responsible for the death they are grieving. See Helping Children Who Are Grieving.
- Teens perceive death much as adults do. However, they may express their feelings in dramatic or unexpected ways. For example, they may join a religious group that defines death in a way that calms their feelings. They may try to defy death by participating in dangerous activities, such as reckless driving, smoking cigarettes, drinking alcohol, taking illegal drugs, or having unprotected sex. Like adults, preteens and teens are capable of suicidal thoughts when grieving. See Helping Teens Who Are Grieving.
What Happens in the Grief Process
Grieving a significant loss takes time. Depending on the circumstances of your loss, grieving can take weeks to years. Ultimately, passing through the major stages of grief helps you gradually adjust to a new chapter of your life.
Becoming Aware of a Loss
Full awareness of a major loss can happen suddenly or over a few days or weeks. While an expected loss (such as a death after a long illness) can take a short time to absorb, a sudden or tragic loss can take more time. Similarly, it can take time to grasp the reality of a loss that doesn't affect your daily routine, such as a death in a distant city or a diagnosis of a cancer that doesn't yet make you feel ill.Coming to grips with the reality of your loss may be facilitated by talking about it with trusted friends, loved ones, colleagues, clergy, or a professional counselor.
Feeling and Expressing Grief
Your way of feeling and expressing grief is unique to you and the nature of your loss. You may find that you feel irritable and restless, are quieter than usual, or need to be distant from or close to others, or that you aren't the same person you were before the loss. Don't be surprised if you experience conflicting feelings while grieving. For example, it's normal to feel despair about a death or a job loss, yet also feel relief.
The grieving process does not happen in a step-by-step or orderly fashion. Grieving can be unpredictable, with sad thoughts and feelings coming and going, like waves. After the early days of grieving, you may sense a lifting of numbness and sadness and experience a few days without tears. Then, for no apparent reason, the intense grief may strike again.
While grieving may make you want to isolate yourself from others and hold it all in, it's important that you find some way of expressing your grief. Use whatever mode of expression comes to mind-talking, writing, creating art or music, or being physically active are all ways of expressing grief.
Spirituality often enters into the grieving process. You may find yourself looking for or questioning the higher purpose of a loss. While you may gain comfort from your religious or spiritual beliefs, you might also be moved to doubt your beliefs in the face of traumatic or senseless loss.
Adjusting to a Loss
The length of time spent grieving depends on your relationship with the lost person, object, or way of life. Even after your acute grieving is over, you may re-experience feelings of grief over the loss of your loved one. Be prepared for this to happen during holidays, birthdays, and other special events, which often revive feelings of grief.
Some grief experts consider grieving to be the recovery from a disrupted attachment: After losing something or someone to whom you are deeply attached, your sense of self and security is disrupted. Strengthening connections with other people, places, or activities and developing new connections can be very helpful in healing from a loss. Joining a grief group, volunteering, or otherwise being involved with others, is quite therapeutic. These new parts of your life are not meant to replace what you have lost. Instead, they serve to support you as you begin to start a new phase of your life.
Getting Help
Grief itself is a natural response that usually doesn't require medical or psychological treatment. Sometimes, however, people need help getting through the grieving process. Here are some options for getting help:
- Counseling and support groups. Even if you feel you're doing OK, and especially if you are finding it difficult to function after a loss, talk to a therapist or grief counselor, attend a bereavement support group, or both. Counseling and support groups can also help you transform unresolved grief from a past loss.
- Medication. During the initial days of grief, anxiety or sleeplessness can make it difficult to function. If you suffer more than a few days of severe agitation, talk to your health professional about whether a short-term prescription medication can help you. (Health professionals disagree about the usefulness of medications for people who are grieving; some health professionals believe that giving medications for anxiety or sleep may hinder the ability to grieve.)
If you find that a major loss has caused ongoing complications, such as depression, prolonged anxiety, post-traumatic stress disorder (PTSD), or disabling grief, see your health professional and a grief counselor for treatment.
Caring for Yourself During a Time of Grief
If you are caring for a dying loved one, it is important to take good care of yourself as well. When you know that a loss is approaching, especially if you are able to participate in the care of a loved one who is dying, you may be better able to recognize and deal with your feelings of grief. It is important that you get caregiver support to provide relief from caregiving and time for yourself.
If you are experiencing a major loss in your life, it is important to:
- Get enough rest and sleep. During sleep, your mind makes sense of what is happening in your life. Not getting enough rest and sleep can lead to physical illness and exhaustion. Try activities to help you relax, such as meditation or guided imagery.
- Eat nourishing foods. Resist the urge not to eat or to eat only those foods that comfort you. If you have trouble eating alone, ask another person to join you for a snack or meal. If you do not have an appetite, eat frequent small meals and snacks. Consider taking a multivitamin daily.
- Exercise. Take a walk. Brisk walking and other forms of exercise, such as yoga or tai chi and qi gong, can help release some of your pent-up emotions.
- Comfort yourself. Allow yourself the opportunity to be comforted by familiar surroundings and personal items that you value. Special items, such as photos or a loved one's favorite shirt, may also give you comfort. Treat yourself to something you enjoy, such as a massage.
- Maintain your normal activities. Stay involved in activities that include your support network, such as work, church, or community activities to help regain your sense of normalcy.
