Symptoms of “Normal” Grief

Cognitive
 Confusion, disorientation
 Difficulty concentrating
 Memory impairment
 Thoughts of wanting to join the deceased
Physical
 Achy, stiff muscles
 Changes in appetite, weight loss or gain
 Changes in sleep patterns
 Dizziness, vertigo
 Fatigue, exhaustion
 Headaches
 Nausea, stomach aches, intestinal problems
 Pounding heartbeat, tightness in the chest
 Restlessness
 Weakened immune system
Emotional
 Anger – at the deceased, survivors, doctors, self, God
 Anxiety, fear, panic
 Deep sadness
 Denial
 Depression
 Frustration
 Guilt
 Helplessness
 Irritability
 Loneliness, isolation
 Numbness
 Relief that deceased’s suffering has ended or that a bad relationship is over
 Shame
 Shock and disbelief that the death has occurred
 Worry
Behavioral
 Accident-proneness
 Frequent crying
 Loss of interest in usual activities
 Nightmares
 Over-activity
 “Paranormal” experiences – visions of the deceased, etc.
 Withdrawal from friends and family


The Community Hospice, Inc. 2006

What Does Grief Feel Like?

Grieving is the natural response to loss, a gradual process of healing. Grieving is not about “getting over” the death. It is about expressing your sorrow, sharing your memories, and learning how to go forward with your life. Grief is not a mental illness, but it can sometimes feel like depression or anxiety.

Each person grieves in their own way and at their own pace. Not everyone will experience all of what is discussed here, but these are some of the most common reactions. There is no timetable for grieving, no exact moment when you should “feel better.” However, grieving is about healing, and most of the intense feelings of grief do become less frequent and less intense over time. With time, you will find that your memories bring more pleasure than pain.

Emotional Reactions
Many people describe grief as an emotional roller coaster – some days are good, some are bad, and some days you just feel numb. The key to getting through it is to allow yourself to feel the feelings as they come. Because the grief experience is uncomfortable, many people try to avoid these feelings, shutting them down or pushing them aside. Unfortunately, this tactic rarely works for long – buried grief feelings can emerge later as emotional difficulties or relationship problems. Unacknowledged grief can also lead to problems with alcohol, drug use, or other destructive behaviors.

Many feelings accompany grief, not just sadness. Some of the most common include:
numbness, shock
disbelief
sense of unreality
helplessness
anger
worry
fear, anxiety, panic
loneliness, isolation
frustration
shame
irritability
relief that deceased’s suffering has ended or that a bad relationship is over
guilt

Many grievers feel as if they have lost control of their emotions, or as if they are “going crazy,” never knowing how they will feel from one moment to the next. Painful as these feelings can be, they are all part of the natural response to the death of someone loved. Expect ups and downs, and be patient with yourself.

Physical Reactions
Since our emotions affect our bodies, it is reasonable to expect some physical symptoms during grief. It is normal to have changes in sleep patterns – difficulty getting to sleep, waking up in the middle of the night, or wanting to sleep all the time. Changes in appetite are also common, as is exhaustion – grief takes a lot of energy. Headaches, muscle stiffness, and stomach upsets are experienced by many grievers. Some people find themselves jumpy and restless, or overly sensitive to loud noises or other people. A pounding or racing heartbeat, dizziness, or chest tightness may also occur.

Some grievers become afraid that they may have a serious illness, or find themselves experiencing symptoms similar to those of the deceased.

Take care of yourself. Getting regular exercise can help you sleep better, lowers your risk of depression, and can boost your immune system. Try to eat regular, nutritious meals. As best you can, try to get enough sleep – take naps during the day if you find you can’t sleep at night, and rest as much as you need to. Lighten your schedule as much as possible, and don’t be too hard on yourself when you can’t get as much done as you’re used to. While physical symptoms are often a part of normal grief, any physical conditions that are worrisome should be evaluated by a doctor.

Thoughts and Behaviors
Frequent and unexpected bouts of crying are common in grief, and most people expect such reactions. However, there are other, less well-known but equally common thoughts and behaviors that accompany grief.
It is normal to have difficulty concentrating, remembering things, or making decisions. Many grieving people describe themselves as “going around in a fog.”

