Understanding and processing grief

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Most of us associate grief with loss, such as the death of a loved one or pet. However, you can also experience grief when you go through any big change. No matter how or why you grieve, the most important thing to know is that it's normal. And, the more you learn about grief, the more likely you're able to work through it and minimize its effect on your mental or physical health.

What is grief?

There are many ways to define grief, because it’s unique and different for every person. Grief is a natural response to losing someone or something important to you, and can cause various feelings and emotions like shock, anger, disbelief, guilt and extreme sadness. There are also different kinds of grief. Prolonged or complicated grief is grief that lasts longer than one year, and anticipatory grief is grief you feel when you know a loss will happen but it hasn't happened yet. Though often used interchangeably, grief (the internal feeling in reaction to loss) is different from bereavement (the state of experiencing loss) and mourning (the outward expression of loss).

Why do people grieve?

Grief is often associated with losing someone or something you love, because this type of loss can be very intense. However, any type of loss — no matter how subtle — can cause a sense of grief, such as:

• Experiencing a sudden change in routine
• Divorcing or ending a relationship
• Losing a job or financial stability
• Having a miscarriage
• Losing a pet
• Retiring
• Growing apart from a friend
• Selling your home
• Graduating from college
• Changing jobs

How do people grieve?

You may have heard about the five stages of grief. These stages, coined by Elisabeth Kübler-Ross, are simply a framework to help you process your grief — not a set of guidelines. These stages don’t necessarily happen in order, and not everyone goes through all of them. Though you can’t often control the grieving process, these stages may help you understand why you’re feeling the way you are.

1. Denial: You may feel shocked, numb or be in total disbelief about your loss. You may even go about your day as if nothing has happened — for example, trying to call a loved one who just died or going back to work the day after you were fired. This is temporary and is essentially a defense mechanism your brain uses to deal with the sudden onset of overwhelming emotions.
2. Anger: You may feel frustrated and helpless when feeling the pain of your loss, which then may turn into anger — toward other people, life in general or even the person or thing you lost.
3. Bargaining: You may often think about what you could have done — or can still do— to prevent the loss.
4. Depression: You may feel incredible sadness as you begin to fully understand how the loss is affecting your life. You may feel overwhelmed, cry, experience sleep issues, have a decreased appetite and more.
5. Acceptance: As you start to accept the reality of your loss, knowing that you can’t change what happened, you may still feel sad but will be able to start moving on. This doesn’t mean that you will forget about your loss. It’s possible to reach this stage of grieving and return to previous stages if you aren’t fully ready to heal.

Because grief is classified as an emotion, it’s easy to forget that it can manifest in physical symptoms. You may feel stressed, extremely tired or nauseous, have little appetite, lose or gain weight, feel physical aches and pains and have trouble falling or staying asleep.

How can I manage my grief?

Because grieving is an inevitable part of life for everyone, it’s important to know how you can help yourself cope. Here are several ways you can take care of yourself to lessen the impact of grief on your daily life:

• Try to maintain a routine. As best you can, try to go about your daily life and prioritize things that bring you joy — whether that means meeting up with a friend or curling up in bed with a good book.
• Seek out support. This could mean spending more time with family and friends who are able to help you work through your loss or joining a grief support group to get outside perspective. If a loved one has died, you can ask your religious leader or funeral home director for recommendations for an in-person support group. You can also find support groups in your area, both in-person and virtual, at GriefShare.org.
• Don’t suppress your feelings. When you’re grieving, you need to allow yourself to feel sad to heal. If you avoid negative feelings or thoughts, you’ll end up prolonging the grief process. The longer you grieve, the more vulnerable you become to other issues like depression, anxiety, substance abuse and other health problems.
• Keep potential triggers in mind. Because grief can be a long process, certain days may be harder than others after you lose a loved one — like anniversaries, holidays, birthdays and other milestones. You don’t necessarily need to do anything to prepare for these triggers, just know that they will happen and any setback you feel in the healing process is normal.
• Don’t forget about your physical health. Your mental and physical health are intertwined, so the better you feel physically, the better you’ll able to cope with the feelings you experience during the grieving process. You can help yourself feel your best by getting enough sleep, eating healthy foods, and getting active — even just a regular walk around the block will do. Try these ideas for self-care, too, if you feel up to it.
• Consider professional help. Complicated or unresolved grief may lead to clinical depression. If your symptoms do not improve over time or if there is significant impairment to your ability to function in everyday life, contact your primary care provider (PCP) or a behavioral health professional.

When should I ask for help?

Grief doesn’t follow a specific timeline — it can last for months or years, depending on how intense your feelings are surrounding your loss. When your grief doesn’t resolve, however, it’s called “complicated grief.” Some signs that you are unable to accept your loss include not being able to go about your daily life, feeling depressed, thinking that life isn’t worth living or being unable to stop blaming yourself for your loss.

If you experience any of these signs, it’s time to talk to your PCP, a mental health professional or a grief counselor. Log in to myWellmark^® to find an in-network doctor if you don't already have one.

If you need the extra help to heal but don’t want to physically take that step, you can access virtual help for grief through Doctor On Demand^® if you’re a Wellmark Blue Cross and Blue Shield member. With Doctor On Demand, board-certified physicians can treat everything from the common cold and physical injuries to mental health conditions like anxiety, depression and more. Before setting up a visit, log in to myWellmark to see if it is covered under your benefits.