Grief Happens

One of the certainties of life is that we will all experience grief in one form or another. While we will experience grief, will we really understand what is happening as we go through this process. Yes, this is a topic that most people would rather not talk about, or avoid as it can be an uncomfortable one, or maybe it awakens unpleasant memories. 
However, having some insight and knowledge about this experience may just help you understand your feelings and behaviors when grief happens.
 
Definitions
 
Let’s start with some basic definitions and clarifications regarding grief. Along with the term grief, there are some other terms that may be used interchangeably. You may hear the words bereavement and mourning. While there are similarities, there are also some significant differences.  

• Grief refers specifically to the emotional responses, feelings, and reactions related to loss.
• Bereavement refers to the period of time after the loss.
• Mourning is how grief is expressed, such as rituals, funerals, or celebration of life ceremonies.

While understanding terminology is important, it is imperative to recognize the emotions, feelings, and behaviors associated with grief. And it is especially important to understand that everyone experiences grief differently. It is a unique journey!
 
What Happens When We Grieve
 
When someone is experiencing the grief process, it is unlikely that time will be given to analyzing the feelings and behaviors they are experiencing.  Elisabeth Kubler-Ross provided understanding and awareness of these feelings with her research on the grieving process, and publication of the book “On Death and Dying.” While her book was first published in 1969, it is still referenced frequently and introduced the Kubler-Ross Model with the  five stages of grief and loss.

• Denial
• Anger
• Bargaining
• Depression
• Acceptance

To address the complexities of the grieving process, the Seven Stages of Grief model was developed by adding additional stages.

• Shock and Denial
• Pain and Guilt
• Anger and Bargaining
• Depression
• The Upward Turn
• Reconstruction and Working Through
• Acceptance and Hope

While these models provide us with insight and a framework for understanding the grief process, it is important to remember that grief is very personal. Grief does not follow a schedule or timeline.
While everyone copes differently, grief can affect the mind, body, and spirit, and can demonstrate the following symptoms.

• Emotional
  • Sadness
  • Guilt
  • Apathy
  • Anger
  • Confusion
  • Feelings of hopelessness
• Physical
  • Fatigue
  • Nausea
  • Gastric upset
  • Restlessness
  • Heart Palpations
  • Chest or throat tightness
  • Appetite changes
  • Changes in sleep routine
  • Joint Pain

Grief can also affect an individual’s ability to concentrate, make decisions, or focus. In some circumstances the person grieving can only focus on their loss.
 
Complicated Grief
While experiencing the above symptoms can be a normal part of the grieving process, there are times when grief becomes overwhelming, incapacitating, and will not improve as time goes on. This is referred to as complicated grief.  While it is uncertain why complicated grief occurs in some individuals, it is important to recognize the signs, symptoms, and complications, as they can lead to serious outcomes if not addressed.
Signs, Symptoms, and Complications

• Intense feelings of pain and sadness.
• Constant focus on loss.
• Intense feelings of longing.
• Difficulty accepting the loss.
• Feelings of bitterness.
• Feeling that life has not purpose.
• Inability to enjoy life.
• Difficulty carrying out daily routines.
• Isolating self.
• Depression, guilt, or self-blame.
• Suicidal ideation.
• Substance abuse.

How Do We Cope With Our Grief?
We know grief happens, and we know everyone will react and cope differently when it does. But knowing there are some coping strategies to help us get through the grieving process is also important. Here are some suggestions which may make the process easier.

• Be patient with yourself and give yourself the time you need.
• Take care of yourself and remember it is important to take care of your mind and body.
  • Get adequate sleep
  • Exercise
  • Get adequate nutrition
  • Relax with meditation or yoga
• Stick to your routine.
• Be aware of your emotions.
  • Cry if you need to
  • Express your feelings by journaling, or sharing stories
• Ask for support and help.
  • Do not isolate yourself.
• Seek professional help if needed.

As you explore different coping strategies, do not forget-everyone grieves differently. While Elizabeth Kubler Ross increased awareness with her book in 1969, much has been accomplished since then to increase awareness on the grief process and how unique it is for everyone. 
Angie Cartwright founded Grief Awareness Day in 2014, and it is recognized every August 30th.  Her motivation was to provide education, increase awareness on the uniqueness of grief, and to honor her late Mother. There are many helpful sources available which provide education, information, and resources.
So, take some time this August, specifically on August 30th, to check out some resources and become familiar with what is available and where you can find support when you need it. And remember there is no right way or wrong way to grieve, just your way.
 
                                                                                              - Peggy Fossen DNP, RN CNE
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
References
Cleveland Clinic. Grief.  https://my.clevelandclinic.org/health/diseases/24787-grief
 
Elisabeth Kubler-Ross Foundation. https://www.ekrfoundation.org/elisabeth-kubler-ross/biography/
 
Elisabeth Kubler-Ross Foundation. On Death and Dying.  https://www.ekrfoundation.org/5-stages-of-grief/on-death-and-dying/
 
Good Grief. Grief Resources. https://good-grief.org/resources/
 
Grief Recovery Method. Grief Awareness Day; Normalizing Grief and Grief Recovery. https://www.griefrecoverymethod.com.au/grief-awareness-day-normalizing-grief-and-grief-recovery/
 
Holland, K. (2023). The Stages of Grief and What to Expect. https://www.healthline.com/health/stages-of-grief#7-stages
 
Mayo Clinic. Complicated Grief. https://www.mayoclinic.org/diseases-conditions/complicated-grief/symptoms-causes/syc-20360374
 
Moore, M. (The Difference Between Mourning and Grieving.(2022). PsychCentral.  https://psychcentral.com/health/mourning-vs-grief
 
National Grief Awareness Day. https://nationaltoday.com/national-grief-awareness-day/#:~:text=This%20National%20Grief%20Awareness%20Day,we%20know%20who%20are%20grieving.
 
The Difference Between Grief and Bereavement. (2012).
https://www.differencebetween.com/difference-between-grief-and-vs-bereavement/
 
Vasquez, A. (2022). Is Bereavement the same as Grief. https://www.joincake.com/blog/bereavement-vs-grief/
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