Losing a loved one is painful – as it is expected to be. But when is your grief ‘normal’ and when does grief and bereavement become depression?
First we need to define what grief is and why we feel it. Simply put: grief is the natural emotional response to losing something or someone you care about. Generally speaking, the more significant the loss, the more intense your grief will be. “We often associate grief purely with the death of a loved one, but any loss can cause grief, including the break-up of a relationship, loss of a friendship, retirement, moving out of your family home, or the death of a pet”, says SADAG’s Dessy Tzoneva. Whether it’s the death of a friend from a long-term illness or the break-up of a relationship you thought would last forever, grief makes us suffer an array of emotions that we often feel will never ease or go away.
“There are a range of emotions and reactions that people have to grief”, says psychiatrist Prof. Chris Szabo. Sadness, anxiety, anger, irritability, tearfulness, and reduced appetite are all expected amongst other changes in functioning, while some people feel numb after a loss, like they are disconnected from the situation. “There is no right or wrong way to grieve”, says Szabo.
Abby* and Lily* are twins who lost their brother in 2012, when he was 36. Five years their senior, the girls idolised their big brother. When he was killed, Abby and Lily reacted very differently. “I went numb all over”, says Lily. “It seemed like I was watching everything from outside myself. I saw my sister fall to pieces, crying and unable to sleep or eat, and I felt like I couldn’t reach out or do anything to help.” Abby thought she was losing her mind, Lily worried she had no heart - “Everyone thought I was cold and calm and dealing with Brendon’s* death just fine, but I wasn’t.” That’s the issue that many people forget, says SADAG, that everyone grieves differently and grieving is a very personal and individual experience.
In 1969, psychiatrist Elisabeth Kübler-Ross introduced the “five stages of grief”: denial, anger, bargaining, depression, and acceptance. While Abby and Lily ultimately accepted their brother’s death, they didn’t go through the same stages of grief – and they both thought there was something wrong with their grieving as a result. “People tell you that you should cry, that you’re allowed to feel angry, that you’re allowed to fall apart”, says Abby, “But you feel guilty if you’re not following the ‘shoulds’ or feeling the way people expect you to.”
Don’t worry about what you “should” be feeling or which stage you’re supposed to be in, advised SADAG, just mourn and heal the way you need to right now. Dr Kübler-Ross said in her last book before her death in 2004, “The 5 stages were never meant to help tuck messy emotions into neat packages. 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.”
Healing takes time; it happens gradually and can’t be forced. It will take as long as it needs to take – for you. “There is no ‘normal’ timetable for grieving”, says Szabo. “Some people start to feel better in weeks, some in months, for others, the grieving process takes years.” It’s important to be patient with yourself and allow the process to naturally unfold. As time passes, so the emotions of grief and loss should ease as you start to accept the loss. But if you are not able to move forward or your feelings are intensifying, it may be a sign that your grief has developed into depression.
“The sadness of losing someone you love never goes away completely, but it shouldn’t remain center stage”, says Tzoneva. “If the pain of the loss is so constant and severe that it keeps you from resuming your life, you may be stuck in an intense state of mourning.” Differentiating between grief and depression isn’t always easy because they share many of the same symptoms. One sign to look for is that there is no easing of sadness and despair. Grief has a mix of good and bad days. “Even when you’re in the middle of the grieving process, there are moments of pleasure or happiness. With depression, on the other hand, the feelings of emptiness and despair are constant”, says Szabo.
SADAG has some tips on how to cope with grief and loss:
Get Support: Support from others is important in the healing process. It’s important to express your feelings with people you trust when you’re grieving. Accept support; don’t try to grieve alone no matter how strong and self-sufficient you are. Sometimes people want to help but don’t know how to – tell them what you need.
Take care of yourself: The stress of a loss can deplete your energy and emotional reserves very quickly. So look after your physical and emotional needs.
Face your feelings: You may be able to suppress your grief for a while but you can’t avoid it. Healing means facing your feelings and acknowledging your pain. Unresolved grief can also lead to depression, anxiety, substance abuse, and health problems.
