Coping with Bereavement for Better Mental Wellness

Grief and loss is a progression of different intense emotions, and these may affect children and adults. Here are some tips on coping with bereavement.

How to Deal with Bereavement?

Grieving takes place after any sort of loss but most powerfully, after the death of someone we love. It is not just one feeling, but a whole succession of intense emotions which takes a while to overcome. The grieving process cannot be hurried. Often the experience of grieving takes place in stages, and different emotions are experienced during different stages of grief.

Although we are all individuals, the feelings which we experience are very similar. However, not everyone experiences the same bereavement symptoms or stages, nor with the same intense emotions. There is no “right way” no necessary order or stages of grief, nor is there a “correct” time period for this process.

Stages of Grief

Grief is most commonly experienced after the death of friends or family. However, it is clear that people who have had stillbirths or miscarriages, or who have lost very young babies suffer a similar experience of grieving and need the same sort of care and consideration when coping with bereavement.

In the few hours or day following the death of a close relative or friend, most people feel simply stunned, as though they cannot believe it has actually happened. They may feel like this even if the death has been expected.

This sense of emotional numbness can be a help in getting through all the important practical arrangements that have to be made, such as getting in touch with friends and family and organising the funeral.

However, this feeling of unreality may become a problem if it goes on for too long. Seeing the body of the dead person may, for some, be an important way of beginning to overcome grief and loss. Similarly, for many people, the funeral or memorial service is an occasion when the reality of what has happened really starts to sink in.

It may be distressing to see the body or attend the funeral, but these are ways of saying good-bye to those we love. At the time, these things may seem too painful to go through and so are not done. However, this often leads to a sense of deep regret in future years when we are not given a chance to grieve properly.

Related: Grief Management

Soon though this numbness disappears and may be replaced by a dreadful sense of agitation, of pining or yearning for the dead person. There is a feeling of wanting somehow to find them, even though this is clearly impossible. This might affect your mental wellness and make it difficult to relax or concentrate or even sleep properly.

Dreams may be extremely disturbing and overwhelming. Some people feel that they “see” their loved one everywhere they go — in the street, the park, around the house, anywhere they had spent time together.

People often feel very angry at this time — toward doctors and nurses who did not prevent the death, towards friends and family who did not do enough, or even towards the person who has left them.

Another common feeling is guilt. People find themselves going over in their minds all the things they would like to have said or done. They may even consider what they could have done differently that might have prevented the death.

Of course, death is usually beyond anyone’s control and a bereaved person may need to be reminded of this. Guilt may also arise if a sense of relief is felt when someone has died after a particularly painful or distressing illness. This feeling of relief is natural, extremely understandable and very common.

This state of agitation is usually strongest about two weeks after the death but is soon followed by times of quiet sadness or depression, withdrawal and silence. These sudden changes of emotion can be confusing to friends and family but are just part of the normal way of passing through the different stages of grief.

Although the agitation lessens, the periods of bereavement and depression become more frequent and reach their peak between four and six weeks later. Episodes of grief and reactions to loss can occur at any time, sparked off by people, places or thing that bring back memories of the person who has died.

Other people may find it difficult to understand or embarrassing when the bereaved person suddenly bursts into tears for no obvious reason. At this stage, it may be tempting to keep away from other people who do not fully understand or share the grief.

During this time, it may appear to others as though the bereaved person is spending a lot of time just sitting doing nothing. In fact, they are usually thinking about the person they have lost, going over again and again both the good times and the bad they had together. This is a quiet but essential part of the grieving process.

Related: Depression

As time passes, the fierce pain of early bereavement begins to fade. The depression lessens and it is possible to think about other things and even to look forward to the future. However, the sense of having lost a part of oneself never goes away entirely.

For the bereaved partners, there are constant reminders of their new singleness, in seeing other couples together and from the deluge of media images of happy families. After some time, it is possible to feel whole again, even though a part is missing. Even so, years later, you may sometimes find yourself talking as though he or she were still here with you.

These various stages of grief often overlap and show themselves in different ways in different people. Most recover from a major bereavement and depression within one or two years.

The final phase of grieving is letting go of the person who has died and the start of a new sort of life. When bereavement and depression clears completely, sleep improves and energy returns to normal. Sexual feelings that were dormant now return — this is quite normal and nothing to be ashamed of.

Having said all this, there is no standard way of grieving or coping with bereavement. We are all individuals and have our own particular way of handling the grieving process.

Stages of Grief in Children and Adolescents

A child’s mental wellbeing can also be affected by grief and loss.

Even though children may not understand the meaning of death until they are three or four years old, they feel the loss of close family members in much the same way as adults. It is clear that even from infancy children grieve and feel great distress.

However, they have a different experience of time from that of adults and may go through the stages of mourning quite rapidly. Preschool children usually see death as temporary and reversible — a belief reinforced by cartoon characters who “die” and “come to life again”. In their early school years, children may feel responsible for the death of a close relative and so may need to be reassured not to feel guilty for their passing.

