Stage 4 Depression
This stage is really the time to say good-bye. You have exhausted your anger, bargaining has led nowhere, and you realize the lost loved one is not coming back. There is nothing you can do, no one you can blame, and no reasons, excuses, or negotiations that can bring the lost person back. It is the feeling of sadness, of actual irreversible loss, that is embraced during this stage. According to clinical science, depression can be categorized as low mood, insomnia or hypersomnia, fatigue, feelings of guilt, sadness, hopelessness, diminished interest in usual activities, irritability, or lack of concentration. All of these feelings are normal for grief; however, the major difference between grief and depression is that the above symptoms in grief focus on the absence of the loved person, while in depression they focus on ones self and feelings of helplessness or hopelessness about current or future situations.
What can you do when someone close to you is suffering from depression? The first rule is to not tell them that you know how it feels. The truth is you dont. Everyone carries their own cross, and everyones sadness is different. The best you can do is be there, silent or talking, and make your presence felt. Cook a meal, make a cup of tea, and take care of the person going through this stage. Ensure that they feel listened to and that they can talk to you about anything. Watch out for suicidal thoughts you need to get help, in that case. Often you will hear thoughts like Ive lost any meaning in life: acknowledge that, but be firm in reassuring the person that life also can continue with the memory of the late loved one. Ask the grieving person how their loved one would have liked to have seen them at this moment, and what would they have wanted them to do.
Dealing with depression is not an easy task. There are specific chemical processes happening in the brain and body of a depressed person which are difficult to reverse. In depression, the interaction of the endocrine system with the immune and the nervous systems is altered, as neurological processes activated by chronic stress and by depression are similar. During depression, the levels of catecholamines serotonin, noradrenaline, dopamine drop, and glutamate raise.
Depression has been associated with the weakening of the immune system. Depressed individuals suffer from impairments of the sleep cycle such as insomnia, further reinforced by the lack of physical exercise and an alteration of eating patterns. Therefore, the critical task in this stage is to encourage the grieving person to take care of themselves and pay attention to their own health by maintaining a well-balanced diet, taking the necessary medications, getting enough sleep, exercising regularly, and avoiding excessive alcohol, smoking, drugs, or other self-destructive behavior. Exercise is particularly important as it helps restore the chemical balance in a persons brain by adjusting the levels of neurotransmitters and hormones.
Stage 5 Acceptance
This stage is the trickiest stage of all. People may think they have accepted their loss, when really they havent. In fact, every big milestone and every major event in life will trigger grief again, over and over. This is normal, as it is hard (or even impossible) to accept that someone so important and dear to you is gone. Some people will claim that they have accepted the loss immediately after their loved one has passed away, while others will come to this stage only after passing through all the other stages first. No matter what the timing, the real manifestation of acceptance is the calmness a grieving person will experience as they move on with their life, discovering meaning in continued living and finding the strength and motivation to move on. Acceptance of loss does not mean forgetting the person who passed away or changing your life to avoid any reminders of the loss. Acceptance is more about integrating the loss into your life and moving on while holding onto the heritage of the person you lost and using this as your strength.
Death is a given from the moment we are born. It is the one sure thing that will happen to every one of us, no matter our social position, health status, education, or political values. Grief is strengthened by the realization that we are not immune from death. Awareness of ones mortality is a conscious perception; an anticipation of the inevitable, which human beings often fear to embrace.
Integration of our own and our loved ones mortality is a very important step in achieving psychological wellness and avoiding living in fear. The time of death is beyond our control, much as the time of birth is beyond our control before we are born. Thus, acceptance is a truly powerful and important stage in the grieving process, allowing the person to grow stronger, value life more, and honor the memories of a lost loved one by continuing this life journey.
Chapter four. Types of Losses
The reality is that you will grieve forever. You will not get over the loss of a loved one; you will learn to live with it. You will heal and you will rebuild yourself around the loss you have suffered. You will be whole again but you will never be the same. Nor should you be the same nor would you want to.
Elisabeth Kübler-Ross (19262004)Some losses may be easier to come to terms with than others: for example, the death of elderly family members. Other losses, such as losses of children or young adults to accidents, illnesses, or wars, are far harder to process. When an elderly person dies, I often hear people saying that he or she lived a good and long life. That doesnt mean that the spouse or the children will not grieve their loss. Every death takes away a part of the life of the grieving person, as well as reminding them about their own mortality and awakening the fear of death.
In general, the death of a child and the death of an elderly person have a lot of similarities and differences as far as the grief process and adapting to the loss are concerned. Due to the nature of the loss and the expectation that parents are expected to die before their children, the loss of a child is an unexpected event; while the loss of an elderly person, in contrast, is usually an expected one. This, however, does not mean that the loss of an elderly person will not evoke emotional distress and grief. The disruption of the child-parent bond causes emotional upset and bereavement irrespective of timing, when it dissolves.
In the following chapters we will look at the differences that the loss of a spouse, parent, child, or sibling bring with them. No loss is easy, so by no means should one consider that it may be easier to cope with one type of loss over the other. As we discussed before, our grief depends on the level of attachment and on the type of the relationship we had with the deceased. So the more you cared for the person while he or she were alive and the more you felt attached to and depended upon the person, the more you will grieve the loss of the attachment bond and the more difficult learning to live with that loss will be. One of the further chapters will also talk about the loss of a loved one through suicide.
Anger, despair, emptiness, and being haunted by question «why?» are some of the difficult feelings the loved ones of the deceased go through as they cope with their sudden loss.