Express your feelings: In whatever way makes sense for you, express your feelings. Write about your loss in a journal; write a letter saying the things you never got to say; make a scrapbook or photo album; get involved in a cause or organization that was important to him or her; or allow yourself alone time to mourn in your own way. Keeping your pain bottled up doesn’t help you heal.
Plan ahead for the ‘empty chair’: Anniversaries, holidays, favorite music can reawaken memories and feelings. Be prepared for an emotional thump, and know that it’s completely normal.
If you’re feeling like life isn’t worth living, wish you had died with your loved one, blame yourself, feel numb and disconnected from others for more than a few weeks, or are unable to perform your normal daily activities, seek help. Call SADAG on 0800 21 22 23 to speak to a counsellor and get help. “SADAG is open 7 days a week from 8am to 8pm”, says Tzoneva. “No-one has to struggle with loss and depression alone. There is help.” Support is important so share issues and feelings with the people you trust. Prof Szabo says that “seeking professional help if you are struggling to cope with the grief in spite of support is important”.
Remember that no-one can tell you how to feel, how you should react, or how long you are allowed to grieve for. Your grief is your own – don’t feel that you have to “move on” or “get over it” because others say it’s time. “Feel what you feel without embarrassment or self-judgment”, says Tsoneva. You don’t need permission to be angry, to yell, to cry or not to cry. And it’s also okay to laugh, and to find moments of joy despite your grief. “You’ll move on when you’re ready
Myths and Facts About Grief
MYTH #1: The pain will go away faster if you ignore it.
FACT: Trying to ignore your pain or keep it from surfacing will only make it worse in the long run. For real healing it is necessary to face your grief and actively deal with it.
MYTH #2: Its important to be “be strong” i the face of loss.
FACT: Feeling sad, frightened, or lonely is normal reaction to loss. Crying doesn’t mean you are weak. You dont need to “protect” your family or friends by putting on a brave front. Showing your true feelings can help them and you.
MYTH #3: If you dont cry, it means you aren’t sorry about the loss.
FACT: Crying is a normal response to sadness, but it is not the only one. Those who dont cry may feel the pain just as deeply as others. They may simply have other ways of showing it.
MYTH #4: Grief should last about a year.
FACT: there is no right or wrong time frame for grieving. How long it takes can differ from person to person.
Common symptoms of grief
While loss affects people in different ways, many experience the following symptoms when theyre grieving. Remenber that almost anything that yo experience in the early stages of grief is normal- including feeling lke your going crazy, feeling like your in a bad dream, or questioning your religious beliefs. Here are some common symptoms fo grief.
Shock and disbelief: Righ after a loss, it can be hard to accept what happended. You may feel numb, have trouble believing that the loss really happened, or even deny the truth. If someone you love has dided, you may keep expectin him or her to shopw up, even though you know he or she is gone.
Sadness: profound sadness is probably the most universally experienced symptom of grief. You may have feelings of emptiness, despair, yearning,, or deep loneliness. You may also cry alot of feel emotionally unstable.
Guilt: you may regret or feel guilty about htings you did or didnt say or do. You may also feel guilty about certain feelings (e.g. feeling relieved when the person died after a long, diffiuclt illness) After a death, you may even feel guilty for not doing something to prevent the death, even if tere was nothing more you could have done.
Anger: even if the loss was nobodys fault, you may feel angry and resentful. If yo lost a loved one, you may be agngry with yourself, God, the doctors, or even the person who died for abandoninig you . ou may feel the need to blame someone for the injustice that was doen to you.
Fear: a ssignifcant loss can trigger a host of worries and fears. You may feel anxious, helpless, or insecure. You may even have panic attacks. The death of a love on e can trigger fears about your own mortality, of facing life without that person, or the responsiblities you now face alone.
Physical symptoms: we often think of grief as a striclty emmotional process, but grief oten involves phsical problems, including gatigue, nausea, lowereed immunity, witght loss or wieght gain, aches and pains, and insomnia.