Grief

Grief refers to the natural emotional and psychological reaction to loss of a loved one or a living being an individual was attached to. A person who has lost something they valued or someone they shared a close bond with may experience severe emotional suffering.

What Is Grief?

It refers to an emotional and mental pain or distress experienced as a response to the death or loss of an individual, a relationship or a thing. Although everyone experiences it differently, this emotional reaction typically involves feelings of sadness, disbelief, anguish, loneliness, anxiety, guilt, regret, despair and even anger. Grief is closely associated with bereavement [mfn] PDQ Supportive and Palliative Care Editorial Board. Grief, Bereavement, and Coping With Loss (PDQ®): Health Professional Version. 2020 Dec 3. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK66052/ [/mfn] , but can also be felt for various other reasons, such as relationship dissolution, terminal or chronic illness, job loss etc.

While it is widely considered as an emotional experience, it can also have cognitive, physical, behavioral, functional, philosophical and spiritual influences. A person experiencing such distress may also experience adverse physical effects such as changes in sleep & appetite, aches & pains and other physical health issues.

According to a 2009 study [mfn] Zisook, S., & Shear, K. (2009). Grief and bereavement: what psychiatrists need to know. World psychiatry : official journal of the World Psychiatric Association (WPA), 8(2), 67–74. https://doi.org/10.1002/j.2051-5545.2009.tb00217.x [/mfn] , duration and intensity of the experience varies depending on the individual and the experience of losses overtime. It is also influenced by different factors such as the person’s-

• Pre-existing personality
• Attachment style
• Genetic makeup & vulnerabilities
• Health & age
• Spirituality
• Cultural identity
• Support systems & resources
• Number of losses
• The relation & nature of the relationship (Parent, spouse or friend & interdependent or distant relationship )
• The type of loss (natural or anticipated vs accident or sudden)

This emotional response to loss is often overwhelming for most people and therapy may be needed for recovery. However, recovery may vary for each individual depending on their loss and their distress. While some individuals may overcome such profound sadness in months, others may take years. According to recent research [mfn] Mughal S, Azhar Y, Siddiqui WJ. Grief Reaction. [Updated 2020 Aug 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507832/ [/mfn] , this experience is a process rather than a state. Although most people tend to recover from it within a span of 12 months, when someone takes more time to recover than the “standard grieving process they are said to be experiencing complicated grief or prolonged grief disorder, which is thought to result from failure to transition from acute to integrated grief,” explain the researchers.

Understanding Grief

Grief can have a profound effect on our mental and physical health [mfn] Utz, R. L., Caserta, M., & Lund, D. (2012). Grief, depressive symptoms, and physical health among recently bereaved spouses. The Gerontologist, 52(4), 460–471. https://doi.org/10.1093/geront/gnr110 [/mfn] . As it is a universal emotion, different people have different ways of grieving like getting angry, crying, isolating or socially withdrawing themselves or experiencing a feeling of emptiness. The pain that people feel with this emotional distress can disturb someone’s daily activities. It can interfere with our physical health, make it difficult for us to eat, sleep or even think in a rational manner. The more intensely a person grieves, the more he/she will feel these effects.

Some of the common causes of grief are:

• Poor health
• Ending of a relationship
• Loss of a job
• Loss of a long awaited dream
• Death of a loved one or a pet
• Poor financial stability
• Loss of close friends
• Coping up after trauma

Even subtle or insignificant losses in life can trigger it. This feeling is extremely personal and thus we do not feel ashamed about it. Some individuals may need professional help in assisting them with the grieving process and coping with their normal everyday life.

Symptoms Of Grief

The symptoms [mfn] Mughal S, Azhar Y, Siddiqui WJ. Grief Reaction. 2020 Aug 10. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 29939609. [/mfn] associated with loss or grief can be physical or emotional. Sometimes, the emotional symptoms can give rise to physical symptoms. There can be times when people might feel overwhelmed and that they are losing control, feeling like they are in a bad dream or question their basic religious beliefs.
Here are the emotional and physical symptoms of this emotional reaction to loss:

1. Emotional symptoms

The emotional symptoms of this emotional experience may include:

A. Shock and Denial

The person may feel numb, have trouble accepting the loss or deny it altogether. If someone they loved died, they might keep expecting that person to come back, even though logically they know that person has gone forever.

