[HEALTH] Good Grief!

What is grief? And, what is the ultimate fallout when it runs rampant? Grief is complicated and takes dangerous turns over a period of time if left unchecked. This here is my first post since early November 2021. That is 141 days or 4 months, 21 days and 20 weeks ago. Something happened in this period of time that impacted me mentally and slowly shut me down health-wise as well. Today I try to understand it as I slowly recover and throw some light on what I discovered through this crazy journey.

What looked like a successful year personally and professionally was going to end with a bang as little sister Sophie was set to be married in December. Work was going well after a rather long spell and the ghosts of the past were more or less just that. Ghosts. But a surprise was around the corner that brought me to a standstill. Completely. It was like hitting a brick wall. Slowly shutting me down.

The one person I can without a doubt say was someone who inspired me and impacted my life immensely, suddenly died in November. Healthy and active, it came as a shock. I’m grateful I met and shared a big chunk of my life with him, but sad he left us so suddenly. I was okay I guess at that time but, as the days went by things got worse. Could it be because we hadn’t spent time together the last couple of years? I left the city and moved back to my parents’ home in the country due to health complications in 2017 and then the pandemic and lockdowns complicated things further. But, things certainly did take a turn for the worse by the time Sophie’s wedding came around.

Was this me grieving? Could a loss a month earlier hit me mentally and start shutting down my health? I pushed it back to the dark recesses of my overactive brain. It didn’t help that I was returning to the city for the first time since I left four years earlier. I’m guessing there were ‘triggers’ involved here. Triggers similar to what I wrote about with regard to addiction-recovery. Nevertheless, I enjoyed the wedding and headed back home, looking forward to an awesome 2022 with great promise.

By the time January came around, I thought I had things under control but there was a blowout in my marital life and shit hit the fan once again. I was back to deteriorating health that included loss of appetite, weight loss (I lost 18 kilos in two months), double vision, anaemia and more importantly, the will to live. I tried pushing it back to the dark recesses of my overactive brain once again but this time things got a little too complicated. I ended up in the emergency room of a local hospital.

Now here’s the thing. Grief is the natural emotional response to the loss of someone close, such as a family member or friend and is loosely divided into two broad categories – normal and prolonged or complicated grief. Grief can affect your physical & mental health and grieving is an individual process, different for everyone. As I dug deeper for more information, there was a whole gamut of the varied grief people go through that I found on the Vista Pines Health website.

Anticipatory grief For family caregivers, grieving can start long before the person you are caring for actually passes way. Anticipatory grief often starts when the person you are caring for gets a significant diagnosis and their health begins to deteriorate. Feelings are related to the loss of what was or what you thought life was going to be like. It can be difficult to speak with others about anticipatory grief because the person you care for is still alive and you may have feelings of guilt or confusion as to why you are feeling this kind of grief. Normal grief Contrary to what the name might suggest, there really are no set guidelines to define normal grief in terms of timelines or severity of grief. Instead, think of normal grief as any response that resembles what you might predict grief to look like (if that makes any sense!). Many people define normal grief as the ability to move towards acceptance of the loss. With this comes a gradual decrease in the intensity of emotions. Those who experience normal grief are able to continue to function in their basic daily activities. Delayed grief (was this what happened to me?) Delayed grief is when reactions and emotions in response to a death are postponed until a later time. This type of grief may be initiated by another major life event or even something that seems unrelated. Reactions can be excessive to the current situation and the person may not initially realize that delayed grief is the real reason for becoming so emotional. Complicated grief (traumatic or prolonged) Complicated grief refers to normal grief that becomes severe in longevity and significantly impairs the ability to function. It can be difficult to judge when grief has lasted too long. Other contributing factors in diagnosing complicated or prolonged grief include looking at the nature of the loss or death (was it sudden? violent? multiple?), the relationship, personality, life experiences, and other social issues. Some warning signs that someone is experiencing traumatic grief include: self-destructive behaviour, deep and persistent feelings of guilt, low self-esteem, suicidal thoughts, violent outbursts, or radical lifestyle changes. Disenfranchised grief (ambiguous) Disenfranchised grief can be felt when someone experiences a loss but others do not acknowledge the importance of the loss in the person’s life. Others may not understand the importance of the loss or they may minimize the significance of the loss. Disenfranchised grief can occur when someone experiences the loss of an ex-spouse, a pet, or a co-worker. The other side of disenfranchised grief is when you experience a loss such as when the person you are caring for has dementia or a decline in their physical abilities. The person is physically present but they are also absent in other significant ways. Chronic grief This type of grief can be experienced in many ways: through feelings of hopelessness, a sense of disbelief that the loss is real, avoidance of any situation that may remind someone of the loss, or loss of meaning and value in a belief system. At times, people with chronic grief can experience intrusive thoughts. If left untreated, chronic grief can develop into severe clinical depression, suicidal or self-harming thoughts, and even substance abuse.