- Surround yourself with loved ones. You may feel lonely and separate from other people when you are grieving. You may think that no one else can understand the depth of your feelings. Surrounding yourself with loved ones and talking about your feelings and concerns may help you feel more connected with other people and less lonely.
- Avoid quick fixes. Resist the urge to drink alcohol, smoke cigarettes, or take nonprescription medications (such as sleeping aids). When you are under emotional stress, these may only add to your unpleasant feelings and experiences and may mask your emotions and prevent you from normal, necessary grieving.
- Ask for help. During times of emotional distress it is important to allow other people to support you and take over some of your responsibilities. Other people often feel the need to show you how much they care about you. It can be a gift for them if you accept their help.
For more information, see Managing Your Feelings of Grief.
Helping Others Cope With Grief
There are many ways to help and support a person who is grieving. If someone you know is grieving:
- Encourage the person to grieve at his or her own pace. The grieving process does not happen in a step-by-step or orderly fashion. There will be good days and bad days. Do not try to "fix" the person's grief. Provide support and be willing to listen.
- Be sensitive to the effect of your words. Don't try to minimize their loss.
- Recognize that this person's life has changed forever. Encourage the person to participate in activities that strengthen his or her support network, or arrange a care circle to bring food for the first few days or weeks.
- Respect the person's personal beliefs. Listen to his or her feelings, without making judgments. Do not try to change the person's beliefs or feelings.
Helping young children who are grieving can be part of the adult's healing process. The best way to help a child varies according to age and emotional development. For more information, see Helping Children Who Are Grieving.
Teens may need special consideration and care when they are grieving. For more information, see Helping Teens Who Are Grieving.
Older adults may express grief differently than younger ones. They are more likely to become physically ill after a major loss, especially if they already have a chronic physical illness. Older adults may also be more likely than other people to experience several losses in a short period of time. For more information, see Helping Older Adults Who Are Grieving.
Other Places to Get Help
Online Resources
American Hospice Foundation
This website offers information about death and dying, grief and grieving. The "GriefZone" has separate links to categories of readings on grief and kids, grief on the job, hospice information and support, and grief and faith.
The Dougy Center
This website offers an extensive list of books about children and grief, and gives addresses of child grief treatment providers by state. Supportive information is offered for a child audience, as well as for caring adults wanting to help a grieving child.
Organizations
Compassionate Friends National Headquarters
P.O. Box 3696
Oak Brook, IL 60522-3696
Phone: (312) 990-0010
Fax: (630) 990-0246
Compassionate Friends is an organization that helps family members through the grieving process when they have lost a child.
Hospice Association of America
228 Seventh Street, S.E.
Washington, DC 20003
Phone: (202) 546-4759
Fax: (202) 547-9559
The Hospice Association of America (HAA) seeks to heighten the public visibility of hospice services. HAA offers a number of helpful, practical publications for people who are considering hospice, including consumer guides, fact sheets, historical perspectives, and other background information. The Web site offers information from the legislative, regulatory, research, legal, and public relations departments, including Hospice Facts and Statistics.
Jenna Druck Foundation
3636 Fifth Avenue
Suite 201
San Diego, CA 92103
Phone: (619) 294-8000
E-mail: JDFound@aol.com
The Jenna Druck Foundation offers bereavement resources and services to families who have experienced the death of a child.
National Hospice and Palliative Care Organization
1700 Diagonal Road
Suite 625
Alexandria, VA 22314
Phone: (800) 658-8898, (703) 837-1500
Fax: (703) 837-1233
The National Hospice and Palliative Care Organization (NHPCO) offers information on local hospice and palliative care programs across America. NHPCO is committed to improving end-of-life care and expanding access to hospice care with the goal of improving quality of life for dying people and their loved ones.
Support Groups
AARP (Association for the Advancement of Retired People) Grief and Loss Programs
601 E Street, N.W.
Washington, DC 20049
Phone: (800) 424-3410
AARP is a national organization founded in 1958 to promote quality of life for older people. The grief and loss programs are open to everyone. These programs provide support to widows and widowers of all ages and to people grieving the death of a parent, sibling, or other loved one.
Rainbows
2100 Golf Road
Suite 370
Rolling Meadows, IL 60008-4231
Phone: (800) 266-3206, (847) 952-1770
Fax: (847) 952-1774
E-mail: info@rainbows.org
Rainbows is an international organization that offers peer support for children and adults who are grieving a death, divorce, or other painful transition in their families. Groups are led by trained adults. This organization provides an online newsletter, information, and referrals.
The Wellness Community
919 18th Street, NW
Suite 54
Washington, DC 20006
Phone: 202-659-9709
Toll-free phone: 888-793-WELL
Fax: 202-659-9301
www.thewellnesscommunity.org
The Wellness Community is an international, nonprofit organization dedicated to helping people with cancer and their loved one regain a sense of control, reduce their isolation, and restore hope. It offers professionally led, free of charge support programs, educational workshops, nutrition and exercise programs, and stress reduction classes in cities and towns around the United States, abroad, and online. There 22 Wellness Community facilities in the United States, plus 56 satellite and off-site programs, two centers abroad in Tel Aviv and Tokyo, and online at the Virtual Wellness Community at www.thewellnesscommunity.org.
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