B. Sadness

This emotion associated with grief is probably one of the most universal symptoms. It can be accompanied by feelings of despair, yearning, emptiness or even deep loneliness. The person can also cry uncontrollably and be emotionally unstable.

C. Anger

It is common for people to feel angry after a loss, even if it had nothing to do with anyone. This anger might be directed to other people or themselves. They need to find someone to blame for the injustice done to them.

Read More About Anger Here

D. Fear

The person might start feeling insecure, anxious or even helpless. They can also have panic attacks due to their anxiety. The loss of a loved one can trigger fears revolving facing life without that person, the new responsibilities and also fear about their own mortality.

E. Guilt

This emotion can pertain to things we did or words we said. A person can start feeling guilty about their feelings. They might feel guilty about what they did or did not do, like being more compassionate & caring, to prevent the death of the situation.

Read More About Guilt Here

2. Physical symptoms

The physical symptoms of grief typically involve:

1. Fatigue

Fatigue and exhaustion are common physical symptoms for people suffering from grief as they are constantly depressed or anxious. Everyday activities may appear difficult and they may lack motivation.

2. Nausea

People grieving tend to find it difficult to eat and feel nauseous at times. This might be because of the emotional pain they are suffering from, which makes them feel like vomiting or even have difficulty digesting food.

3. Weight gain or loss

It is common for people suffering from grief to experience weight loss or gain. This happens when people usually overeat or not eat at all, both of which are caused by grief.

4. Insomnia

The emotional turmoil which grief induces, can cause sleeplessness in people. However, this tends to get better with time when people get a hold of their emotions and become mentally stable.

Theories On Grief

For years, psychologists have been trying to understand the process of grieving. Some of the notable theories [mfn] Hamilton I. J. (2016). Understanding grief and bereavement. The British journal of general practice : the journal of the Royal College of General Practitioners, 66(651), 523. https://doi.org/10.3399/bjgp16X687325 [/mfn] on it by renowned psychologists are

1. Grief work theory

Sigmund Freud was the first person to come up with a theory. His work was known as the Grief Work theory. He said the process of grief involves “the breaking of ties with the deceased, readjusting to new life circumstances, and building new relationships.”

2. Kubler-Ross Theory

Kubler-Ross stated a stage-based theory where a series of “predictable” stages succeeded grief, which includes “shock and denial, anger, resentment and guilt, depression, and finally acceptance.” These processes later gave rise to more modern stages of grieving which we shall discuss later.

3. Dual-process model

Famous psychologist duo, Stroebe and Schut theorized a “dual-process model”, where grief tends to oscillate between two modes. One is the “loss orientation” mode where the person copes by focusing on their emotions and letting their thoughts settle down and accept the loss. The second mode is “restoration orientation”, where the person tries to cope up by focusing on the problems they are facing in life by grieving.

The Stages Of Grief

Psychiatrist Kubler-Ross introduced the 5 stages [mfn] McAlearney, A. S., Hefner, J. L., Sieck, C. J., & Huerta, T. R. (2015). The journey through grief: insights from a qualitative study of electronic health record implementation. Health services research, 50(2), 462–488. https://doi.org/10.1111/1475-6773.12227 [/mfn] of grief in 1969. He based his theory by studying the coping mechanisms of terminally ill patients. These 5 stages are mentioned below:

1. Denial

Denial, the first stage of Kubler-Ross’ theory, is an automatic defense mechanism. It helps us to minimize or ease away some of the pain associated with a loss. In this stage, we are still trying to process the reality of us losing something or someone. We are also trying to cope up with our emotional pain at the same time. Thus, it is not unusual for us to pretend as if nothing major happened. This gives us more time to slowly process the new reality and absorb it. The positive side of denial is that it prevents us from getting overwhelmed with our emotions.