Young people may not speak out of fear of adding extra burdens to grown-ups around them. The grief of children and adolescents and their need for mourning should not be overlooked when a member of the family has died. They should, for instance, be included in the funeral arrangements.

Once children accept the death of family members, they are likely to display their feelings of grief and loss. The family members should spend as much time as possible with the child making it clear that the child has permission to display their reactions to loss openly or freely.

Bereavement Support From Friends and Family

It is crucial to have a strong network of friends and family when coping with bereavement.

Friends and family can help by spending time with the person who is coping with bereavement. It is not so many words of comfort that are needed but more the willingness to be with them during the time of their pain and distress. A sympathetic arm around the shoulder will express care and support when words are not enough.

It is important that if they wished, bereaved people are allowed to cry with somebody and talk about their feelings of pain and distress without being told to pull themselves together. In time they will get over it, but first, they need to talk and grieve properly.

Others may find it hard to understand why the bereaved have to keep going over the same ground over and over again, but this is part of the process of resolving grief and should be encouraged. If you don’t know what to say, or don’t even know whether to talk about it or not, be honest and say so.

This gives the bereaved person a chance to tell you what he or she wants.

People often avoid mentioning the name of the person for fear that will be upsetting. However, to the person coping with bereavement, it may seem as though others have forgotten their loss, adding a sense of isolation to their painful feelings of grief and loss.

It must be remembered that festive occasions and anniversaries (not only of the death but also birthdays and weddings) are particularly painful times when friends and family can make a special effort to be around.

Practical help with cleaning, shopping or looking after children can ease the burden of being alone. Elderly bereaved partners may need help with the chores that the deceased partner used to handle — coping with bills, cooking, housework, getting the car serviced and so on.

It is important to allow people enough time to grieve. Some can seem to get over the loss quickly, but others take longer to overcome bereavement and depression. So don’t expect too much too soon from a bereaved relative or friend — they need the time to grieve properly, and this will help to avoid problems in the future.

Related: Q&A: Coping with Grief

These are people who hardly seem to grieve at all. They do not cry at the funeral, avoid any mention of their loss and return to their normal life remarkably quickly. This is their normal way of dealing with loss and no harm results. But others may suffer from strange physical symptoms or repeated spell of depression over the following years.

Some may not have the opportunity to grieve properly. The heavy demands of looking after a family or business may mean that there just isn’t the time.

Sometimes the problem is that the loss is not seen as a “proper” bereavement. This happens often but by no means always, to those who have had a miscarriage. Periods of bereavement and depression may follow.

Some may start to grieve but get stuck. The early sense of shock and disbelief just goes on and on. Years may pass and still the sufferer finds it hard to believe that the person they loved is dead. Others may carry on being unable to think of anything else, often making the room of the dead person into a kind of shrine to their memory.

Occasionally the depression that occurs with every bereavement may deepen to the extent that food and drinks are refused and thoughts of suicide arise.

Help from your Doctor

If you can’t overcome bereavement and depression, seek medical help.

Occasionally sleepless nights may go on for so long as to become a serious problem. The doctor may then prescribe a few days’ supply of sleeping tablets.

If the bereavement and depression continue to deepen, affecting appetite, energy and sleep, antidepressants may be necessary. These are not habit-forming drugs. If depression still does not improve or if it develops into unresolved grief, then it is necessary to see a psychiatrist for professional help.

Loss, grief and bereavement turn our world upside down and is one of the most painful experiences we endure. It can be strange, terrible and overwhelming. In spite of this, it is a part of life that we all go through and usually does not require medical attention. For those who do run into a problem, help is at hand.

Hotline / Helpline	Who is it for?	Day	Times	Telephone
S.O.S.	Anybody in crisis and the suicidal.	Daily	24 hours	1800-221-4444
SAMH Helpline	For people who have a psychological, psychiatric or social problem and others who need information on services for such persons.	Mon – Sat	9am – 5pm	1800-283-7019
Counselling & Care Centre	For individuals, couple and families experiencing psychological, marital or family problems.	Mon – Fri	8.30am – 5pm	6536 6366
Parentline	Parents with child development and management difficulties or requiring marital counselling.	Mon – Fri	9am – 5pm	6289 8811
Hotline 800	Mandarin-speaking community with a family marital and personal problem.	Mon – Sun	10am – 9pm	1800-353-5800
AMP Hotline	Malay / Muslim families in crisis or those who need help.	Mon – Fri	2pm – 7pm	6345 2911
SINDA Family Service Centre	Families in need of assistance or counselling.	Mon – Fri Sat	9am – 5pm 9am – 1pm	6294 0115
Aware Helpline	Women with problems.	Mon – Fri	4pm – 10pm	1800-774-5935
Institute of Mental Health	Those suffering from psychological and psychiatric problems.	Mon – Sat	8am – 4.30pm	1800-389-2200