Grief and loss

Signs to look for, how the doctor can help, support options and important strategies to support recovery.
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Found in: Mental Health Conditions
Date: November 2019

About grief and loss

Grief can be an extremely painful process. You may experience all kinds of emotions and physical reactions. You may feel you will never recover from the loss, or that you don’t know how you are going to carry on.

We experience grief if we lose people we love, or things or places we are attached to, including:

  • people – through death or a relationship break-up or because a relationship changes
  • health – through illness or accident
  • things we own – by accident or theft
  • places – through moving countries, schools, houses or cities
  • our place in the world – through losing a place on a team or a job, or because we have changed ourselves
  • pets.

Grieving is a very individual process. How you grieve will be different from how others grieve. Many factors influence this, including your personality, your life experience, how you cope under stress, your faith or your spiritual beliefs, and the support system you have at the time of the loss.

The circumstances around the loss are likely to affect how you experience grief, too. For example, some people may have had more time to prepare for the loss, while other circumstances mean that a loss has happened very suddenly. Whatever factors are at play, there is no right or wrong way to grieve.

The time it takes for you to grieve is unique to you. There is no set time or process – grieving and healing takes as long as it takes. For some that could be weeks, for some months and others longer still. However, it’s important to know that over time the emotions of sadness, numbness or anger do fade and become more manageable as you start to rebuild your life.

Symptoms

Signs to look for (symptoms)

While loss affects people in different ways, there are patterns of emotions and responses that occur, such as:

Shock and disbelief – Straight after a loss, like when someone passes away, it can be hard to accept what happened. You may not believe what you are hearing and expect the person to turn up at any moment.

Sadness – Complete sadness, emptiness or loneliness are what most people describe when they talk about their experience of grief. You may cry a lot or feel emotionally unstable, or you may not cry at all and feel numb.

Guilt – You may feel terribly guilty about things you did or didn’t say or do, or about how you are feeling.

Anger – Even if the loss was nobody’s fault, you may feel angry and have a desire to blame someone for what has happened – yourself, God, the doctors, or even the person who died.

Fear – After a significant loss, you may feel anxious, scared, helpless, or insecure. If you have lost a loved one, you may worry about how you can manage on your own without them.

Physical symptoms – We often think of grief as an emotional process, but it can contribute to physical problems, including fatigue, nausea, weight loss or weight gain, aches and pains, or sleep changes (sleeping less or more than usual).

Signs that you might need further support

It’s important to remember that almost every feeling you have when you first suffer a loss is normal. However, if you do not notice some changes in your grief after some time, or you don’t feel as though you can handle things on your own, you should consider speaking to your doctor.

It’s especially important to seek help if you:

  • feel like life isn’t worth living
  • wish you had died with your loved one
  • are having difficulty trusting others since your loss
  • are unable to perform your normal daily activities
  • are unable to care for your children or dependants
  • are using alcohol or other drugs excessively
  • are unable to do self-care tasks, such as showering or preparing meals
  • have had a breakdown of relationships with those close to you. 

These symptoms, if present for a long time after the loss, could indicate that a person is experiencing “complicated grief”, a term used when a person is struggling to process and adjust to a loss.

Sometimes a loss can be a traumatic experience. Most of the time, people can process these experiences appropriately with time. However, sometimes that is not the case. If, after six months following the loss, you are experiencing flashbacks, nightmares or panic attacks frequently, or still notice that you are more irritable, impulsive or easily startled than in the past, your brain may be struggling to process the event.

In these situations, your GP may be able to help by suggesting support and treatment options.

Support options

Generally, resolving grief will not require any medication, just time, before you begin to feel more able to cope. However, to rule out any specific mental health issues, it’s important that your doctor spends time with you to get a full understanding of how you are feeling and coping.

Your doctor can help by recommending grief counsellors and therapists to help you work through how to come to terms with your loss.

Treatment for grief and loss can involve a number of aspects, each of which can be tailored to your individual need.

Therapy, such as talking therapies

Supportive counselling can be useful for providing someone with a space to grieve and to process their loss. Your doctor will explain what is available locally and which type of talking therapy is most suitable for you. Where appropriate, social workers may be available to provide some support in managing day-to-day demands in the time after a significant loss.

Complementary therapies

The term complementary therapy is generally used to indicate therapies and treatments that differ from conventional western medicine and that may be used to complement and support it.

Certain complementary therapies may enhance your life and help you to maintain wellbeing. In general, mindfulness, hypnotherapy, yoga, exercise, relaxation, massage, mirimiri and aromatherapy have all been shown to have some effect in alleviating mental distress.

Cultural supports

Different cultures have different ways of understanding and processing loss and grief. Support may be available through your local iwi, and reaching out to your marae or kaumatua may be a helpful way of finding support while you are grieving. Your doctor may be able to provide advice on further cultural supports, too.

For those from Pasifika, Asian or other cultures, it could be helpful to access local cultural support groups – your GP should be able to assist you with finding such groups. 

Medication

Grief is a natural process and, with time, will resolve without medication. However, your doctor may prescribe antidepressants for a short time, or may be able to prescribe a short course of medication to help improve sleep if necessary.

Finding the right medication can be a matter of trial and error – there is no way to predict which medication will be effective and tolerated (have fewer troublesome side effects) by any one person.

If you are prescribed medication, you are entitled to know:

  • the names of the medicines
  • what symptoms they are supposed to treat
  • how long it will be before they take effect
  • how long you will have to take them for and what their side effects (short and long-term) are.

Before making any decisions about taking medication, you should talk with your doctor about the potential benefits and problems, and together you can decide which medication is best for you.

Physical health

It is also important to look after your physical wellbeing. Even when grieving, it is important to try and maintain regular food and water intake. Do what you can to get enough sleep and be physically active through the day. Discuss any health concerns with your doctor. Being in good physical health contributes to your overall wellbeing.

Important strategies to support someone through grief

If you’re supporting someone through grief, take things at their pace. Grief can’t be “fixed”, and the process cannot be sped up – it will take as long as it takes.

Those who have experienced grief and helped others cope suggest the following:

  • Let the person grieve in their own way. They may want to look like they’re coping, but inside they’re hurting. They may find it easy to express what’s inside – or impossibly difficult. Just because their expression of grief is different to yours does not mean that either is “wrong”. 
  • Check in regularly – help them feel connected and cared about.
  • Recognise when they need their own space – don’t make them feel guilty for this.
  • Help them to keep normal routines going as much as possible. Support with practical things such as cooking them a meal, grocery shopping, or childcare can help to maintain overall routine when someone is struggling with grief.
  • Encourage them to keep connected with others, while also giving them permission to decline your offers if they are not feeling up to socialising. Include them and keep offering invitations, even if they’re declined.
  • When a whole family, whānau or group is grieving the same loss, a young person can get overlooked. Give them time and attention, and involve them in making plans and choices.
  • A long time after a loss, even years afterwards, a young person can experience new waves of grief. At different ages and stages, or as new milestones are reached, it’s normal for them to sometimes think about the loss and feel grief. Expect this. They may have new questions. Look out for when some extra support might be needed.
  • Comfort them in the toughest times with hugs, making time for tears, encouragement or just being there. Or offer practical help, like driving them somewhere, fixing something broken or sorting something out for them.
  • Help them take a break from grief. You could watch a movie, watch a comedy on TV, listen to music, hang out with friends, or play sport together.
  • If you’re very concerned about how intensely grief is affecting them, encourage them to see a doctor or other support professional, such as a counsellor, psychologist, social worker, community or youth worker, or local family/youth support agency. You could support them practically to do this, e.g. by researching options, helping them make a booking, or driving them to the appointment.