2. Anger

Unlike denial, anger is a masking mechanism. The anger that you feel might actually be masking your pain and your emotions during grief. It usually forms when reality sets in after depression and people are confronted with their loss. From feelings of frustration to helplessness, people usually start feeling angry. This anger can be directed towards yourself, other people, the person who died or even family and friends. You know that rationally other people are not to blame here but your feelings at that moment are too intense to ignore. However, not all people will be experiencing this stage.

3. Bargaining

In this stage of grief, people mostly start to feel helpless and vulnerable. People tend to focus on what they could have done to prevent their loss. Thus, they tend to search ways for regaining control of the situation or think that they can change the outcome of the event. Here we ask ourselves questions like what if or if only we had done something to prevent the outcome of such situations. We tend to reflect on the past and try to find answers for the outcome that occurred. We may also turn to a higher power for seeking guidance and to influence the way things work out. Bargaining gives them a supposed sense of power and they tend to feel not so out of control.

4. Depression

This stage of grief slowly sets in when people start to realize that anger and bargaining are really ineffective coping strategies. They slowly realize the helplessness of their situation and sadness sets in, when they finally begin to fathom the loss in their lives. In this stage our emotions start calming down and we start to embrace the reality of our situation. People start to realize their loss here more clearly and evidently which can lead to depression and profound sadness. However, if you find yourself dealing with severe depression, reaching out to a professional therapist might help.

Read More About Depression Here

5. Acceptance

In this stage, acceptance does not mean that the person is in an uplifting or happy state of mind. It does not mean that they have moved on with their loss or grief. However, it means that they have come to terms with what has happened and what it feels like now. People here no longer try to resist their reality and do not struggle with changing what has already happened. Although the regret and sadness still lingers, they accept the situation now for what it is and remind themselves that there might be better days in the future for them.
However, it should be noted that it is not necessary that an individual will go through each specific phase or in any particular order. They may experience certain stages before the other or may not go through a particular stage at all.

Coping With Grief

Grief can seem to last forever. It makes people want to withdraw from their social life and retreat into their own shell, where they find solace and comfort. However, expressing your grief and talking about your emotions can help to alleviate some of the symptoms associated with it. Although most people prefer not to talk about their loss and pain, expressing your emotions can be a vital part of the healing process. Here are some of the ways in which you can learn to cope and eventually heal from your pain.

1. Seek support from loved ones

Sometimes, while grieving, it can help if you turn to your friends and family for support. While it may seem that it feels better to grieve all by yourself, turning to your friends and family can actually be beneficial for you. Try to talk openly and honestly about your thoughts and feelings and allow them to connect with you once again. This can aid in alleviating your grief a lot.

2. Engage in outdoor activities

It might seem a daunting task at first when you are grieving, but getting some fresh air and a feel of the outside environment can actually do you some good. You can engage in some outdoor activities like going for a walk or taking a stroll. Getting away from your grieving environment can facilitate the healing process.

3. Understand that others are trying to help

If you understand that most people out there feel uncomfortable or awkward when trying to talk or help someone who is grieving, things can be a lot less heavy on you. Most people are unsure of what to say or do when trying to help someone who is going over their loss and experiencing grief. However, they trying to reach out to you means they care for you. It can help to open up to them and speak your heart out.

4. Seek professional help

Sometimes, the process of grieving can make you lonely and vulnerable at times. It is recommended in situations like these you seek professional help. Joining a support group or even talking to a psychologist or therapist might help you in coping with your grief. A therapist might also have unconventional ways to help you come back to a normal life soon.

Grief Is Normal

Grieving is a normal life process and each of us grieve in our own unique way. Regardless of how long it may take for you to heal, there is nothing to be ashamed of. However, do not let your grief take away your normal healthy life from you. If you feel like your loss is becoming debilitating or hampering your life, it can work wonders to seek help from a professional counselor, a psychologist or even a licensed therapist.