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Grief and Bereavement (cont.)

When Should I See a Counselor for Grief?

  • Some situations are unique in their challenges and may necessitate professional help.
    • One such situation is the death of a child. Such an event is just against the natural order of things, and it is a type of grief that we may be unable to truly work through to an accommodation.
    • Another such situation is the murder of a loved one. Trauma such as murder complicates grief, adding a whole new dimension to our bereavement, one that we are reminded of with each news broadcast.
    • Disenfranchised grief occurs when we experience a loss that cannot be openly acknowledged, publicly mourned, or socially supported. An example would be the loss experienced by someone who was having an affair with a married person who dies. Because the usual opportunity for mourning is not available, disenfranchised grief is hard to work through and may be prolonged.
    • Complicated grief is delayed or incomplete adaptation to our loss. In complicated grief, there is a failure to return, over time, to pre-loss levels of functioning, or to the previous state of emotional well-being. Grief may be worse in younger people, women, and people with limited social support, thus increasing their risk for complicated grief. Counseling from a minister, grief counselor, family physician, or mental-health professional may be required to effectively deal with complicated grief.

What Are the Potential Health Effects of Grief?

Grief may cause significant physical symptoms and psychological distress.

  • Physical manifestations of grief
  • Risk for health problems and death: Grieving people are at increased risk for health problems and death.
    • Physical complaints such as changes in weight, chest pain, and palpitations, while often seen in the bereaved, nevertheless should be discussed with a doctor since they may be due to other conditions.
    • Chest pain that is alarming; that radiates to the neck, jaw, arm, or back; or that is sudden in onset, should prompt an immediate call to 911 for emergency medical services.
    • Similarly, seek immediate help for chest pain or palpitations associated with shortness of breath, nausea, sweating, lightheadedness, weakness, or profound fatigue.
  • Psychological manifestations of grief
    • sadness
    • anxiety
    • helplessness
    • emotional swings
    • irritability
    • apathy
    • disbelief
    • impaired concentration
    • lowered self-esteem
    • hallucination that the deceased person is present (visual or auditory)
    • feelings of unreality, numbness, denial
    • searching for the deceased
    • flashbacks
    • individuals may progress and then suddenly feel worse, without an obvious trigger
  • Suicidal thoughts
    • Thoughts of suicide occur in up to 54% of survivors and may continue up to six months after the death.
    • Although it is common to have such thoughts, individuals should talk with a doctor or a mental-health professional.
  • Depressive illness
    • Depressive illness, not to be confused with situational depression caused by the loved one's death, occurs in 17%-27% of survivors during the first year after a death.
    • Symptoms of depression typically begin after one to two months of bereavement, last for several months after the loss, and are constant.
    • Depressive illness is associated with prominent thoughts of suicide, profound changes in appetite or sleep, or substantial decreases in function. The help of a mental-health professional is needed.
Medically Reviewed by a Doctor on 11/11/2016
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