Grief can be devastating, and as anyone who has experienced it knows, it can take a very long time to come to terms with the array of feelings and reactions that it triggers. Even after a person feels better, certain milestones, like holidays, birthdays or family events can bring it to the forefront again.
“How long grief lasts depends on the situation, the loss, and how we deal with it,” said Carol Dundes, resident therapist, Samaritan Counseling Center of Western PA. “I’ve encountered people in therapy just days after losing someone, and others who, 20 years later, have still not processed a loss. In our culture, there is an unspoken rule that one year is enough time to ‘get over it,’ but that’s not how it goes. Grief changes and adapts over time depending on how we address it.”
“When we see someone in pain, we want there to be an endpoint, but grief is a lifelong journey,” added Krista A. Ball, M.S., ATR-BC, CT, program manager, child grief specialist, The Highmark Caring Place, a center for grieving children, adolescents, and their families. “That sounds overwhelming, but it can actually be validating to know that grief doesn’t have to look a certain way or be on a certain timeline. You have to give yourself permission to grieve throughout your lifespan, instead of trying to force everything to be okay.”
What is Grief?
People can grieve for many reasons, with the most common being the death of a loved one. Other causes can include the loss of a relationship, including friendships and romantic partnerships, the loss of a home, or the loss of abilities as a result of a chronic illness or accident, among other reasons.
“In addition to grieving what you once had, people also grieve what could have been; for example, if someone wants to have children and then finds out that they can’t, they may grieve the loss of the life they expected to have,” explained Kristen Walker, licensed professional counselor at the Counseling and Wellness Center of Pittsburgh.
Grief can manifest in many ways, including sadness, loneliness, low energy and more. People may withdraw from friends, lose interest in hobbies, or become more detached in general.
“Someone grieving may be more forgetful, indecisive, or irritable, and may focus a lot on the loss or death in general,” said Dundes. “They may have feelings of hopelessness and despair and worry about or long for their own death.
“Depending on the person, grief can have a big impact on religious or spiritual beliefs as well,” she added. “A person may experience a crisis of faith and pull away from religion, or double down on their faith. Those who weren’t previously religious may now find solace there.”
While some people turn to overworking or focusing too much on school or hobbies to distract themselves, others may engage in self-harming behaviors or things that are reckless or unsafe like drugs, alcohol and other substances.
“Often, how people grieve is affected by societal expectations,” said Dundes. “Men are expected to be strong and angry, while women are allowed to be sensitive and to show sadness. Unfortunately, this really closes the door on the full gamut of human emotions you experience when grieving. And that may mean that people are less likely to seek help.”
Physical Reactions to Grief
Grief is no different than any other mental health condition; it affects the body as well as the mind. People grieving may experience or exhibit signs of shock, have trouble falling asleep or sleep too much, have an increase or decrease in appetite, or be constantly exhausted.
“When you look at the amount of energy we have as bandwidth, grief takes up so much of that bandwidth that we are left with little to do anything else in life,” said Dundes.
People may also experience unexplained stiffness or soreness, headaches or stomaches and get sick more often and stay sick longer.
“Grief can intensify into a whole host of problems including major depression, anxiety disorders, anger, stress, and high blood pressure,” said Walker. “Oftentimes, people try to suppress their grief, especially those folks who believe they can just ‘pull themselves up by the bootstraps.’ They don’t allow themselves an outlet for grief, but you can only suppress it for so long before it comes out.
“Those things we squash down and ignore will find a way to show up in life, whether that’s through unsafe behaviors, changes to physical health, issues in relationships or even suicidal thoughts or attempts,” she added. “People are left feeling so alone.”
How to Find Help
The best way to treat grief is to find a way to process it, whether that’s by relying on friends, mentors or religious fixtures for support or by attending therapy in an individual or group setting.
“I’m a big fan of the group approach, because grief makes people feel so lonely, isolated, and misunderstood,” said Dundes. “Being in a group gives them the chance to realize that they are not actually alone and that others have similar experiences and are going through similar things. It’s a good way to reconnect with other people.”
“I don’t know that people always understand the intensity of grief until they lose a parent, sibling, or spouse, so cognitive behavior therapy can help people work toward accepting that loss,” agreed Walker. “Group therapy enables them to have that shared experience, and support groups can also be really helpful. Self-care is a big part of it, too.”
Those who are trying to help someone through the grieving process should be patient and empathetic, and provide a place where people feel safe and understood.
“Be present and hold space for people; meet them where they are,” said Walker. “Don’t try to fix it or change it, or convince them that they should be feeling better. Bring them some food, go for a walk, talk about it if they want, or just be together silently.”
“So often, we get hung up on trying to say the right thing, but it’s not really about what you say; it’s about what you do,” agreed Dundes. “Focus on letting the other person feel your presence, support, acceptance and lack of judgement. Check in regularly, especially after the first few months when that huge influx of sympathy and casseroles tapers off. Let them tell you what they need from you.”
Grief in Children
Sadly, grief doesn’t just affect those who are old enough to understand it; it often affects children as well. But grief in children can look very different than grief in adults, and it’s not always easy to know the signs.
“One of the biggest things we see is that grief in children comes in bits and pieces; adults see the big picture, but kids can’t make sense of the whole picture all at once,” said Ball. “Sometimes it looks like they are turning grief on and off, or we think that they’re not grieving because it comes in spurts and waves.
“Children and teens will also revisit their grief every time they reach a new stage of development or reach a new milestone,” she added.
Children may also overreact to things that spark their emotions, such as an everyday frustration, even if the situation is not related to their loss. They may also show psychosomatic symptoms such as stomachaches, headaches, and tiredness, as the emotions they are experiencing can affect them physically as well.
“The main thing to do is to validate their feelings, and let them know that it’s okay to feel whatever they are feeling,” said Ball. “Sometimes they are having big, hard feelings, and sometimes they are feeling happiness and joy.”
Support can be extremely helpful to children and teenagers who have experienced such a life-changing event, and The Caring Place offers peer support for families to come together for mutual understanding and support on their grief journeys.
“It is helpful, particularly for children and teens, to know someone their own age who has had a loss; it helps them understand that they are not alone, and that their feelings are okay and normal,” said Ball, adding that if more individualized support is needed, The Caring Place works with area providers to arrange individual and family therapy as well.
The Caring Place also encourages parents to share their own grief with their children as a way to open lines of communication and to help validate their feelings.
“When it comes to modeling emotions for children, it is really important for them to see your grief journey as an adult,” said Ball. “Let them know that you are grieving, too, and that you are available to talk.
“Put into words what grief looks like,” she adds. “It’s okay to say, ‘I’m really missing dad today,’ or ‘Every time I think of dad I cry.’ It’s good for kids to see true emotions in adults.”
While parents often want to provide a fix or an answer, when it comes to grief, there is no easy fix, according to Ball. “Offer a listening ear. Talk about grief, share memories, or just sit there with your child,” she said.
“Ultimately, we all want to find a meaning in what happened, and while grief leaves a scar on us, it doesn’t mean that we can’t engage with the world and lead a happy, healthy life,” added Dundes. “But you are going to be changed. You may assume that things will go back to normal, but normal will have changed.”