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Grief and loss

A fact sheet produced by the Mental Health Information Service

When someone you love dies Grief may be painful and at times seem bottomless. The purpose of the information here is to help you identify some of the stages of grieving that are commonly experienced by people who are bereaved. The aim is to assist those grieving to feel less isolated in their feelings. These intense emotions and mood changes are a normal part of grieving. Grief is a reaction to loss. Grieving is a very personal experience and there isn’t a right or wrong way. It is determined by culture, the relationship to the person lost and the way the person died. Working through grief is a very personal and painful experience. Some stages of grief are commonly experienced although not everyone will go through all these stages. Grieving is a fluid process.

Stages of grief

1.Numbness/Denial Feeling emotionally numb can be the first reaction to a loss. In the denial stage you may refuse to believe what has happened. This could mean laying clothes out for a child or expecting the person to walk through the door.

2.Anger Anger with ourselves or blaming others for our loss is not uncommon. Other strong emotions and a longing for the person who has died can accompany anger. You may also feel agitated or angry, find it difficult to concentrate, relax or sleep.

3. Bargaining Many imagine the ‘what if’s..’ Some people may blame themselves and feel guilty. They may dwell on arguments they had with the dead person or things that they ‘should’ have done differently.

4. Sadness Extreme sadness is a likely outcome for all those who have lost a loved one. During this time many withdraw from family and friends, feel listless and tired, become withdrawn or are prone to sudden bouts of tears. Many feel like their life has lost its purpose and suffer from feelings of guilt.

5. Acceptance Pain, sadness and depression start to lessen; things are seen in a more positive light, although you may never overcome fully the feeling of loss. There is a greater acceptance that life has to go on. After a while your sadness will clear and your energy levels and sleeping patterns will return to normal.

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How can you cope during the grieving process?

Ask for help and support from family, friends or a support group Tell people what helps and what doesn’t help Accept that some things are beyond your control Avoid making major decisions If you’re are religious talk to the appointed person in your religion Take care of your health-try to eat and get some rest Be patient with yourself Gentle exercise may help Express your emotions

How can you help a family member or friend who is grieving?

At some time in our lives we will all feel loss and must find a way to cope with it. It is a helpful part of the grieving process to have people around to comfort and help. If you are like most people you will find yourself wondering what to say, what does the bereaved need from those around them? What are the best things you can do? What are the worst? This information sheet aims to outline some ideas that may assist you in feeling confidant in the comfort and support you offer to those you have lost a loved one.

How does grief affect a person?

People deal with grief in extremely diverse ways and often this can make the person offering support uncomfortable. Despite individual uniqueness, usually an overall pattern does occur, understanding this may help you to show compassion during the different stages of grieving. It often begins with shock and numbness and possibly denial. This is usually followed by a time when the pain sets in. Strong emotions may overwhelm the person. Commonly during the sadness and/or depression following a bereavement the person may have no energy and fell listless. They may withdraw or have mood fluctuations, and this can be the hardest and longest period of the grieving process. Finally, there is acceptance. The feelings of depression and rage are less intense. The losses and scars are accepted - this is not necessarily a happy acceptance. Energy and hope begin to return. The entire process is different for everyone but it is never orderly, emotions will pop up and the time periods will flow into each other.

Ways to help Allow Grief It can be difficult to watch somebody go through the grieving process but it isn't beneficial to give the person a message that says 'chin up'. It is important that the person does grieve. According to research unresolved grief can lead to outbursts of anger and rage, restlessness, depression, addiction, compulsion, anxiety and panic disorders. Physical symptoms can include worsening or developing diabetes, heart disease, hypertension, cancer, asthma, allergies, constipation, diarrhoea and ulcers.

Be Supportive Many people hold back as they are afraid of saying or doing the wrong thing. Rest assured that the person grieving doesn’t expect you to know what to say. It is generally felt that the important first step is to acknowledge the person's loss; if you don't have the words a hug can speak volumes. Accept the person's grief and offer your supportive presence even if this makes you uncomfortable.

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Make allowances Some grieving people may exhibit some (temporarily) unusual conduct that affects relationships and everyday activities,

Isolating themselves / not wanting to be alone

Jealousy that others aren't grieving

Critical in ways that are out of character

Odd events, which seem real, like sensing the presence of a loved one. If the person concerned is worried it may help to know that these things, plus numerous others, are a lot more common than they may think.

Don’ts

Don't avoid the person

Don't say things like "It's god's will", "It's all for the best", or if someone has lost a baby "You have other children" or "You can always have another baby".

Don't forget them after the funeral

Don't expect then "to get over it" some losses we learn to live with not get over.

Unhealthy signs Bereaved people often show symptoms of depression. However only a minority may become clinically depressed and unable to function. Intense and prolonged feelings of hopelessness and helplessness are a sign of depression. If you think you may be depressed it is important to seek help from your doctor or a professional counsellor.

Some more practical suggestions

Plant something as a living memory Keep a journal Write to the person that died Do something your loved one would enjoy Listen to music Do something for someone else Use your hands to be creative (knitting, carving, etc.) Look after your self (get a massage, see a movie)

Book list

Coping with Grief. Mal McKissock and Dianne McKissock. Published by ABC Books & Audio. 2001 Always a Part of Me: Surviving Childbearing Loss. Amanda Collinge et al. 2002 (suitable for children) Remembering my Brother. Ginny Perkins. Published by A&C Black. 1996.ISBN 0713645415 Good Grief: A Constructive Approach to the Problem of Loss. Granger E. Westberg

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For help Mental Health Association NSW Inc. Ph(02) 9816 5688 or 1800 674 200 (outside Sydney Metro) for services in your area. Make an appointment with your GP Contact your local Community Health Centre or Mental health Team (see ‘Emergency, Health and Help’ section of the White Pages) National Association of Grief and Loss (NALAG) Ph: (02) 9976 2803 website: www.griefaustralia.org Sudden Infant Death Association (SIDA) Ph: (02) 9681 4500. For Twenty-four hour support line phone: 1800 651 186. Support for anyone affected by the sudden death of a child 0-6 years old. Grief Support Inc Ph (02) 9489 6644- twenty-four hour telephone and referral support service Club Speranza Ph: (02) 9908 1233 website: www.clubsperanza.org- education, training, counselling, resources and support groups for people affected by suicide or self-harm. Solace Association Inc Ph: (02) 9817 4976. A support group and counselling service staffed by trained volunteers. For people who have lost a partner. Lifeline Ph: 13 11 14- twenty-four hour emotional support and listening Compassionate Friends (02) 9290 2355 Self help for bereaved parents. Disclaimer The information provided is to be used for educational purposes only. It should not be used as a substitute for seeking professional care in the diagnosis and treatment of mental health disorders. Information may be reproduced with an acknowledgement to the Mental Health Association NSW. This, and other fact sheets are available for download from www.mentalhealth.asn.au. This fact sheet was last updated in Spring, 2001.

Mental Health Information Service Mental Health Association NSW Inc 60-62 Victoria Road Gladesville NSW 2111

Phone: 02 9816 5688 or 1800 674 200 (outside Sydney metro) Email: info@mentalhealth.asn.au Web: www.mentalhealth.asn.au