Cumulative grief This type of grief can occur when multiple losses are experienced, often within a short period of time. Cumulative grief can be stressful because you don’t have time to properly grieve one loss before experiencing the next. Masked grief Masked grief can be in the form of physical symptoms or other negative behaviours that are out of character. Someone experiencing masked grief is unable to recognize that these symptoms or behaviours are connected to a loss. Distorted grief Unfortunately, distorted grief can present with extreme feelings of guilt or anger, noticeable changes in behaviour, hostility towards a particular person, plus other self-destructive behaviours. Exaggerated grief Exaggerated grief is felt through the intensification of normal grief responses. This intensification has a tendency to worsen as time moves on. This may result in self-destructive behaviour, suicidal thoughts, drug abuse, abnormal fears, nightmares, and even the emergence of underlying psychiatric disorders. Inhibited grief This type of grief is when someone doesn’t outwardly show any typical signs of grief. Often this is done consciously to keep grief private. Problems can arise with inhibited grief through physical manifestations when an individual doesn’t allow themselves to grieve. Secondary losses in grief Secondary loss is felt after the primary loss and can affect multiple areas of an individual’s life. The grief from secondary loss is the emotional response to the subsequent losses that occur as a result of a death (the primary loss). Collective grief Collective grief is felt by a group. For example, this could be experienced by a community, city, or country as a result of a natural disaster, death of a public figure, or a terrorist attack. Abbreviated grief Abbreviated grief is a short-lived response to a loss. This could occur due to someone or something immediately filling the void, the distance that was felt, or the experience of anticipatory grief. Absent grief Absent grief is when someone does not acknowledge the loss and shows no signs of grief. This can be the result of complete shock or denial of the death. It can be concerning if someone experiences absent grief for an extended period of time. It’s important to note that in some instances, just because you can’t see the signs of grief, it doesn’t necessarily mean that someone is not grieving. Speak with a health care professional if you need help coping with a loss.

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While the cause of grief is simply attributed to the death of a loved one, it is not clear exactly what causes some to derail over time. Here is what I found online. Grief can also occur after a serious illness, a divorce or other significant losses. So, can these be the causes?

• the death of a loved one – grief can be particularly severe following the death of an infant or child, or a suicide
• divorce or separation
• the loss of a beloved pet
• giving up something that mattered
• work changes – unemployment, retirement, retrenchment
• the diagnosis of a terminal illness
• the loss of good health due to an illness, accident or disability
• miscarriage or infertility
• having a child with a disability, a terminal illness, a mental illness or a substance abuse problem
• moving away or separation from family or friends
• having an ‘empty nest’ when children leave home
• Loss of a friendship
• Loss of a personal dream
• Loss of a romantic relationship

Now, I was diagnosed with mental breakdown bordering on something called a “Psychotic Break.” The second time since August 2007 when my younger brother passed in a motorcycle accident. He was 24 and I became an alcoholic over time. I guess some are more screwed than others while dealing with this stuff.

Photo by Camila Quintero Franco on Unsplash

A “Psychotic break” is the deterioration of someone’s mental and emotional state when they have lost touch with reality. A person having a mental breakdown may not have necessarily lost touch with reality. However, people who have had a “Psychotic Break” have lost contact with the actual outside world, and this is a major difference between them.

What Does a Mental Breakdown Look Like?

A mental breakdown can look different depending on who is having it. A range of behaviours can occur, including a person having an angry or emotional outburst or sudden changes in mood. There are no defined symptoms aside from not being able to function as normal, per Medical News Today. The definition of what’s normal changes depending on where a person lives, what culture they live in, and how they generally experience stress, the medical site says. However, it lists 21 features it says are common in having a nervous breakdown. A few of them are:

• Feeling anxious, depressed, sad, or irritable
• Sleeping too much or too little
• Feeling emotionally and physically tired
• Trembling and shaking
• Moving or speaking more slowly than usual
• Showing a lack of interest or motivation
• Feeling unable to complete tasks or keep appointments
• Forgetting to eat or drink
• Having appetite changes or weight changes
• Failing to attend to one’s personal hygiene
• Panic attacks
• Having thoughts of harm, including dying by suicide
• If a person experiences any of these, they may start to miss days at work or school or fail to show up for social engagements and miss appointments.

The WebMD Grief Experience: Survey Shows It’s Complicated

No matter what you’re grieving, other people may expect you to bounce back long before you’re ready, a WebMD survey finds in the “Grief: Beyond the 5 Stages,” that sought to discover how people grieve after different life events and how they got through them. It was taken May 16 to May 19, 2019, by 1,084 US respondents. Of those, 780 said they had grieved over a life event in the past 3 years.

