Patient education: Grief in adults (The Basics)

What is grief? — 

This is a normal, human response to loss. Grieving is a process that can affect your feelings and view of your life. It can also cause physical symptoms.

Some people only think of grief as it relates to the death of a family member, friend, or pet. Experiencing the death of a loved one is called "bereavement." But feelings of grief can also happen because of any type of loss. Examples include:

●Changes in relationships, like divorce or children moving out of the home

●Fertility issues, or an adoption that doesn't go through

●Changes to a job or career

●Moving or losing one's home

●Change in health or mobility

●Loss of hopes or dreams for the future

●Loss of trust or feeling of security

Society does not often acknowledge many of these losses. This can make grieving even more difficult.

People can even grieve a loss when they know it is coming but hasn't happened yet. This is "anticipatory grief." Processing grief before the event happens can help you face a future loss. Examples when this type of grief are common include:

●When a loved one has a terminal illness

●Preparing to sell your home and move

●Facing your own death

How do people experience grief? — 

Each person grieves in a different way, and grief changes over time. There is no right or wrong way to grieve.

Grief can be affected by our personal beliefs, religion, and culture. Some people feel guilty for grieving over certain types of loss, and others might not understand their grief.

People's reactions can also be different based on the type of loss. For example, the death of an older relative who was ill might cause a different type of grief than if someone died unexpectedly. The death of a child can be especially difficult for parents and caregivers. After losing a child, some people feel guilty or like they lost their identity. They also might struggle with unique challenges, like what to do with the child's things or how to answer when people ask if they have children.

Grief can affect all parts of your life. It can affect your:

●Emotions – Some people feel shock, pain, sadness, guilt, or worry. Others might feel anxious, sad, or even relieved. Some might feel angry, and might direct it at anyone, like their family, their doctors, or even the person who died.

●Thoughts – It is normal to feel helpless or forgetful. Some people have trouble understanding things or feel confused. Others might doubt their faith or what they believe in.

●Behavior – Some people cry a lot, and others only a little or not at all. Crying can be a normal way to cope with strong feelings. Some people yell, wail, or are silent as a way to show their grief. Some feel very tired but have trouble sleeping. Some might not want to eat, and others might want to eat a lot. All these are normal reactions to grief.

●Relationships – Some people want to be around others, and others want to be alone. For shared grief, it can be hard when partners or family members have different ways of grieving. For example, if a child dies or is very ill, the parents often grieve differently. This can put stress on their relationship.

It can take time to work through grief before you feel like you have adjusted to normal life again. For some people, it can take 6 months or longer.

It might seem hard to go on with life while grieving. But when people mourn a loss, they are working to transform their experience of grief into a new way of living and coping. The grief is never fully gone. Instead, it becomes a part of the background of life moving forward as we remember and honor the loss.

How can I cope? — 

People cope in different ways. Here are some tips to help you grieve and learn to cope in a healthy way:

●Talk about your feelings – Share with others how you feel and what you are thinking. Even if you are grieving a situation that does not involve death, your feelings are still valid.

•Be honest with yourself, and think about what you are feeling. It is normal to experience many emotions, sometimes at the same time. Try to accept that the loss happened. Recognize this is a hard time. Try not to pretend all is well.

•Talking about what happened is a healthy way of making sense of your loss. It can help you work toward accepting it and accepting the changes in your life.

•Try not to compare your reaction with others' reactions. Everybody processes and expresses grief differently. If a partner or family member is handling grief differently than you, try to be patient and support each other.

•Be kind to yourself and others as you deal with grief. Accept that dealing with loss is a difficult process. It is also OK to feel positive and express positive emotions while you grieve.

●Let others support you – Sharing your grief can lighten the burden. It is important to be with others who share your pain. It can also help you work through your feelings and move forward.

•Get support from people who care about you. Don't be afraid to tell them what you need or how they can help. For example, if being alone is hard, ask someone to spend time with you or plan an activity with you. If it is hard to eat alone or cook for yourself, ask for help with meals or go out to eat with someone. If going through clothing or personal items is too painful, ask a close friend to help.

•It might help to talk with a counselor or go to a support group for people who had a similar type of loss. They can help you deal with the strong feelings of grief and loss. Friends and family might want to help, but they might not have the training to know how in a healthy way.

•Draw comfort from your faith. Praying, meditating, or talking to a spiritual adviser can help.

●Take care of yourself – Taking care of your body and mind can give you the strength to heal and cope with your feelings. Remember that grief can bring other feelings of loss to the surface.

•Eat a healthy diet. Avoid eating too much or not enough. Get plenty of sleep. Talk to your doctor if you are having trouble sleeping.

•If possible, get regular physical activity. Even gentle forms of activity, like walking, are good for your health. Try to get outside a little each day.

•Avoid or limit alcohol. Don't use alcohol, recreational drugs, or prescription medicines to numb strong feelings. Don't gamble or overspend to try and fill the emptiness of loss and grief.

•Put off major life decisions for a while. If you must make a major decision, talk with a close friend or counselor about it. Get others' views before deciding.

●Remember and honor the loss – Gathering together or taking time to remember the loss honors it. This can help support everyone who is grieving.

•Ceremonies and memorials can comfort those affected by loss. Having a lasting keepsake of a loved one can also comfort you. There are lots of different ways to do this. For example, you might plant a tree, rose bush, or flowers. Or you might choose to make donations to a favorite charity in a loved one's name.

•Do things you enjoy to help express strong emotions. You might enjoy painting, drawing, singing, playing an instrument, or dancing. It might help to work with your hands, garden, or do crafts.

•Keep a journal or scrapbook. This is another way to express strong thoughts and feelings as you deal with grief. It also gives you a way to look back as time goes on. You can see how the pain eases and life starts to move on again.

•It can be comforting to talk about a loved one who died.

●Plan ahead for hard times – There will be events and times that trigger strong emotions. Don't be afraid to ask for extra support.

•Make plans for how to cope with holidays or anniversaries. These can bring back memories and feelings. Be ready, and expect these feelings. Talk to your family and friends as a way to honor your loved one.

•Set boundaries with friends or family. Tell them certain times are difficult for you and how they can help.

•If needed, delay or avoid certain situations that bring up strong emotions.

Get help right away if you are thinking of hurting or killing yourself! — 

Sometimes, people who are grieving have thoughts of hurting themselves. Or they might feel like they want to die to be with their loved one. If you ever feel like you might hurt yourself or someone else, help is available:

●In the US, contact the 988 Suicide & Crisis Lifeline:

•To speak to someone, call or text 988.

•To talk to someone online, go to chat.988lifeline.org.

●Call your doctor or nurse, and tell them it is urgent.

●Call for an ambulance (in the US and Canada, call 9-1-1).

●Go to the emergency department at the nearest hospital.

When should I call the doctor? — 

Call for advice if:

●You can't sleep, eat, or think clearly.

●You blame yourself for the loss.

●You show signs of not taking care of yourself. These can include:

•Not eating, showering, or getting out of bed

•Avoiding other people

•Not taking your medicines

•Missing appointments, work, or school

●Your grief does not get better or seems to be getting worse.

●You feel you can't trust other people, or are fearful of others.

More on this topic

Patient education: Helping a child cope with grief (The Basics)
Patient education: Helping a child cope with the death of a pet (The Basics)
Patient education: Coping in times of crisis (The Basics)
Patient education: Coping with worry and stress (The Basics)
Patient education: Depression in adults (The Basics)
Patient education: Post-traumatic stress disorder (The Basics)

Patient education: Depression in adults (Beyond the Basics)
Patient education: Depression in children and adolescents (Beyond the Basics)