The pain of grief is real. Here is some guidance for coping.

[4 MIN READ]

In this article:

• Grief is the fundamental human experience that includes a wide range of ever-changing emotions.
• Although you don’t “get over” the death of a loved one, it is possible to learn to live with that loss and remember a loved one without feeling pain.
• A behavioral health expert from Providence Swedish answers common questions about grief in honor of Grief Awareness Day on August 30.

The American Psychological Association defines grief as “the anguish experienced after significant loss, usually the death of a beloved person.” But if you’ve ever lost someone you love deeply, you know the dictionary definition doesn’t come close to capturing the complicated emotions grief can bring. August 30 is National Grief Awareness Day. To learn more about how grief might affect us and what we can do to work through it, we spoke with Dolat Saleh, a psychotherapist with Swedish Behavioral Health and Well-being, who offered some guidance on identifying grief and handling yourself with care as you deal with its challenges.

What is grief? Is it a form of sadness, or is it something more serious?

Grief comes from a French word “gréve” which means “huge burn out”. It is painful and is much beyond sadness – the kind of burning pain that as we try to avoid or suppress it, pain does not disappear, and it is there wherever we go or whatever we do, like under the surface. It is the fundamental human experience of coping with loss. While sadness is one of the common responses to loss, the emotional landscape of grief will include a big range of emotions that may vary by day and across time.

The pain of loss can be intense and complicated because it reflects a lost connection with someone or something deeply cared for. From this perspective, grief is not more serious than sadness. Rather, it is the flip side of the coin to loving deeply.

Still, there are times when the pain of loss can be so intense or so prolonged that it is difficult to resume functioning in life, and these may be good times to tap into additional sources of support.

Is grief only associated with the death of a loved one? What are some other events that one might be surprised to learn can trigger grief? 

Grief is a normal, healthy response to a loss. It describes the emotions you feel when you lose someone or something important to you. People grieve for many different reasons beside the death of a loved one, including losing their pets, divorce or an interruption to a relationship or old friendship happens. Sometimes even a health condition that interrupts routine or physical capabilities triggers the same feeling of loss. For some people financial challenge and losing what they invested in is a huge grief. Still, people may feel grief by retirement or a move or immigrating to a new social environment. 

How do the symptoms of grief express themselves? Are there any that are surprising or unusual? 

People in grief show very different symptoms based on who they are and who they have lost, how their relationship was, and how much that loss impacts their day-to-day life. Symptoms may be emotional such as feeling shocked and numbness and denial to anger or guilt. People might show behaviors like crying out suddenly, withdrawing from others for a while, lacking  in the things they liked to do before or eating issues. They might feel tired and fatigued, feel pain or cannot sleep or concentrate, which sometimes drives them to make choices for coping, which are not the best, such as drinking alcohol or using drugs, or even thoughts to hurt themselves because of that heavy pain. 

Grief can affect all aspects of one’s being – mind, body and spirit. Emotionally, individuals may experience a full range of feelings — from sadness to anger, relief, and even joy. Feelings associated with grief are likely to ebb and flow. They may surface at unexpected times, like a flood of emotions seemingly out of the blue. Or they may appear in more predictable manners at anniversaries, around holidays or when encountering other significant reminders. 

Some individuals may also experience feeling detached or numb from emotions. Or they may experience confusion at the presence of emotions that seem at odds or conflicting. For example, sadness that a loved one is gone while simultaneously experiencing relief that their loved one is physically at peace. All these experiences can co-exist at the same time, and all are a part of the normal emotional landscape. Importantly, there is no right or wrong emotional response, just as there is no right or wrong way to grieve.

Additionally, with the recognition that grief is an extreme stressor, it makes sense, in turn, that grief can lead to physical changes by overworking our nervous system. This could mean changes like decreased immune functioning, increased risk of sickness or fatigue, changes in appetite or sleep, headaches, aches and pains, or restlessness. Behaviorally, grief can increase difficulty completing seemingly ordinary tasks or interfere with concentration or decision-making.

Can you share some coping strategies? 

Finding supportive people and social environments is crucial, which is different in different cultural settings, but the most important part is sharing the emotion you hold in an environment where you feel safe and ask for help when you need. If there is not someone close to share, or it takes time for you to trust people to open up, start writing a journal or letters and just debrief your thoughts and wishes about hurtful experience. You can process grief mindfully by lighting a candle with the memory of your loved one, set a corner of your house for ritual, review old photos, provide a memorial box from important belongings for the loved one, listen to their favorite music and remember the blessing moments you shared together. 

