Bereavement

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Bereavement and Grief

 

Bereavement is the period of mourning that we go through after a loss. Significant loss is something that we all face at some time in our lives, and for many of us it may be the most distressing experience we have to face. This may be a result of the death of someone close to us, or it may be caused by other circumstances such as loss of health.

Grief is what we feel when we experience that loss. Everyone experiences grief differently and there is no ‘normal’ or ‘right’ way to grieve. Many of us do not experience bereavement or loss until we are older, and there is often little opportunity to learn about death and how it affects us before we have to experience it ourselves.

Whilst our response to loss is a very individual experience, there are common features that many people share.

Grief is a natural process, and most people will cope with help and support from family and friends. However some people need additional help to understand their feelings and to help them come to terms with the loss and find a way to live again afterwards.

 

 

Common reactions to loss

You may feel a number of things immediately, in the hours and days after the death of someone close to you. The main reaction at this time is one of shock, and this can be demonstrated in different ways by different people.

You may feel any of the following things, one of them, or some of them, sometimes depending on the situation that you are in:

  • numb – at first you may carry on as if nothing has happened
  • panicky – not knowing what you need to do to, or can do, feeling unable to cope
  • tearful and weepy
  • feeling unable to cry
  • disorientated – as if you have lost your place and purpose in life, or are living in a different world

 

In the weeks and months after a bereavement you may notice that you are beginning to feel other things:

  • Agitation – some people can feel this for quite a long time after a death. You find that you are very active at this time, perhaps doing a lot of cleaning things out, sorting through things. Sometimes the agitation can build into panic and anxiety.
  • Pain – feelings of pain and distress following bereavement can be overwhelming and frightening.
  • Anger – people often feel angry after a death. This anger is a completely natural emotion, typical of the grieving process. Death can seem cruel and unfair, especially when you feel someone has died before their time or when you had plans for the future together. The anger might be directed towards the person who has died, at family members or other people involved in caring for the dying person, or may be directed at ourselves for things we did or didn’t do or say to the person before their death.
  • Guilt – guilt is another common reaction. People who have been bereaved of someone close often say they feel directly or indirectly to blame for the person’s death. You may also feel guilt if you had a difficult or confusing relationship with the person who has died, or if you feel you didn’t do enough to help them when they were alive. Guilt is also common when there has been relief as someone’s death following a painful or prolonged illness. It is worth remembering that many people feel relief when suffering ends.
  • Depression – many bereaved people experience feelings of depression following the death of someone close. Life can feel like it no longer holds any meaning and some people say they too want to die or have thoughts such as ‘what’s the point in going on?’
  • Odd experiences and longing – some people feel they are ‘going mad’ because following a loss they can have odd experiences. However, thinking you are hearing or seeing someone who has died is a common experience and can happen when you least expect it. You may find that you can’t stop thinking about the events leading up to the death. “Seeing” the person who has died and hearing their voice can happen because the brain is trying to process the death and acknowledge the finality of it. Some people can ‘feel’ the person they have lost, or sense that they are nearby.
  • Fear – many people worry that they will forget the person who has died; how they looked, their voice, or the good times they had together.

 

Other people’s reactions

One of the hardest things to face when we are bereaved is the way other people react to us. They often do not know what to say or how to respond to our loss. They can be clumsy in what they say or do. Because they don’t know what to say or are worried about saying the wrong thing, people can avoid those who have lost someone. This is hard for us because we may well want to talk about the person who has died. Sometimes other people do not realise how long it takes to begin to recover from a death.

 

How long does it take to recover?

When someone close to us dies we have to cope and adjust to living in a world which is irreversibly changed. We may have to let go of some dreams built up and shared with the person who has died. This is a gradual process which can take a long time.

The length of time it will take a person to accept the death of someone close and move forward is varied and will be unique to the individual. How we react will be influenced by many different things, including:

  • age
  • personality
  • cultural background
  • religious beliefs
  • previous experiences of bereavement
  • personal circumstances

 

No one can tell you how or when the intensity of your grief will reduce; only you will know when this happens. It is not unusual for bereaved people to think they are finally moving towards acceptance only to experience strong emotions again, similar to those they experienced shortly after the death.