“Many of us have the misperception that there’s a right way to grieve, and most people think they’re doing it wrong,” says Donna Schuurman, a family therapist and senior director of advocacy and training and at the Dougy Center, a Portland, OR, nonprofit that helps people deal with the death of a loved one. “We live in a society that wants us to get over it and move on.”

The “five stages” in the survey title refers to Elisabeth Kubler-Ross’s pioneering study of grief, which she unveiled in her 1969 book, On Death and Dying. In it, she lays out five stages mourners pass through on their way to recovery: denial, anger, bargaining, depression, and acceptance. But the survey showed that grieving is not a “one size fits all” experience — either in what people grieve for or how they experience it.

Although we may think of grief only in terms of death, a deep sense of loss comes in response to many more events, respondents said:

• Nearly one-third (31%) had faced serious illness — their own or family members.
• About another third (32%) had gone through the death of a family member or close friend, and almost as many mourned a lost friendship or relationship (29%).
• Twenty per cent were recovering from the death of a pet.
• Smaller proportions grieved for divorce or lost jobs, homes, or possessions, among other things.

The duration of intense grieving varied among those who took the survey, depending on what people had lost. Nearly half of all people (48%) said their most powerful feelings subsided within the first 6 months, and two-thirds (67%) had recovered within 1 year. Pet owners were the most likely to recover quickly. Sixty-six per cent of those who lost a pet said their intense grief lasted less than 6 months, compared to 48% of people who lost a close family member or friend to death and 45% who mourned the loss of a friendship/relationship.

Expectations vs. Reality

Grieving is a very personal process, but it can be hard to ignore the expectations of others — and people often expect mourners to return to regular life before they’re ready.

“You’re in that wilderness, off kilter, feeling unmoored, and people aren’t showing up in the ways you hoped they would,” says Schuurman. “We live in a society that wants us to get over it and move on. ‘It’s been this long, are you dating?’ ”

More than half of all participants (53%) said that they’d encountered people whose sympathy seemed to have an expiration date. Of that sub-group:

• 58% of the people who were pressured said they felt expected to recover within the first 3 months. A whopping 81% of those mourning a pet, and 75% of those who’d lost a friendship or went through a breakup, said the same.
• Even for those mourning the death of a close relative or friend, most (91%) felt expected to move on within 1 year.

“It shouldn’t be surprising to see people grieving for longer than we expect,” says Smith. “Clinical texts give you 6 months, but I see it happening for 5 years when it’s the loss of a spouse, child, parent.”

Via Verywell / Alison Czinkota

Mental and Physical Effects of Grief Nearly all (88%) had some type of emotional symptom while grieving, and two-thirds (68%) had physical symptoms.

Just as people needed different amounts of time to recover from their grief, the symptoms they reported varied. Sadness (76%) and depression (43%) were the two main emotions they say they had, while fatigue (59%) and change of appetite (48%) affected the most people physically. But here, too, the symptoms varied, depending on the loss:

• Death — of either a close relative or friend (84%) or a pet (81%) — was more likely to result in sadness.
• Those who’d lost a friendship or romantic relationship were more likely to have depression (53%) and anger (48%).
• Nearly half of those mourning a serious illness (47%) reported a hard time sleeping, considerably more than the next largest group: people who’d experienced a close death (33%).

It makes sense that grief can lead to such varied experiences, says Schuurman.

Grief Triggers

Now, coming back to my original self-analysis. I suspected my return to the city caused the downward spiral and I think this little paper on the subject by Doris Zagdanski, a leading figure in modern-day grief and loss education confirms it. And not surprisingly, grief triggers work very similar to addiction triggers.

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“Grief is a strange beast that we learn to live with. We don’t get over it as if it were a surmountable object. We can become more comfortable with our discomfort but there is no finite time for grief as there is no finite time for love. Grief is often a private affair that others cannot share or perhaps even understand. Grief can spring out of drawers and cupboards, off shelves, from photographs, wafts to our nostrils upon a perfume, is precipitated by music, clutches at our heart, hollows out our insides and plummets us to the depths. It is indeed a strange beast to know and understand, to embrace, digest and assimilate.” The Empty Chair at Christmas’ by Petrea King, CEO of Quest for Life

A ‘Grief trigger’ is anything that brings up memories of a personal loss.

Sometimes, we think of obvious times of the year that such triggers will be the strongest – birthdays, Christmas, family occasions, holiday times and the like. One of the hardest to bear is the anniversary of the death, particularly in the early years – it’s common to recall all the things you did together as you count down the days to the time of the death. Sometimes you will remember every detail of the last weeks, days, hours, moments.