Some grieving persons may have little energy for or interest in others or for activities which formerly provided pleasure. Others may feel a need to be with other people, to talk a lot and retell stories of the deceased over and over.
Vivid dreams or nightmares about the person who has died are common, especially in the early weeks after the death. Many grievers may also experience the sense that they are hearing or seeing the deceased. These experiences can feel comforting, or they may be frightening. In either case, they are common and quite normal.

Some grievers experience a vague longing to join their loved one or to escape from the pain of the loss. Many people find such thoughts and feelings frightening. It may be comforting to know that they are not uncommon and do not mean that the grieving person truly wishes to die. It is important to realize that these feelings are different from suicidal thoughts, which involve active plans about when and how to take one’s own life. If at any point you are worried about such thoughts, seek help from your doctor or a qualified mental health provider.

Spiritual issues and questions are also common after a death. Some people find themselves questioning their beliefs and faith, while others may have a discovery or rediscovery of faith or spiritual understanding. Many people find themselves thinking more about the meaning of life, or about what follows this life.

Give yourself time. As much as possible, postpone making major decisions; if circumstances allow, don’t change jobs, move, or make any large changes to your life until the intensity of your grieving subsides.

Remember that personal faith does not make one immune to grief, or to the spiritual doubts grief can raise. Find safe avenues to explore your feelings, thoughts, and questions, and take spiritual comfort where you can.

Coping with Grief
Sometimes grief feels so overwhelming you wonder if you can survive it. It is important to remember there are some things you can do to make your grief more bearable. These include taking care of your body; exploring healing ways to express your thoughts and feelings; sharing memories of your loved; and finding safe sources of support.

Be patient with yourself as you get used to all the changes your loss brings. Remember, healing doesn't mean forgetting the person who died. That person, and your relationship with them, will always be a part of you, kept alive in your memories.

The Community Hospice, Inc. 2006

Caring for someone who is terminally ill may sometimes feel like a roller-coaster ride with a broken off-switch. Nothing stays the same for long. And just when you think you’ve gotten things figured out, something happens to disrupt the calm you’ve just achieved. This last stage of life may last days, months or years. It is important to get the support you need.

Both the ill person and their caregivers may grieve for the way life was and for the loss of their dreams for the future. Caregivers frequently experience many losses and at the same time, take on additional unfamiliar roles. Let go of unnecessary obligations and get help with new responsibilities when you can.

Sometimes, the inability of friends and family members to manage their own discomfort with serious illness may cause the dying person and caregivers to feel hurt and isolated. Help may come from unexpected people. Share your thoughts and feelings with the ones that can really hear.

As the disease progresses, people react to each change. This can then be followed by a period of calm as everyone adjusts to the new circumstances. It is important to remember that these waves of stress followed by calm are a normal part of the adjustment process and are always in flux.

During these times, all are faced with adapting to new roles while staying emotionally close and at the same time preparing for the final separation. These challenges can produce strong and conflicting reactions. Fear and anger about what is happening can cause loved ones to lash out and say and do things that add to the pain. Be patient with yourself and tolerant of others.

This can also be a time when friends and family rally together to share the load of responsibility. Talking about new concerns as they come up makes it easier to ensure that various needs are met as well as possible. When this happens, people sometimes experience a new closeness or peace in their relationships.

Since no one is perfect, there is usually a combination of both frustration and support. Forgive or apologize when you need to and move on. It doesn’t help to hold on to angry or guilty feelings, use your energy to love and help. You will feel better in the long run.

Day to day coping skills that really make a difference in how you feel include basic self-care (eating, sleeping, exercising), talking to supportive friends, getting important medical information and engaging in activities that nurture the soul.

Goals to keep in mind that will help the overall process include:
• Find a balance between self-care with caring for your loved ones.
• Stay connected by talking, touching and sharing your favorite memories.
• Take time to think ahead and plan as much as possible.
• Talk as much as you can about the things you have shared and how you feel about them.

 The Community Hospice, Inc. 2006

Many people are unsure how to help someone who is grieving the death of a loved one. If someone you know has experienced a significant loss, you are probably seeing some changes in his or her mood and behavior. The grief may seem overwhelming. You may be looking for a better understanding about grief, normal grieving reactions, and specific strategies for helping.

