Grief is an emotional reaction that follows loss of someone or something of great value. There is a difference between normal sadness and grief. Normal sadness is your emotional response to most losses, disappointments, and frustrations in life. When you experience normal sadness, you are able to:

• describe why you are sad
• respond to your environment in a normal way
• get over your sadness in a relatively short period, usually less than a month.

Any loss can cause grief. Death is the one that usually comes to mind, but there are many others. Losses like divorce, being fired, losing a job, losing a pet, or a child moving out, can all result in grief. Sometimes people are afraid that they should not feel the way they do when they are grieving.

Sometimes grief can become clinical depression. You should not try to overcome clinical depression by yourself. Depression can be successfully treated with psychotherapy, antidepressant medicine, or both.

The grief and mourning process associated with the loss of a loved one (especially if it was unexpected) often has the following three stages:

• Stage 1: Shock and Disbelief

  During this stage there may be a wish to deny the importance of the loss. Events may seem unreal and you may feel numb at first. This may last a very short time or as long as a few days. During this time you deal with your need to deny the loss. Common behavior in this stage includes crying, showing anger, even screaming. You should allow yourself these expressions of your feelings. In the case of the death of a loved one it is important, if at all possible, to attend the funeral.

• Stage 2: Developing Awareness

  The second stage may last 3 to 12 months. It usually includes the following:

  • preoccupation with the loss
  • anxiety and restlessness
  • difficulty sleeping
  • physical symptoms including loss of appetite, digestive problems, and fatigue
  • anger
  • guilt
  • identification with the lost loved one
  • occasional experiences of thinking you have seen the person who has died or heard his or her voice
  • a possible depressive response on the anniversary of the loss.

  During this stage awareness of the loss settles in. You also notice the consequences of your loss. Mood swings are common. During this time you should share your feelings, especially with family members and compassionate friends. Direct your efforts toward caring for yourself and planning positive lifestyle changes. Although this stage may last for months, you should gradually feel better month by month. If you are not gradually feeling better, you may be developing a complicated grief reaction, which will require professional help.

• Stage 3: Resolution

  Resolution may begin anytime from 3 to 12 months after the loss. You begin to recover by incorporating new habits and lifestyle changes and by making plans for the future. Gradually you take charge of your life and resolve the loss through activity, readjustment, and education.

It is important to remember that these stages often happen in a somewhat jumbled order. For example, you may be well on your way into Stage 3 but begin to have thoughts and emotions from Stage 1. This is normal. Do not judge yourself badly for not "getting on with your life." Grief takes its own time. Be kind to yourself.

There are ways to help yourself deal with grief and loss. These include:

• Engage in 20 minutes or more of physical activity at least every other day.
• Pursue recreational interests at least once or twice a week.
• Make time for hobbies and listening to music.
• Talk with friends and family.
• Learn ways to lower stress, such as breathing and muscle relaxation exercises.
• Get 7 to 9 hours of rest a night.
• Eat a healthy diet and drink less caffeine.
• Do not abuse alcohol or drugs.
• Postpone major decisions or life changes (such as selling your home and moving) until your judgment and perspective return.

You can also try:

• developing and maintaining the attitude that things will work out
• work on making new friends
• asking for help at home and work when your load is too much for you to handle alone
• telling your friends that it is okay to talk about your loss and let you know they care
• seeking professional help for dealing with life events that produce anxiety, and learning positive methods of coping.

Seek professional help for complicated grief reactions.

The following signs are all common and normal in grief:

• feeling guilty about things you did or didn't do before the loss
• feeling like you should have been the one who died
• thinking you hear or see the person who died
• having problems sleeping
• not wanting to eat, exercise, or socialize
• wanting to isolate yourself from others.

Seek help if you:

• are unable to function adequately at work
• have extreme feelings of guilt or worthlessness
• have unexplained physical symptoms
• have feelings of depression or nervousness that are getting worse rather than better after a month or so
• have persistent and severe trouble sleeping (lasting 4 to 6 weeks), particularly with early morning awakening from which you cannot get back to sleep
• have unintentionally lost more than 10 to 15 pounds
• have suicidal thoughts you cannot get out of your mind.

Once symptoms like these develop, you cannot think yourself out of the complicated grief reaction. You are not weak for having these symptoms. Getting help really can help.

Talk with your healthcare provider about your fears and confusion.

Grief support groups are very helpful. Counseling with a mental health professional or clergy person can make a difference. Let others know how you feel and what they can do to support you through your grief. The best thing you can do with your grief is to cry and talk it out.

Developed by Phyllis G. Cooper, RN, MN.
Published by RelayHealth.
© 2008 RelayHealth and/or one of its affiliates. All Rights Reserved.