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Grieving: Facing Illness, Death and Other Losses
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Am Fam Physician. 2000 Oct 1;62(7):1689-1690.
What is grief?
Grief is a normal, healthy response to different types of losses. One of the greatest losses that can occur is the death of someone you love. Other losses that may cause grief include the loss of your health or the health of someone you care about, or the end of an important relationship, such as a divorce. Healing from a loss involves coming to terms with the finality of the loss and the meaning of the loss in your life.
What are the normal feelings of grief?
As you face a loss, you may have different feelings at different times. These feelings may include shock, denial, anger, guilt, sadness and acceptance. You may find yourself going back and forth from one feeling to another. For example, when it seems that you're starting to accept the loss, you may find yourself feeling sad or guilty again. Your grief may never completely go away. The pain you feel will lessen with time as you work through these feelings.
What usually happens first?
When you're first told about the loss, you may feel shocked, numb and confused. You may not remember what people are saying to you. You may feel dazed, as though you're going through things like a robot. You may think and act as though the loss hasn't occurred. This is called denial.
As the shock wears off, reality will slowly break through. You'll begin to realize that the loss has happened. It's normal to feel abandoned and angry. You may direct your anger toward God, religion, doctors and nurses, the one who has died, other loved ones or yourself.
What happens after the anger wears off?
After you get through some of the anger and denial, it's normal to try to pretend things are like they used to be. If someone you love has died, you may play memories over and over in your mind. You may also feel the presence of your loved one, think you see him or her, or think you hear his or her voice.
You may also find yourself talking to your loved one as though he or she were in the room with you. As you begin to realize that your loved one is gone and that you can't bring him or her back, you'll begin to feel the full impact of your loss. These feelings may be scary because they're so strange and so strong. They may make you feel like you're losing control.
Symptoms of Grief
Feeling like there's a lump in your throat
Feeling like what's happening around you isn't real
Hyperventilating—sighing and yawning
Not being able to get organized
Not feeling hungry or losing weight
Restlessness and irritability
Sadness or depression
Seeing images of the dead person
Shortness of breath
Tightness in your chest
What happens then?
When you begin to realize the full impact of the loss on your life, you may feel depressed and hopeless. You may also feel guilty. You may find yourself thinking things like “if only” or “why me.” You may cry for no apparent reason. This is the most painful stage of healing, but it doesn't last forever. With normal grief, the depression will begin to lift with time.
What is the first sign of relief?
You may start to feel better in small ways. For example, you may find it's a little easier to get up in the morning or you may have a small burst of energy. This is the time when you'll begin to reorganize your life around the loss or without your loved one.
What is the final stage?
The last stage of accepting a loss is when you begin to invest in other relationships and activities. During this time, it's normal to feel guilty or disloyal to your loved one because you're moving on to new relationships. It's also normal to relive some of your feelings of grief on birthdays, anniversaries and holidays, and during other special times.
How long does grief last?
Each person's experience of grief is different, but you'll probably start to feel better in six to eight weeks. The whole process usually lasts six months to four years.
If you feel like you're having trouble getting through the process at any point, ask for help. People who can help include friends, family, clergy, a counselor or therapist, support groups and your family doctor.
Be sure to talk to your family doctor if you have a lot of trouble eating, sleeping or concentrating for longer than the first couple of weeks. These can be signs of depression. Your family doctor can help you get through the loss.
Tips on dealing with a loss
Talk about how you're feeling with others.
Try to keep up with your daily tasks so you don't feel overwhelmed.
Get enough sleep, eat a well-balanced diet and exercise regularly.
Avoid alcohol. Alcohol can make you feel more depressed.
Get back into your normal routine as soon as you can.
Avoid making major decisions right away.
Allow yourself to grieve—to cry, to feel numb, to be angry or to feel however you're feeling.
Ask for help if you need it.
This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
Copyright © 2000 by the American Academy of Family Physicians.
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