All being said, you can find a grief support group that walks with you in this new and scary journey.  Some of the ways to care for yourself while grieving include:

• Find and implement aspects of routine. When a sense of normalcy is disrupted, finding and sticking to something with consistency can provide a small sense of control and help regulate emotions. A morning tea. A midday fresh air break. An afternoon shower. Beginning a bedtime winddown at the same time each evening. Holding space for breakfast, lunch and dinner even if your appetite doesn't feel the same. It is helpful to give yourself credit for each activity completed, even and most significantly, the ones that may seem minor.
• Look after your physical health. To the extent you can, work on getting enough sleep or allowing rest when needed. Eat something nutritious. Do an activity that gets your heart rate up. Take medications as prescribed.
• Incorporate self-care. Experiment with what is soothing, calming or relaxing for you. Maybe it is reading or writing. Perhaps it's taking a bubble bath. Pick up a new or old craft or hobby. Practice mindfulness or meditation.
• Maintain contact with friends and family. Often, loved ones want to help but don't always know how. Letting them know what you need, whether it is a listening ear, a shoulder to cry on, or just physical presence, can provide comfort.
• Connect with others with shared experience. It is not uncommon for those in the midst of grief to feel like the rest of the world has moved on. Support groups, peer- or professionally-led, can provide one with a safe place to talk about their loss with others who are also experiencing similar feelings.
• Connect with a professional. There are licensed therapists who specialize in grief and loss. They can help work through intense emotions and overcome barriers to the grieving process. This may be particularly beneficial if grief interferes with your ability to function adequately for an enduring time.

What are some ways I can let others know that I am dealing with grief? Why is this important? 

I think it starts from inside out! First, we need to accept it ourselves that we are holding that heavy burnout and pain and give ourselves permission to go through the process of grief which is challenging, and not avoiding or suppressing that. It is important to let others know because we don’t want extra headache, misjudgment, or functional impairment in life that led us in the path of other losses (relationship issue, job issue, etc.) adding to the previous one. 

What are some things we SHOULD NOT do if we or someone we love are struggling with grief? 

If someone you care about is in grief, don’t try to avoid the impact of loss, you need to accept it is a life changing event and the fact that nothing would be like before, and by this acceptance give yourself time to find the process of healing around this loss, sometimes with the help of a grief specialist if necessary. And if you are grieving, don’t make huge life-changing decisions in this period, like selling your home, moving, quitting your job. You can give yourself time to make decisions in a more regulated emotional situation. Loss is a huge stress that we need to learn to adjust, finding values that help us believe life is still worthed to live it, even more insightfully. 

What resources does Providence Swedish offer to handle grief?

There are several ways to access support for grief and loss at Swedish, regardless of one's timeline in the grieving experience:

• Primary care clinic resources. A visit to one's primary care provider can include support from one's medical provider, as well as connection, sometimes that same day, to a licensed behavioral health clinician on the team. Together, they can provide whole-person care and build effective strategies for coping during the grieving process.
• Bereavement groups and peer support. Providence Swedish has offered bereavement services to the community for nearly 20 years. They can connect you with a trained, compassionate listener or other grieving people. They offer group series for those newly bereaved, those who navigated loss knowing their loved one was dying, and those who lost their loved one suddenly through suicide or another traumatic event. Additionally, they can connect individuals with other community resources.
• Spiritual care. The Providence Swedish spiritual care department is available to support individuals and families across all faiths and cultural backgrounds. It is available as a part of your medical team 24 hours a day.

Learn more and find a physician or advanced care practitioner (ACP)

If you have questions about behavioral health services, Providence Swedish is here for you. Contact Swedish Behavioral Health and Well-Being. We can accommodate both in-person and virtual visits.

If you think you or a loved one may be suffering from PTSD, talk to a health care professional, whether it’s a trusted primary care provider or a recommended counselor. If it’s an emergency situation, call the 24/7 crisis line at 988 or go to the emergency room. 

Whether you require an in-person visit or want to consult a doctor virtually, you have options. You can also connect virtually with your provider to review your symptoms, provide instruction and follow up as needed. And with Swedish ExpressCare Virtual you can receive treatment in minutes for common conditions such as colds, flu, urinary tract infections, and more. You can use our provider directory to find a specialist or primary care physician near you.

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This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.

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