But there are other triggers that can also trip you up unexpectedly. Like times when you see someone who looks like your loved one or hear of someone with the same name or age or job. Favourite colours, songs, TV shows, food – all of these links can cause a memory to ignite some feelings inside you. The change of the seasons – where smells, colours and nature remind you of this specific time of the year and what it means to you. Favourite places, your regular café or just seeing couples or families spending time together – these can trigger memories when you too shared happy times like this.

Grief triggers can be upsetting because they re-kindle emotions and create feelings of sadness, longing, regret, loneliness, thoughts of ‘if only’ and more. Often they spring up unexpectedly to embarrass you amongst company or surprise you with their intensity. Of course, they can also bring memories of great joy and gratitude for the happiness that you had. But one of the problems for grievers is that it’s hard to know if it’s OK to share these memories and feelings because those around you probably think you have moved on and are no longer still affected by your loss. They don’t know that there is nothing more comforting than being able to share and reminisce with someone, even cry with someone. Finding the right person who is sensitive to such triggers can make a real difference to the way you cope with them.

Doris Zagdanski is a leading figure in modern day grief and loss education. Her seminars are included in vocational qualifications in Allied Health, Counselling and Funeral Directing. Photo: MyGriefAssist

“Memories are where our loved ones continue to live after they’re gone; it’s why we hold onto objects that remind us of them and go to places where they feel near. True, when someone we love dies we are forevermore at risk of their memory triggering aftershocks of the pain. But inversely, if we let them, such reminders may also fill us with warmth and comfort.” Eleanor Haley, ‘Grief Triggers and Positive Memory: a Continuum’ Co-Author of What’s Your Grief

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Fight It!

I found an interesting article online at Verywell that discusses some of the strategies that you can use to cope.

Coping with grief unfortunately has no method to eliminate or avoid the physical effects you might experience. While difficult and often painful, grief is a normal and necessary response to the death of a loved one, and most people will see a reduction of grief-induced physical effects with the passage of time.

For some symptoms, such as stomach upset, over-the-counter medications may be helpful. Always take these medications as directed on the label.

If any of the physical effects you’re experiencing do not subside in time or feel unbearable, you should consult your physician or healthcare provider. This is particularly the case for pain or physical discomfort, digestive problems, illness or flu, or if an existing chronic health issue worsens. In addition, the most important way you can help yourself while grieving is to take care of yourself and your needs. Many of the physical effects of grief listed above arise from the failure to listen to our bodies and practice the healthy habits we otherwise might. Here are several important ways grievers can care for themselves.

Stay Hydrated Drink plenty of water throughout the day and avoid excessive alcohol consumption. Alcohol acts as a diuretic and can actually dehydrate your body. Exercise If you regularly exercised before the death of your loved one, then try to continue that routine as much as possible. And if you led a sedentary lifestyle, then consider finding some time to exercise each day, such as taking your dog for a walk, riding your bike, or asking a friend to stroll with you in the local park or shopping mall. Even moderate daily exercise can help you sleep better, help work out some muscle stiffness or discomfort, and can often lift your spirits and improve your outlook. Eat Nutritious, Nourishing Foods As noted above, grievers often find it difficult to have a meal even if they feel like eating. At times like this, consider eating several smaller meals during the day if your schedule interferes with your usual breakfast, lunch, and dinner routine. In addition, the foods you consume should consist of healthy, nourishing items rather than fast food or something you purchase from a vending machine. If you lack the time or energy to shop for groceries, consider asking a loved one to visit the market for you. Rest While grief typically disrupts our normal sleep patterns, getting proper rest is important. To whatever extent possible, try to develop a regular bedtime routine and schedule; minimize distractions, such as a television, iPad or tablet, or cell phone; and keep your bedroom dark. In addition, try to avoid caffeinated drinks for at least three hours before bedtime. Make Plans Making plans for the future and staying busy can also help with the physical pain of grief. Having things to do in the future can give you something to look forward to. Staying busy at the moment can help take your mind off of your discomfort and grief.

While there isn’t any quick or easy way to relieve the physical symptoms of grief, there are steps you can take to start feeling better. Staying hydrated, being physically active, eating well, and getting plenty of rest can help. Making plans for the future can also offer a distraction from your physical symptoms.

A Word From Verywell People don’t just experience grief on an emotional level; they also feel it on a physical one as well. These symptoms can be concerning at times, but it is important to recognize that the physical pain you feel is a normal part of the grieving process. Many of these symptoms gradually resolve on their own with time. However, if they are causing serious impairment or lasting longer than you think they should, don’t be afraid to talk to your Doctor.