About Grief
About Grief

In 1969, based on her years of working with terminal cancer patients, psychiatrist Elisabeth Kübler-Ross introduced what became known as the "five stages of grief." While these stages represented the feelings of people who were themselves facing death, they also have come to be applied by many to people who are experiencing other negative life changes (a break-up, loss of a job) and to people facing or experiencing the death of loved ones. Kübler-Ross proposed these stages of grief:

Denial: "This can't be happening to me."
Anger: "Why is this happening? Who is to blame?"
Bargaining: "Make this not happen, and in return I will ____."
Depression: "I'm too sad to do anything."
Acceptance: "I'm at peace with what is happening/has happened."

However, Kübler-Ross herself never meant these stages as a rigid framework that applies to everyone who mourns. In the last book she wrote before her death in 2004, she said of the five stages, "They were never meant to help tuck messy emotions into neat packages. They are responses to loss that many people have, but there is not a typical response to loss, as there is no typical loss. Our grief is as individual as our lives."

So there is no single pathway through grief. People can feel multiple emotions at once; they can reach a point of acceptance only to have a birthday or bit of news plunge them back into despair. Siblings mourning the same parent can experience their grief in completely different ways.

That said, some recent experts have described three general categories of a beginning, middle, and resolution to grief:

    Shock The first reaction to loss, shock can involve just minutes or last for days. You might feel numb or be in disbelief. You might be unable to make simple decisions or attend to your daily routine.

    Suffering When the shock wears off, the pain begins and can last for weeks, months, and intermittently for years. If you're suffering from a loss, you'll typically experience waves of emotions that can involve sadness, anger, guilt, anxiety, or any combination of those feelings and others. The pain is as palpable a physical experience as it is emotional. You might also experience physical symptoms such as loss of appetite, sleeplessness, or chest pain, and behavioral symptoms such as withdrawal from society, mood swings, or inability to concentrate.

    Recovering Recovery represents not the end of pain over a loss but the ability to reconnect to the interesting and joyful parts of life - to refocus your attention from your pain of loss to living with meaning and purpose. Again, though, remember: There is no timetable for grieving. While the sense of loss and the intermittent sadness never go away completely, people experience the cycle of grief differently. Some find that within a few weeks or months, the period between waves of distress lengthens, and they are able to feel peace, renewed hope, and enjoy life more and more of the time. Others may face years of being hit with what feels like relentless waves of grief.

    How is grief different from depression? If you are grieving, you may experience a number of depressive symptoms such as frequent crying, profound sadness, and depressed mood. However, while major depression is categorized as a psychological disorder, grief is not. Grief is a normal and healthy response to bereavement, not an illness. Its symptoms are painful, but they serve an adaptive purpose. As Webster University's Dennis Klass notes in The Culture of Grief, healthy grief "lines us up with reality" and helps us come to terms with who we are apart from our lost loved one. In fact, it is cause for concern when a bereaved individual doesn't exhibit any signs of grief because it suggests that the death is not being processed. The American Psychiatric Association states that as a general rule, normal grief does not warrant the use of antidepressants. While medication may alleviate some of the symptoms of grief, it cannot treat the cause, which is the loss itself. Furthermore, by numbing the pain that must be worked through eventually, antidepressants delay the mourning process. However, it is important to distinguish between a normal grief reaction and one that is disabling or does not diminish over time. When grief doesn't resolve over time, but continues to be a disruptive presence, it may be an indicator of major depressive disorder. According to the American Cancer Society, about 1 in 5 bereaved people will develop major depression. Those with a prior history of depression or a lack of social support are particularly at risk.

    SYMPTOMS THAT SUGGEST A BEREAVED PERSON IS ALSO DEPRESSED: Intense feelings of guilt. Thoughts of suicide or preoccupation with death. Feelings of worthlessness. Slow speech and body movements. Inability to function at work, home, and/or school. Finds no pleasure in previously-enjoyed activities. Hallucinations of the deceased. If you develop major depression following the death of a loved one, you may benefit from therapy, medication, or a support group for the bereaved.

    Do I need an anti depressant medication? In the above article it states that normal grief does not warrant anti-depressants. Not everyone needs these types of medication to get through the first stages of grief but some may feel they need something to help. I have recently read that St. John's Wort is as effective as Prozac the #1 selling anti-depressant in America. Please read this article by the Mayo Clinic. Because of the severe side effects of most anti-depressants, I think it is wise to ask your doctor to try St. John's Wort FIRST, before starting any anti-depressant. In this article you will find studies and dosage information

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