Health Break | Published June 19, 2006 | Written by David Doll, psychiatric counselor, behavioral health, Mount Nittany Medical Center

Grief Is Characterized By Complex Issues and Deep Emotions

Loss of a loved one is something all of us face sometime in our lives. We lose that person not just on a physical level, but we also face the loss of potential—what could have been. A husband misses his wife's presence and thinks about trips they never had the opportunity to take or anniversaries no longer celebrated. Parents who lose their children feel the pain of never seeing them graduate from college or marry and have children of their own.

The emotions that accompany the loss of someone dear are known as grief. It is an experience of deep sorrow, one that touches every aspect of a person's life. The grieving process is a complex and individual one. Although death is a part of life, we should not marginalize or judge an individual's experience of sadness as an abnormal response to significant loss.

Not everyone's experience with grief is the same and each of us reacts in his or her own way. Common feelings are numbness, difficulty concentrating, anger, helplessness, incredible emptiness, loneliness, or despair. There are typical physical symptoms of grief, including sleep problems, weight loss or gain, low energy, headaches, chest pain or racing heart, digestive problems and hair loss.

More than 30 years ago, David Kessler defined five stages of grief as denial, anger, bargaining, depression and acceptance. Since that time, experts have used this approach to help us identify what we might be feeling, but they are not stops on a linear timeline. Grief is an individual journey and the traveler may experience some or all of these emotions and may return to one or more in a phase or cycle.

Denial is a feeling of numbness or shock and is a defense mechanism of the mind, which allows us to pretend for a time that something isn't true. Time seems to be suspended until reality sets in.

Feelings of anger can be directed at the doctor or anyone we can hold responsible for our grief—sometimes even the person who died. This reaction is understandable. There is a need to know why this happened and if it could have been prevented. Others may turn the anger inwards and blame themselves for what happened.

Bargaining is trying to negotiate the situation, either with another person involved or with God, but one finally realizes there is no way to make things go back to the way they were before. When this realization hits, depression often sets in with feelings of loneliness and hopelessness, remorse or regret.

Acceptance comes gradually with the reality of the situation and this allows us to move beyond our suffering and find peace. This doesn't mean we will cease to miss our loved one. In fact, we might often return to stronger emotions at times of remembrance, such as birthdays, holidays and anniversaries.

Approximately two out of 10 people experiencing grief need professional help. If emotions are long-lasting or severe and include inability to accept the loved one's death, along with feelings of worthlessness and the inability to perform daily activities, the help of a grief counselor or other professional is needed.

For those going through the grieving process, there are some positive steps to take to help get through this difficult time. Perhaps most important is the support of family. Family members can be most helpful when they know and understand the physical and emotional support that is needed. If church or synagogue has been a source of strength, continue to attend. In every community there are support groups that are helpful as well. Be aware that holidays and anniversaries will need special planning, and outside support is a great help on these occasions.

During the grieving process, remember to take care of physical needs by eating regular nourishing meals, getting enough rest, keeping up with an exercise program and avoiding alcohol, drugs or tranquilizers. Physical health and strength encourages the mental and emotional strength that is needed to move beyond grief.

Those experiencing grief should know that they will get better as time goes on and there will be a time when they can look forward to getting up in the morning. They should not feel guilty as they begin to enjoy life again. They will move on, but the memories of their loved one will remain forever in their heart.

David A. Doll is a psychiatric counselor at Mount Nittany Medical Center.

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