Grief is the most common feeling experienced by anyone affected by death. It is normal after a loved one’s death.
You may experience anticipatory grief, which is grieving associated with an expected event.
In this case, you are aware of and will be grieving your loved one’s impending death and you may be grieving about additional things personal to you.
Grief is a very personal process and there is no right way to do it. Grief can be a long and difficult process full of ups and downs, relapses, confusion, and changing hopes for the future. Your family and friends will also be grieving about what you are going through and the loss of someone who is their loved one as well.
The well known Kübler-Ross model “Stages of Grief” is a good guide of how feelings and emotions can be mixed together and change over time. Originally, there were five stages of grief observed, but the model has since been updated to include a total of seven stages.
Many grieving people will go through all of these stages, but not everyone will. Each of us experiences the stages of grief in different orders, intensities, and lengths of time. Often the stages overlap and may even take place at the same time. Denial tends to come first and acceptance is typically the last stage.
The well known Kübler-Ross model known as “the Five Stages of Grief” is a good guide of how feelings and emotions can be jumbled together and change over time. Some or all of the following may be seen when you are grieving.
Dr. Kübler-Ross later refined her model to include seven stages of loss. For this updated guide, there are an additional emotional stage (stage 2) that includes pain and guilt and two stages (5 and 6) that describe the ebb and flow of emotions over time during the recovery process. Three stages now combine a milestone with the predominant emotion during that stage, shock and denial, anger and bargaining, and acceptance and hope.
This stage recognizes that denial is usually a result of a state of shock, disbelief, and numbed feelings. Inability to accept your loss may lead to overwhelming longing for your loved one or even the belief they are still alive.
In this stage you are now reacting to the situation and may feel that the loss is unbearable, and guilty that you’re making loved ones’ lives harder because of your situation. You may also feel guilt about lost opportunities with, previous treatment of, and negative feelings toward your loved one.
This stage recognizes that anger is the most likely emotion to make you want to bargain. You may lash out at those around you or reach to a higher power, offering anything in exchange for relief from your feelings and illness.
Depression is not always a psychological condition, but a normal emotional reaction to loss. It usually happens when you are feeling overwhelmed and helpless. This may be a period of isolation and loneliness during which you process and reflect on the loss.
This new stage reflects the ups and downs of grief and recognizes that there is a point that things do improve. During this stage anger and pain have died down, and you’re left in a more calm and relaxed state.
This is a new stage that recognizes that you can begin to move forward before you have fully accepted your situation. Although there are ups and downs, you are now able to start putting pieces of your life back together and carry on.
This stage now combines the feeling of hope with acceptance. For those facing the end of their life, it is the time when you accept the prognosis and begin the process of making life more comfortable. For those who have lost a loved one it is a time when they become more optimistic about their lives without their lost loved one.
There are many powerful emotions that are mixed into the grieving process. Some or all of them may be experienced while you are grieving. You may need to deal with them before you can move onto another stage. There are general ways to cope, such as talking with sympathetic friends, loved ones, or others who are going through similar experiences, attending support groups, and/or reading books or listening to recorded material that may be a guide through grief. In many cases there may be specific ways to help relieve or channel certain emotions or feelings.
There are many fears that can be associated with the death of a loved one, such as being afraid:
In some cases knowing what you fear can help you face it and manage it.
While a common stage of grief, anger is also a powerful emotion.
When you are losing or have lost a loved one there are many types of loss you experience other than the loss of the person. Secondary losses can include the loss of your identity (parent, spouse, or best friend), lifestyle, and the feeling that you have lost your future and purpose in life.
Life rarely goes how we want, so it is not uncommon to have regrets or feel guilty about things you have or have not done or said to your loved one. You may even feel you have not met their expectations. This is a time you must try to look forward and control those things you can.
Depression and anxiety are not always a psychological condition, but a normal emotional reaction to loss, and are quite common when a loved one is very ill or has died.
Although the line between typical depression due to grief and clinical depression may be difficult to recognize, it is important to know if you have crossed it.
After a loved one dies, it is easy to feel that you are alone going through your loss. However, your family and friends have also lost one of their loved ones and enough people have gone through similar situations that you have available support.
While taking time and space for yourself is important in times of grief, try not to isolate yourself from life or family and friends no matter how alone you may feel. Maintaining a connection with your loved ones and making new connections to others in a similar situation are the best way to prevent the loneliness that can come with an end of life experience.
In addition to emotions, grief can also manifest in unexpected ways. There can be physical symptoms as well as changes in behavior and in your ability to think.
How intense these manifestations are will depend on the circumstances. A lot of how you experience grief will depend on how significant your loss was, how your loved one died, your emotional response, personality, ability to cope, life experience, faith, and support system.
Your grief is likely to be more intense if your loved one dies suddenly or violently, especially from suicide. In contrast, if they are dying of or have died from old age or a chronic illness, grief may be less intense.
Grief tends to be more intense if associated with guilt, shame, and regret.
Losing a spouse is devastating and may have consequences beyond grief which can affect your lifestyle and make the loss worse.
Depending on the circumstances you may grieve about missing a part of yourself, lost opportunities, unresolved differences, lost potential, unfulfilled dreams, and their suffering.
You may experience extreme loneliness, as you have probably lost your best companion.
You will have a new identity, such as being single, a widow/er, or a single parent, and an entirely different life that you have to adapt to. When the loved one who dies is elderly, the effect will differ depending on your relationship with them.
As a spouse, you are losing your closest companion and a lifetime of shared experiences. The feelings of loneliness may be compounded, since deaths of close family and friends are more likely to have occurred at an advanced age.
Unlike other strong emotions associated with the death of a loved one, grief is an adaptive and healthy reaction to loss. It may happen right away or take time to set in, especially if you are in shock and feeling numb from the initial loss. Although it may never truly go away, the intense stages of grief may last for months to years.
Traditionally, you express your grief in two ways.
Complicated or unresolved grief over a loved one’s death occurs when your grief is excessive or does not fade. This is abnormal and negatively affects you and your family’s ability to move on with your lives. It is associated with a high risk of suicide and you should seek help as soon as possible. Symptoms present for at least six months are considered complicated grief and can include: