Grief

Grief, also sometimes called bereavement, is a hard thing to define. Most often we think of grief as being an emotional response to the death of a loved one, but sometimes grief happens because of other types of major losses, life changes or transitions. Grief can be defined as a natural response to loss, not a disorder or illness (unless it’s complicated by other factors).

You might describe grief as being in a state of very low mood. Think about mood as if it were a sliding scale: If someone feels “stuck” in a very low mood for a prolonged amount of time or finds it hard to feel content or happy for any length of time after experiencing loss, they might be grieving. Grief might also cause a person to feel anger, shock, guilt, disbelief, despair or numbness. Grief isn’t just about feeling something emotionally. Grief can also affect our thoughts, actions, behaviour, and bodies.

Grief as a Natural Part of Life

Grief is a part of life. At some point, everyone will experience loss. Someone who is grieving can go through a series of emotional phases as they work through their feelings and learn ways to move ahead and cope.

The Temporary Nature of Grief

For most, grief is a temporary state. This doesn’t necessarily mean that people “get over” the loss; the loss of someone close to you will be felt in some way forever. It does mean, however, that the pain and low mood that grief brings usually lessens over time. Because we will all experience loss at some point, coping with grief is a vital part of our mental health.

It’s tricky to decide how long grief should last, and there is no “right” or “wrong” way to grieve. When someone experiences a loss, they may grieve in some way for the rest of their life.

Prolonged or Complicated Grief

Sometimes the grieving process is prolonged and turns into “chronic” or “complicated” grief. Complicated grief might be triggered by the circumstances of the loss (like death by suicide, a sudden or unexpected illness or accident, or after a long and painful illness), by life experiences (like lack of support from family or friends, or if a person is also dealing with other mental or physical health issues). The grief process might also be prolonged if the loss causes a big life change for a person (if someone was very dependent on a parent, for instance, and that parent dies) or the loss changes their identity somehow (the loss of physical or cognitive ability, or the loss of a child). The medical term sometimes used to describe prolonged or complicated grief is persistent complex bereavement disorder.

What Grief is Not

Grief is not:

• Something someone can “snap out of”
• A sign or result of low intelligence or weakness
• The same for everyone

Grief is caused by a loss of some sort. Typically, we think of grief as being a response to a death, but it can also be caused by other types of loss or transition. Some other examples include:

• Loss of a home or life you were used to
• The loss of culture or identity
• Loss of an important relationship
• Loss of physical health or ability
• Job loss

Factors Influencing How We Grieve

Someone’s ability to cope with loss is going to be determined by a number of factors and is very much connected to the circumstances of the loss, their overall mental health, the level of support they have in their life and how resilient they are. Culture, age, circumstances, life experiences etc. will all be factors in how someone grieves.

How Grief Impacts Mental Health and Resilience

Mental health and resiliency are generally affected by any and all of the following factors:

• Biological – family history, brain development, etc.
• Psychological – trauma, ongoing stress, etc.
• Physical – ongoing sickness, hormones, substance use, etc.
• Environmental factors – life events, relationships, support network, etc.

No two people will grieve in the exact same way. The process of grieving will differ according to the circumstance of the loss, the person and their culture. The signs and symptoms listed here can be explained by a number of factors or illnesses. Many signs of grief are similar to the signs or symptoms of depression, but it is important to remember that  grief is not an illness.

Only if these symptoms are excessive, go on for a longer period of time than is “typical”, and interfere with normal everyday functioning will grief be seen as problematic or “complicated”.

Emotional Symptoms of Grief

There are a number of feelings that people experience while coming to terms with a loss, and these feelings can come in “waves” or appear to happen in “phases”:

• Shock, numbness, bewilderment, a sense of disbelief, denial.
• Feelings of emptiness or intense suffering.
• Dreams and/or hallucinations that their loved one is still alive.
• Feelings of despair as one comes to terms with the loss.
• Feelings of sadness; the inability to feel pleasure.
• Tense, restless anxiety may alternate with lethargy and fatigue.
• Individuals may alternate between avoiding reminders of the deceased and reclaiming memories.
• Self-blame for treating the deceased badly.
• Feelings of sadness may also be complicated by feelings of relief, fear, guilt, anger, etc.

Physical Symptoms of Grief

Physical symptoms of grief can include:

• Weakness
• Sleep disturbances
• Loss of appetite or overeating
• Headaches
• Back pain
• Indigestion
• Shortness of breath
• Heart palpitations
• Occasional dizziness and nausea

Cognitive Changes Associated with Grief

• Cognition is slowed down, difficulty thinking, concentrating or remembering.
• Difficulty making decisions, avoiding making decisions.

Behavioural Changes Associated with Grief

• Social isolation, withdrawal from work, school, friends, hobbies, etc.
• Neglecting duties such as homework, housework, paying bills, etc.
• Decrease in physical activity and exercise.
• Decrease in self-care (not showering, grooming, eating, etc.).
• Increased use of alcohol or drugs (prescription and/or non-prescription).

Someone who is grieving can go through a series of emotional phases as they work through their feelings and learn ways to move ahead and cope. Some ways to manage feelings of grief include:

Honour Loss in Your Own Way

The way someone recognizes a death in the family or any type of loss will be different for each person, culture and/or circumstance. Most cultures have a way of recognizing a loss through a celebration of life or funeral practice. Recognizing a death with family and community by participating in some type of ritual or cultural practice can be useful in helping someone through a loss and finding a sense of closure. Sometimes a person’s faith or community of worship is integral to how someone thinks about and deals with loss.

Lean on Connections for Support

Connection with others can help someone when they are experiencing loss. This could be informal, like spending time with family, friends or community or in the form of an organized support or bereavement group. For some, however, bereavement groups might not be helpful or might make someone focus too heavily on their loss. Every person is different.

Reintegrate Into Daily Life at Your Own Pace

Moving forward with “regular life” can help someone move through loss. Returning to work or school (when ready) or resuming hobbies and social life can help someone feel productive and learn to adjust their life after a loss. For others, a break from “regular life” is needed for a time in order to process and cope with their grief, so taking time off from work or school can be helpful.

Seeking Professional Support

If the grieving process seems particularly intense or doesn’t seem to be resolving itself over time, it’s a good idea to talk to someone. That someone could be a friend you trust, a teacher, your family doctor, a crisis line, or counsellor.

If you feel like your friend might hurt themself or someone else, it’s time to call emergency services.

Visit the Help Section to find out how to get help for yourself or a friend.

Psychological Help

Formal psychological help usually isn’t used in grief cases unless someone is experiencing complicated grief. In this case, psychotherapy might be helpful for someone to resume daily activities and work through feelings like anger, regret or guilt in order to heal.

For some, complicated grief can turn into or complicate mood or anxiety disorders, in which case a person might need more or different treatment to deal with the symptoms and causes of those illnesses.

Finding the Right Support Plan

Every story is different, and sometimes people need to try different types of supports before they find the right plan for them.

Supporting a Friend Through Grief

If it is a friend you are concerned about, they may resist help in managing their feelings of grief or not even recognize that they need it. They might need you to take the first step.

A person experiencing grief, like any other person, will benefit from maintaining wellness and having good supports in their life.

Myth: Grief has a definite ending point. You should be done grieving after about a year.

Fact: Grief doesn’t run on a schedule, and everyone experiences and copes with grief differently.While you may get through the initial, more intense period of grief or bereavement and resume “regular life” after a while, it doesn’t mean the loss isn’t still felt. Certain holidays or anniversaries, situations, objects or settings may create a wave of emotion and grief over a loss, even if the loss happened years ago. There are instances where people do seem to grieve intensely for a prolonged period of time, and it starts to interfere with or complicate their life or health (sometimes referred to as complicated grief or persistent complex bereavement disorder), but this isn’t simply diagnosed based on a set number of weeks or months someone has been grieving. It is determined by how the grief is affecting a person’s life.

Myth: The length of time and intensity you grieve for a loved one is a direct reflection of how much you loved them or how close to them you were.

Fact: While it’s true that losing people that are close to you (a parent, partner, sibling or child) can be particularly hard, how someone grieves the loss of a loved one is likely going to depend on their personality, their life experiences, their age, their culture, the circumstances around the loss etc. Some may lose someone very close to them and seem to resume regular life fairly quickly. This doesn’t mean they didn’t love their friend or family member – it might mean that they have coped with the loss in their own way or find returning to work, school or hobbies comforting. For others, the loss of someone, even if they weren’t that close to them or had a strained relationship with them, can affect them much more and for longer than expected. There is no right or wrong way to grieve.

Myth: Grief is about feeling sadness.

Fact: Feeling a loss is often about feeling intensely sad. But it is often more complicated than that. Sometimes people feel shocked, angry, guilty, regretful, scared, numb or even relieved. For instance, losing a parent can affect your financial stability, causing one to feel uncertain and worried on top of feeling sad for their loss. Someone else might lose someone after a long and painful illness, causing them to feel relief that the illness is finally over. Someone who has lost physical ability due to an accident might feel sad but also angry or scared as they figure out how to adjust their life. There is no right or wrong way to feel while grieving over the loss of a loved one. How someone feels while grieving can change over time or depend on the circumstances of the loss.

