Grief has been described as an emotion; however, it is currently being regarded more and more as a disease. As this trend continues, grief will accrue more and more definitions particular to disease and will lose the definition of being an emotion.
Earlier research provides solid evidence of biological links between grief and an increased risk of illness and mortality. Bereaved individuals are at higher risk for depression, anxiety, and other psychiatric conditions, and are highly susceptible to infections and a variety of other physical illness due to a considerable weakening of the immune system. Bereaved individuals have higher consultation rates with doctors, use more medication, and are more often hospitalized. An increased risk of mortality and suicide is associated with medical conditions in bereavement.
Needless to say, people in grief will neglect their own health by not maintaining a well-balanced diet, forgetting to take necessary medications, not getting enough sleep, and not exercising. Some may abuse alcohol, smoke excessively, use drugs, or engage in other self-destructive behaviors.
Social support is very important in grief. However, a grieving person should be advised to designate their own comfortable boundaries of support (for example, by telling people what exactly they can do to help them, when, and for how long they would like to be together, or sharing that they may not want to do certain activities now, but would consider doing them later).
Finally, the grief process may be different for every individual. It is important for the bereaved to do as they feel, especially during the mourning phase: to be left alone if they so wish, or allowed to cry or to have a chance to talk to someone when they feel the need. It may be helpful to engage in activities that help commemorate their loved one: for example, through attending religious services, visiting the gravesite, praying, creating a memory book with photos and stories, or assembling a memory box with the belongings of the deceased, or by giving to a good cause such as medical research, a scholarship fund, or charity.
Grief is often compared to Post Traumatic Stress Disorder (PTSD), particularly in the acute phase of traumatic grief, which holds similar symptoms such as re-experiencing, avoidance-numbing, increased arousal, guilt, shame, changes in value systems and beliefs, and a search for meaning. Often, in traumatic grief, the relatives of the deceased are preoccupied with issues surrounding the trauma such as the pain of dying, the cause of death, and self-blame for not being able to protect/save or for having survived. Traumatic images flood the consciousness of survivors.
In grief, it is important to resolve feelings of guilt, anger, anxiety, and depression. Sadness occurs both in depression and grief. The difference is that in grief, sadness is focused on missing the person who died, while in depression, sadness is focused on hopelessness and helplessness about self, the world, and the future. Sadness is normal in grief; however, depression in a time of grief can make it very difficult to come to terms with loss and reconstruct a life going forward.
There are a lot of examples of unhelpful thinking that can block the normal bereavement process and cause emotional distress. Negative thinking can lead to the symptoms of complicated grief and depression. For example, self-blame or self-reproach can heavily impact the emotional condition of the bereaved.
In overcoming the pain of grief, it is critical to consider what is causing self-blame and other negative thinking about self, the world, life, the future, and what causes anxious and depressive avoidance behavior. Often patients with complicated grief continue to perceive their loss as “unreal” or remain preoccupied with thoughts and recollections of the deceased or the death event. Working through grief in therapy helps patients change the perception of loss into something more “real”, helps them to acknowledge their loss, and ensures the loss is recognized as permanent and not reversible. Unless this is done, thoughts of the deceased will constantly bring fresh emotional distress and sorrow.
Let’s look at some myths and negative thoughts that may be obstacles to recovery, and consider how to handle them.
Myths about Grief
«Give sorrow words; the grief that does not speak knits up the o-er wrought heart and bids it break.»
There are many beliefs in the culture and traditions of different people about how to deal with death and grief. Many traditions are passed on to us through generations and we follow them without questioning the reasons behind them. Indeed, it is not easy to change the long-held beliefs of our families or to insist on doing things differently. But holding on to archaic knowledge at a time when we have gained so much understanding about the subject from research and therapy would be wrong. It is in the best interest of each of us – our families, loved ones, and society as whole – to embrace this new knowledge and dispel the myths that still govern our societies and often cause harm to people.
Some of the common myths I often hear are:
All losses are the same
No loss is equal. There are many different factors that affect grief. Grief varies between young and old, between cultures and religions, and depends on the type of relationship the bereaved had with the deceased (parent, child, spouse, sibling, grandparent, friend, lover), the levels of existing dysfunction, and upon the nature of death (if the death was expected or sudden). It depends on previous experiences with death and on the attachment style, and of course, interpersonal factors play a very important role. It depends on the personality of the bereaved, as well. Unprocessed emotions in that relationship, conflicts, repressed feelings, unspoken words: all these all come out in grief and weigh heavily on the grieving person, thus complicating recovery.
Mourning should last for a year
There can be no exact time frame for grief or mourning. As every loss is different, it will take every person a different amount of time to come to terms with their loss. Different cultures also may have their own rules on mourning (i.e. widows required to wear black for several months, a year, or a lifetime, or are prohibited to re-marry, and so on). Irrespective of all rules, every person will ache differently, will go through their memories of the deceased on their own terms, will arrive at forgiveness for him/herself and the deceased, and will find their own meaning in continuing to live.
Once you get over your grief, it never comes back
Stages of grief known as denial, anger, bargaining, depression, and acceptance may come and go in sequence and interchangeably. The duration and intensity of each stage may vary greatly. The stages can overlap or occur together, and a grieving individual can miss one or more stages altogether. It is also not rare for someone to go back and forth between the stages, as important pieces of information about the nature and causes of death come to light. New cycles of grief can be launched at milestone birthdays or anniversaries of the deceased or the bereaved person, and during major family events (the birth of children, the death of other family members, a family relocation, or the sale of the house where the deceased lived, for example).
It is better to avoid anything that reminds you of the deceased
Avoidance is the worst coping strategy in grief outside of denial. Even the most painful reality is better dealt with head on and with full realization of what has happened. Avoiding reminders of the deceased and denying a loved one’s death will only extend the time needed to come to terms with the loss and achieve acceptance. Denial and avoidance may come naturally as the first reaction to the shocking news; however, it should not last too long, as a healthy coping pattern requires that the