There is no one size fits all when it comes to grief. During Mental Health Awareness Month, learn the causes of grief and some resources for getting through — and living with — loss.
Loretta Wilson is a psychiatric nurse practitioner specializing in end of life and psycho-oncology at Kaiser Permanente San Francisco. She helps individuals and their families cope with the mental and emotional ramifications of illness and terminal diagnoses. A daily witness to grief in its myriad manifestations, Wilson shares what she has learned about the condition.
How do you define grief?
While we might first think of grief as the mental suffering and sorrow provoked by losing someone, a person can feel grief related to other losses as well. Divorce, losing a home, being the victim of a crime, even a career change: Each can carry its own kind of loss and grieving.
I often work with people grieving the loss of the expectation that they will be healthy or the loss of an anticipated future, which can be quite scary.
What are the symptoms?
Sadness, crying easily and often, isolating oneself, low energy, poor concentration, and eating too much or too little are all common signs of grief. However, there is no ‘right’ way to grieve, and it can look a lot of ways.
Clinician Elizabeth Kubler Ross named the 5 stages of grief: denial, anger, bargaining, depression, and acceptance. In follow-up books she conceded there is variability in intensity, length, and order of the stages. Some people will travel through the stages over and over. Others may linger a long time in one stage or another.
How can people work through grief?
Grieving a loss is natural and appropriate, but it does take time. If we think of the loss as an injury — like a broken bone — we wouldn’t keep moving without attending to the injury, so why with grief? I would encourage someone who is grieving to stay connected with friends and family, but don’t be afraid to set limits on time and energy: balance effort and rest. Practice self-care — getting plenty of sleep, hydrating, eating healthy food. Small acts of kindness toward oneself, even turning down the bed covers and leaving yourself a cup of tea at the bedside or listening to music can help.
There is also talk therapy or groups. People sometimes think they will be bothered to be around others in pain, but often it is the opposite: We feel less alone.
Finally, maybe open just a little window of trust and identify one close person to confide in more deeply. Say that you are still hurting and could use a good meal and conversation. Then ask your friend if they are up for it. Try to be specific in asking for what you need.
What surprised you about grief?
It’s not uncommon to experience a guilt associated with the loss. I often meet with people who are berating themselves for small things they could have done better or differently, when really, they did fine and really need to hear that over and over.
New losses can reignite old ones, too. If you never had the chance to metabolize a big loss in the past, for example, another, later loss may become more complicated. The good news is that may offer a chance to work through both.
When is one ‘cured’ of grief?
With a profound loss, you may always grieve. But you will also learn to live with your loss, heal, and build around it. You can be whole again, but not necessarily the same as before. To honor your loss, you really wouldn’t want to be. Through suffering we have the opportunity to hone our compassion for others, and for some people their losses of the past will be their tools for connecting with others in the future.