Myth: Grief won’t last as long as you avoid talking about or thinking about the loss. Grieving alone and in silence is better.

Fact: While this may work for some in the short term, most often if there’s a way to process the loss – by talking, thinking, writing, etc. about it – it can help to process feelings of grief. Reaching out to someone that will listen and help you through it can really help.

Supporting someone through their grief can feel uncertain or challenging. It is easy to feel like you’re doing or saying the wrong thing or feel helpless because you want to help but don’t know how.

Here are some possible ways to help and support a friend or loved one who is grieving:

Be a Compassionate Listener

Be reassuring and sympathetic company and a good listener. Listen without judging and resist the urge to try and “fix” their problems for them. Dealing with grief is a process.

Offer Specific Support

Saying something like “if there’s anything I can do, let me know” is always done with the best intention, but it puts the responsibility on the grieving person to reach out and ask for help. Instead try “I’m going to drop by tomorrow with some groceries”, “I’m going to call you in a few days, and we’ll go catch a movie” or “how about we go for a walk tomorrow?” might be more effective, because they are specific plans to help or connect.

Avoid Unhelpful Phrases

Saying “God has a plan…” or “time heals…” when someone is experiencing a significant loss may not be helpful. It might be said or thought with the best intentions, but it could also make someone feel like their feelings of grief aren’t validated or appropriate. It’s ok for people to feel angry or sad when they lose something/someone and have their feelings validated.

Encourage Healthy Expression of Grief

Discouraging expressions of grief or shutting off discussions about the person who died is not helpful, because these things are part of the healing process for a lot of people. Don’t worry- talking about the loss isn’t going to “remind” them, because the loss is likely not far from their thoughts anyway. Sharing stories of the loved one who died or the times in the past before the loss can actually be very comforting and help someone move forward.

Validate Their Feelings

Reassuring someone that their feelings are valid and normal is a very supportive thing to do. Don’t judge a person because they aren’t thinking, feeling or behaving in the same way you would. They need to feel and express themselves in their own way.

Recognize Grief Beyond the Loss

Grief is often bigger than the loss. For instance, if someone loses a parent, there might be other stresses felt around financial support, family roles or security.

Keep Them Included

Keep including your friend in your life and social activities. Don’t always assume that they want to be alone or with family. Invite them out to dinner, coffee, or for a walk. They might say “no”, but they’ll probably appreciate the offer because it shows you care.

Connect Them to Grief Support Services

If you feel like your friend needs extra support or that their grief is prolonged or intense enough that it is interfering with their life, try connecting them to some services in your area for support (see Help Section).

Be Patient

Stay calm and don’t take things personally. Sometimes grief can really  affect how someone reacts or communicates, which can be confusing, distressing or even hurtful at times. They may be feeling overwhelmed and acting out, and it’s probably not about you.

Respect Their Needs

Some people need time to themselves to process the loss, while others might need to spend time with people. Be supportive and try to resist the temptation to tell them what you think they need to do. Remember that everyone deals with things differently.

Take Care of Yourself Too

Set some boundaries for yourself and take care. You can’t help someone deal with their grief if you’re feeling overwhelmed by yourself.

See the Help Section for more info about helping a friend and self-care and coping with grief and loss.

Memorializing Tattoo – a blog about how one woman has turned to tattoo art to help her cope with the loss of her son.

Sara Westbrook shares her thoughts on grieving and how complicated it can be.

Loss –  short animated film narrated by Bif Naked

Coping With Grief and Loss – A collection short tips for coping with grief

Exploring Grief – a blog with resources

Find more about Grief and Loss

For more in-depth information about dealing with grief, please visit these resources and references or speak to a medical professional.

Ontario – call ConnexOntario to find out where there are mental health supports in your community.

Crisis – in any situation where someone is at risk of hurting themselves or others, call 911 or a local crisis line. You can find resources near you on the free and confidential Be Safe App.

Canada-wide – YouthGrief.ca is a website with content by grieving youth, for grieving youth. MyGrief.ca was created by the same organization for all ages with modules to help you understand your grief and learn how to cope. What’s Your Grief is a website run by counsellors who have experienced a loss. They created this website when they realized they couldn’t find a resource that fit what they needed at the time. There are lots of great blogs and a few e-courses to guide you through the grieving journey.

Please see the Help Section for more information and resources.

References

1. Centre for Addiction and Mental Health (CAMH)
2. Canadian Mental Health Association (CMHA)
3. Mood Disorders Association of Canada
4. Canadian Psychological Association