Managing Grief

Grief is something most of us will experience during our lifetimes, whether grieving the loss of someone we love, or the loss of a job, or even losses of familiar routines due to the pandemic. That is not to say that these types of grief are equally weighted, only rather that grieving is not limited to losses due to death. Grief is an umbrella term for the sum all the feelings you have when someone or something important to you is no longer a part of your life. There is only one cure for grief, which is to grieve.

Kelly Russell, a chaplain with INTEGRIS Health Hospice and Palliative Care Services, notes that while grief is a universal experience, each individual’s grief experience is unique. “Two people grieving the loss of the same person will do so each in their unique way. One may appear to move on, going about daily life, while grieving privately. The other may deal with the loss by grieving publicly,” he says. 

Grief can feel like an emotional roller coaster. Emotions change quickly, and we may feel unsteady. Sadness, depression, anger, guilt, relief, panic, resentment and fear are all possible. They may visit one at a time; they may come in groups.  You may feel one emotion, predominantly, for days or weeks or you may cycle through emotions several times a day. There is no right or wrong way to feel while you are grieving a loss. 

Grieving the loss of a loved one

When a loved one dies, those left behind will experience one of the greatest sorrows that can occur in life. Although painful and at times overwhelming, grief is a normal, healthy response to loss. A person who’s loved one has died is referred to as being bereaved. People who are bereaved will not recover in a specific amount of time, and each person’s grief will take its own path. 

“Talking is important especially during early phases of grief. It’s important to have a circle of people who will support you and who you can vent to. If you’ve been caring for a loved one, your circle may have lessened, and people may not know what to say or do, so it’s important to reach out to people when you need to,” Russel says.

The bereaved may experience trouble sleeping, crying spells, sleeping too much, changes in appetite, difficulty concentrating, lack of productivity at work or feelings of anger.

Anger might be directed at the deceased, yourself, other loved ones, doctors and nurses, God or even the rest of the world for carrying on as though nothing has happened.

Feelings of guilt, lamenting things you imagine that could have been different, things you could have, should have or wish you had done are also common.

There is no set time frame for grief. The National Cancer Institute suggests that in normal grief, symptoms will occur with less frequency and will feel less intense as time goes by. For most bereaved people, symptoms will start to lessen between six months and two years after the loss.

You may never fully stop grieving, but in time grief lessens and positive or loving memories return. The duration of intense grief, and a person’s reaction to loss will be partly influences by the circumstances surrounding the death and your relationship to the deceased.

“You begin to heal by acknowledging your loss. One tactic is, when you feel overwhelmed by loss, is to allow a moment to sit in that pain. Set a literal timer and experience what you are feeling.” Then, Russell says, when the timer goes off, get up and do something. Make a list of things you can do, even very small things, to honor the life of the loved one who has died. 

Grieving other losses 

We most often associate grief and grieving with death, but there are many other types of loss that can trigger a sense of bereavement or grief. Here are a few.

• Relinquishment, which is a chosen loss, such as a breakup or giving up a bad habit like smoking. 
• Institutional loss is when a social system fails you. An example would be a church or company failing to live up to its promises to protect or look after you.
• Financial or worldly loss. Loss of a job, or your home or financial security are events which trigger grief in many.
• Estrangement is the feeling of loss that comes from a shift in the status of a family relationship, romance or friendship. 

Some common causes of grief might be a bit of a surprise, such as the following.

• Marriage 
• Retirement 
• Pregnancy 
• Changing to different line of work 
• Different responsibilities at work 
• Outstanding personal achievement 
• Spouse starting or stopping work 
• Beginning or finishing school 
• Moving
• Vacations 
• Holidays

Physical effects of grief

Sadness is perhaps the emotion most closely associated with grief. Anger, resentment and loneliness are other emotional effects of grief. It’s important to be aware that grief can also have distinct physical side effects on people. Grief and its associated stress can profoundly affect the body. During the first six months after the loss of a loved one, people are more likely to experience some sort of physical ailment or malady, and men are more likely to do so than women. Common things to look for include the following.

Headaches. The pain is caused by the overwhelming amount of stress hormones being released during the grieving process, and can affect the head, back or joints.

Chest pain. We often say that our heart aches during grieving. There is even a condition called Takotsubo Syndrome or broken- heart syndrome, in which the symptoms feel similar to a heart attack, including shortness of breath and chest pains.

Stomach pain. For many of us, the gastrointestinal system tends to be the most reactive to stress. Grief is an extreme source of stress, and those experiencing grief may also experience nausea, queasiness, constipation, bloating, diarrhea, flatulence, heartburn and acid reflux.

Loss of appetite/weight loss. A grieving person may not have the energy to cook a meal or venture to a restaurant. They may, during the days and weeks after a death or loss, be so consumed with planning a memorial or funeral and dealing with visitors, relatives and friends, that they forget to eat or eat small, irregular meals on the go. 

Increased appetite/weight gain. Conversely, a grieving person may gain a few pounds in the days and weeks following a death or other loss. Factors involved could be getting less exercise, grief-induced emotional eating, 

Sleeping too much or not enough. One of the more common early signs of grief is that feeling of being extremely tired all the time. It’s that can’t-get-out-of-bed tired that may keep you from getting up and doing all the things you used to do every day. Conversely, after loss, your racing mind can keep you awake with thoughts and memories. 

Trouble concentrating/difficulties with memory. The cognitive effects of grief can interfere with your ability to think clearly, to make wise decisions and to problem solve. Studies have shown that short-term memory can be affected for those who are grieving.

Chills or sweats. Perspiring more than usual, having the chills or even night sweats are common among people who are grieving. 

Reaching out to a grieving person

Try not to be afraid to reach out to the bereaved. While you cannot take away the pain of grieving, your presence as a friend or loved one can be a source of comfort. Almost nobody knows exactly what to say or do to help someone who is grieving, and that’s ok. Even small gestures like sending a card or offering to pick up groceries or mow the yard are important. 

“Think ahead. Before you reach out, make a plan to do it regularly, even if you feel rejected at first,” Russell says. “Listen more and talk less. Allow them to vent, for it to be about them. I caution people not to say ‘I know how you feel,’ because we are each unique. Don’t try to fix it.” Instead, he suggests asking questions about the person’s life, or even asking to see photos.

Here are a few more tips.

• Don’t avoid mentioning the deceased person or the situation that has triggered the grieving process. You won’t ‘remind’ the person of their loss, and he or she will appreciate hearing your words.
• Say ‘how are you feeling today?’ instead of ‘how are you?’ The bereaved person is clearly not great, because they’ve just experienced a devastating loss, so by asking the question you greet everyone with, her profound loss is diminished. Recognize the extraordinary circumstance.
• Offer hope, but don’t be glib. Say something along the lines of: "You will grieve for as long as you need to, but you are a strong person, and will find your way through this." 
• Listen and don’t judge. Often, people work through grief and trauma by telling their story over and over. Unless you are asked for your advice, don't offer it.
• Help. Offering specific help is best, being too general puts the burden of what to ask for back on the grieving person. Bring a meal, mow the yard, offer to run errands. 

Grief is a universal experience. We will all face it at some point in our lives, and there is no right or wrong way to experience bereavement. Help is here. INTEGRIS Hospice in OKC offers a confidential, co-cost grief support program. To learn more, please visit our Grief Support program page.