Normal Grief and Grief Reactions
Grieving is the natural response to loss. It is not about “getting over” the death; it is about expressing sorrow, sharing memories, and learning how to go forward with life. Over time, the person who is grieving learns to create a new reality without their loved one in it, but this is not the same as “getting over” the death. It is important for most grieving people to continue to commemorate their relationship with the deceased in some meaningful way. Sometimes it may be important for survivors to come to terms with difficult parts of their relationship and to find a way to make peace.
Grieving takes time. The person you know who is grieving may take many months, often well over a year, to gain a sense of having a new normal life. Grief is a form of healing. You would not push a friend to hurry up and walk if his leg was broken. In the same way, understand that a part of the griever is broken and needs time to heal.
Grief is not a mental illness, but it is a time of strong physical, emotional, mental and spiritual changes. Many grieving people experience disruption in their moods, thoughts, concentration and energy. Most people have some changes in their eating and sleeping habits. Each person is unique, and so is each person’s grief. Some people will become more irritable and angry, some may cry frequently, others may become quiet and withdrawn. Most people are exhausted by grief, and may become absentminded and distracted. All of these reactions are normal, and to be expected.

You Can Help
Call. It is normal for grieving people to be somewhat inwardly focused, making it difficult to express their needs. Rather than say, “Call if you need anything,” you should make the call. Not just once, but periodically over time, call and check in. Don’t offer help you can’t actually provide, and make sure to follow through on any help they accept.

Be specific. Are you running errands? Offer to pick something up or take care of some chore. If the person is a coworker, can you help make it easier for them to function during the distractible grieving period? Can you offer to take over a task or relieve one burden? This strategy is useful for the first several months.

Listen. Just listening to the stories grieving people want to tell is enormously helpful. They may need to talk about the death itself to help them figure out how to make sense of an overwhelming experience. They may express great sadness or anger. Do not take their emotions personally. Let them express them and just listen. You do not have to try to fix the feelings or problems that the griever is sharing, just be there. Avoid clichés, as these often make the griever feel you are trying to shut them up or aren’t really listening.

Be available over time. Often after a death, people are supportive for the first few weeks. Many grieving people report that their support system rallies well at the time of the death but then vanishes two or three months later – long before their grieving is over. If you can, be there for the long haul. Judge your own capacity for helping, and make it clear what you can do. You do not have to feel guilty about the limits of your helping. Give what time you can give with an open heart, and trust that by not burning out you can give more over time.

Normalize. The grieving person may be overwhelmed by reactions to the loss. Letting the person who is grieving know that you understand these reactions are normal responses to a difficult circumstance may provide needed comfort and relief.

Encourage healthful living. Gently encourage the grieving person to try to get some rest, eat well, and exercise. Understand that the griever will probably have some changes in eating and sleeping patterns. A wonderful way to help the griever is to go for a walk together. This lets the griever get some exercise and talk about whatever is on his or her mind at the same time.

When Professional Help Is Needed
Most grief reactions will lessen over time. There are times however when grieving becomes complicated and counseling may be helpful. The following circumstances may indicate a need for professional assistance:
• If a grieving person has a history of mental illness
• If a grieving person is turning to drugs or alcohol, or has had problems with drugs or alcohol in the past
• If a grieving person has a limited support network
• If a grieving person is taking unusual and/or dangerous risks
• If grieving is causing significant daily problems for the griever
• If the grief is complicated by trauma (the death was difficult, sudden, or unexpected, or due to violence or suicide)
• If a griever expresses a desire to join their loved one in death. These thoughts are common and are rarely truly suicidal. However, if the griever speaks of actual plans about when and how to take their life, immediate evaluation by a doctor or mental health professional is required.

(c) The Community Hospice, Inc. 2006

Among Democrats, 90% say the government should do “a lot” or “some” to reduce the gap between the rich and everyone else, including 62% who say it should do a lot. But only half as many Republicans (45%) think the government should do something about this gap, with just 23% saying it should do a lot. Instead, nearly half of Republicans say the government should do “not much” (15%) or “nothing at all” (33%) about the wealth divide.
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When asked what would do more to reduce poverty, 54% of all Americans say raising taxes on the wealthy and corporations in order to expand programs for the poor. Fewer (35%) believe that lowering taxes on the wealthy to encourage investment and economic growth would be the more effective approach.