September 24, 2019

Managing grief

Madison, Wis. — The thing about grief is that we may not even realize that’s what we’re feeling. Often, we tie it to a significant loss – such as the death of a loved one or a beloved pet. But feelings of grief can also result from a medical issue or illness such as an injury or a diagnosis like cancer or heart disease.

Health psychologist Shilagh Mirgain explains that grief – in simple terms – is the experience of a loss. Developing a medical condition like chronic pain or diabetes can leave some feeling like they’ve lost their sense of self and their plans for the future. Making the situation even more complicated is that the diagnosis can bring about other changes. It can affect a person’s ability to work, live at home, participate in activities, even the ability to continue eating favorite foods.

“Grief is an emotion we experience when something we value is taken away – whether that’s the loss of a loved one or our lifestyle,” said Mirgain. “While everyone grieves in a way unique to them, there are similar feelings we all experience.”

She points to the stages of grief identified by psychiatrist Elisabeth Kübler-Ross – denial, anger, bargaining, depression and acceptance. While we all experience these responses, we don’t move through them in the same way.

“The grieving process takes time,” said Mirgain. “We can move through the stages, jump between them, even come back to them after we thought we had moved on. It’s important to be patient and accept that it will take time.”

Grief can bring about physical symptoms, including fatigue, nausea, aches and pains, difficulty sleeping, weight loss or gain, even a lowered immunity. While we may feel pressured to "pull ourselves together and move on," the reality is that grief is something we have to come to terms with. If we don’t, it will build up until it becomes overwhelming.

Mirgain uses the analogy of a river to explain the experience of grief. It can be calm in some moments, turbulent in others but it is always moving forward.

“If we try to numb ourselves with work, too much TV, food or substances, then that is like the river freezing. We become stuck and can’t move forward,” she said, adding that eventually, the pressure can become too much until it breaks through whether we want it to or not. “We have to surrender to the current and allow it to lead us. But, as with any trip, it’s also important to pace ourselves so we don’t exhaust ourselves on the journey.”

Working through grief

While it can be hard work, it is possible to come to terms with the loss we’ve experienced and move toward healing. Mirgain offers a few tips to help:

Feel your feelings

The only way to begin healing, according to Mirgain, is by allowing ourselves to experience the emotions.

“If you feel like crying, cry. If you’re angry, acknowledge it,” said Mirgain, adding that expressing feelings whether by journaling, speaking to a trusted person or even writing a letter you don’t intend to send can all help to process the emotions.

Let grief transform you

Because grief arises from loss, the experience is life-changing – the loss never goes away, instead it becomes something we learn to live with. Because it is such a personal experience, it’s important to remember that no one else can define what that loss should mean or how long the grieving process should take.

Increase self-care

It can be easy to isolate from others when experiencing grief, but Mirgain said it is important to connect with others when grieving. Consider a support group, therapist or even a clergy member. Self-care is also critical.

“Be gentle with yourself,” said Mirgain. “Exercise, eat well, get good sleep and spend time in nature. Put a priority on engaging in your life – your hobbies, the things you enjoy, spending time with the people you care about.”

Create meaning from the experience

Mirgain says that some consider this the sixth stage of grief – when we’ve experienced the loss (the grief) and yet take a step forward. This could be fundraising for a non-profit charity that is meaningful. Volunteering time to help support a local group. Even planting flowers in memory of someone can help acknowledge the loss and yet move past it.

Create a coping plan

Something random – an anniversary, a birthday, a milestone or even a happy event like a wedding or birth of a new baby can unexpectedly trigger strong feelings of grief. Mirgain recommends having a self-care plan for dealing with those moments – something to do, or even just words to say like a mantra to help process the emotion.

Know the difference between grief and depression. Mirgain said that over time the sadness and sense of loss should start to lessen. If the emotional pain continues to stay constant or begins affecting the day-to-day, then it is time to seek professional support.

Ways to support those experiencing grief

If someone you know is experiencing grief, it’s important to allow them to grieve in their own way and at their own pace. Dr. Mirgain offers a few tips for how to help:

  • Support for the long term. There’s often an outpouring of support immediately following a diagnosis or event. But over time that support often disappears, even though the circumstances may not have changed. Mirgain said one of the best things a person can say is, “I am here for you” and to listen when someone needs to talk.

  • Don’t dismiss their feelings or take over their pain. Although people often want to be supportive, it can sometimes backfire. Phrases like "everything happens for a reason," "give it time," or "I went through this, too," can have the opposite effect than what the speaker intended. Rather than allowing someone to feel supported, it can leave a person feeling like their experiences don’t matter.

  • Be honest. Sometimes it can be helpful to admit you don’t know what to say, or even what to do. Phrases like, "I wish I knew the right words to say, but please know that I care," can mean a lot.

  • Offer help. It can be hard to know how to accept help from others. Either we don’t want to be a burden, or we’re overwhelmed and it can be difficult to know what needs to be done. Offer to drive the person to appointments, mow their lawn or shovel snow – simple tasks can make a big difference and alleviate a lot of stress when someone is trying to balance treatments with taking care of their home.