Life will never be the same again after a bereavement, but the grief and pain should lessen. There should come a time when you are able to adapt and adjust and cope with life without the person who has died. The pain of bereavement has been compared to that of losing a limb. We may adapt to life without the limb but we continue to feel its absence. When a person we are close to dies we can find meaning in life again, but without forgetting their meaning for us.

Most people begin to feel like this within one or two year of the death of someone close to them.

 

What can I do to help?

Bereavement is always a difficult time, but there are things that you can do to help yourself, or others, to get through it.

There are many different resources available to help you, including:

Self-help booklet produced by Northumberland, Tyne and Wear NHS Trust: Bereavement

Cruse offer bereavement care after the death of someone close to you.

If you feel that you are stuck in the grief process, or that you are simply unable to cope with your feelings then talking to a professional for counselling or therapy can be beneficial.

 

Practical Advice

Immediately, or soon after a bereavement, the following advice may help you:

  • If you do not have to, don’t make major changes in other areas of your life until you have had time to adjust to the death.
  • Look after your own health, eat properly and rest.
  • Talk to people about how you feel – to friends, family, or to a professional.
  • Keep socially active – accept invitations, invite people to see you, stay in touch with friends and family.
  • Plan in advance what you will do on anniversaries, birthdays, or other significant dates that are likely to be emotional times.

 

What friends and family can do to help:

  • Spend time with the bereaved person if that is what they want.
  • Talk and listen to them, don’t worry about saying the wrong thing.
  • Let the bereaved person talk about the same thing again and again if they need to. This is normal and helpful.
  • Be tolerant if any anger or irritation is directed towards you, don’t take it personally, it is part of the bereavement reaction.
  • Don’t avoid mentioning the person who has died, talking about them can be helpful.
  • Offer practical help.
  • Include the bereaved person in social events.
  • If the bereaved person seems ‘stuck’ or really not coping, encourage them to seek help, perhaps by talking to their GP.

 

Traumatic Loss

A traumatic loss is one that is sudden, unexpected, and often results from horrific or frightening circumstances.

Detailed information about these different types of loss are provided by Cruse:

When someone we care about dies from a traumatic situation there may be additional features of grief and bereavement. The most significantly different of these are problems associated with trauma:

 

‘I can’t believe it’s true’

Losses for which we are unprepared, particularly if we can’t be with the person when they die, are difficult to make real.

 

What helps?

It takes a long time to take in what has happened. Spend time talking it through with others; if you worry that you are being a burden to friends or family, ask them or talk to a professional. There may be some things about the death that will never be explained. It is difficult, but you may have to learn to live with the uncertainty of not knowing; we cannot explain or control everything.

Some people find it helpful to:

  • visit the place where the disaster took place
  • talk with others involved
  • place a wreath in a significant place
  • attend memorial services or other rituals of remembrance.

 

‘I can’t get it out of my head’

Many people are haunted by pictures in their minds of the traumatic event. While this is most likely to become a problem for eye-witnesses, television or other pictures of actual or similar events, can also ‘bring home’ the awfulness of the way a person might have died. Such images may occur spontaneously or, in a distorted form, as recurrent nightmares. They may be triggered by any reminder of the loss, e.g. loud noises, cries or shouts.

Some people go to great lengths to avoid any such reminders because the images are so painful. They may isolate themselves, avoid talking about the loss, or distract themselves by being extremely busy. This kind of reaction is not uncommon and will usually improve with time.

If severe, this kind of reaction may be a form of ‘Post-Traumatic Stress Disorder’ (PTSD).

 

What helps?

Haunting images can sometimes be eased by talking to others, going over the events again and again until you get used to them. The images will not disappear but they will become less painful and easier to live with.

If the images are stopping you from grieving or getting on with your life, then you should talk to your GP and consider getting professional help. PTSD can be treated with some medications, but the most effective treatments include talking therapies.

Grief and depression

 

It can be hard to distinguish between grief and depression. They share many of the same characteristics, but there are important differences between them.

Grief is an entirely natural response to a loss, while depression is an illness.

People who are grieving find their feelings of loss and sadness come and go, but they’re still able to enjoy things and look forward to the future.

In contrast, people who are depressed have a constant feeling of sadness. They don’t enjoy anything and find it hard to be positive about the future.

Read more about depression here.

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