Why Am I Still Sad?Understanding Grief
Most people understand that when someone we love dies, we will grieve. This is normal and expected. It’s helpful to remember, though, that grief is a natural response to all kinds of loss - changing relationships, losing a job, moving to a new city, experiencing decreased physical or mental functioning, confronting our own mortality, or even becoming disillusioned about the state of the world. Some grief is more complicated, and we may be grieving a loss that others don’t see or understand. When this happens, it’s important to understand our own experience and to be reminded that all kinds of loss are significant and deserve to be mourned.
Grief and emotional distress are natural responses to watching and experiencing loss. You don’t “get over it,” and there is no set time line for moving through it. Everyone grieves differently, and that’s okay. The only way to cope is to take one step at a time. Grief may continue to wash over us in waves for weeks, months, or even years after a significant loss. However, understanding grief and our response to it may help us cope with the waves when they come.
Types of Grief
You might not be aware that there are different types of grief. This is important as the ways we cope might differ depending on the kind of grief we’re experiencing. Here are several common categories of grief:
Anticipatory Grief- experienced when a loss is perceived as inevitable, such as when a loved one is facing an incurable illness.
Disenfranchised Grief - hidden sorrow not always easily acknowledged by society, such as pregnancy loss or the death of a loved one due to a substance use disorder.
Complicated Grief – grief complicated by adjustment disorders such as persistent depressed and anxious mood or disturbed emotions and behavior, that last for months or even years after the initial loss.
Anticipatory Grief
Anticipatory grief can be especially confusing because often we don’t identify what we’re feeling as grief. After all, if my partner has been diagnosed with Alzheimer’s Disease but is still here with me, how can I say I’m grieving? Sometimes the messages we perceive from those around us, or even the message we send to ourselves, is that we don’t have the right to grieve a loss that hasn’t happened yet. We may feel pressure to “enjoy the time we have left,” “stay hopeful,” or “be strong for the kids.” While these sentiments may have their place, they are not helpful to us when they disallow us from feeling authentically.
No emotion is inherently good or bad: it’s just the way you feel. On days when you feel sad about an approaching loss, allow yourself to feel sad. At other times, you may feel happy, hopeful, grateful, or a range of other emotions. When you feel sad, angry, or hopeless, take time out to care for yourself or talk with a trusted friend.
Disenfranchised Grief
While anticipatory grief may be difficult to recognize because it precedes a loss, disenfranchised grief is associated with loss that may not be as easily recognized by others in your life. Though the loss may be very painful for you, others might not be aware of your loss or might not understand that you are grieving. Someone might have an experience of disenfranchised grief following events such as:
Pregnancy loss
Death of an ex-partner
Losing a job
Elective abortion
Loss of a limb or other loss of physical function
Illness or death of a loved one due to a substance use disorder
Death of a patient or client
An anticipated adoption that doesn’t go through
Death of a loved one by suicide
Loss of a loved one who is incarcerated
When your loss is not recognized by those around you, you might feel more isolated or believe you don’t have the right to grieve. You might push your own feelings aside and deprive yourself of the opportunity to mourn your loss. These suppressed feelings can make you more vulnerable to developing depression or complicate your coping with future losses. Remember: loss comes in all forms. You have the right to grieve and to do so in your own way without judgment.
Complicated Grief
While all grief is not depression, complicated grief often is characterized by persistent depressed mood, and grief may mask underlying depression. If you notice symptoms in yourself or your grieving loved one such as persistent depressed and anxious mood or disturbed emotions and behavior that last for months or even years after the initial loss, you may be dealing with complicated grief.
While risk factors might not be present in order for someone to develop this type of grief, some factors predispose us to complications of grieving:
Sudden, unanticipated death
Experiencing multiple losses in close succession
An individual’s personal history with loss or depression
Violence, mutilation, or destruction involved in the loss
Preventability and/or randomness of act leading to loss
Loss following healthcare-related trauma (such as experiencing the ICU)
It’s normal to feel waves of grief for months or even years after experiencing a significant loss. However, if your grief continues at a level of high intensity that never abates for many months to a year, seek professional counseling. You will benefit from having more support in coping with your loss.
Grieving is Normal and Expected
We grieve because the person or entity we lost was meaningful to us, and it’s normal and healthy to form meaningful connections. Acknowledge your loss and your own (sometimes complicated) emotions. This is especially important if you are coping with anticipatory or disenfranchised grief, as your support system might not be as aware of your loss.
Understand that you may experience waves of grief for a long time, and be patient with yourself. Leave yourself space to cry and to feel angry and frustrated. You’ll also have good days and times when you feel happy. This is okay and doesn’t mean you’re not grieving. The grieving process has space for lots of emotions.
If you notice signs of depression when you or a loved one is grieving, such as persistent feelings of guilt, worthlessness, or thoughts of suicide, seek professional help. About 1 in 5 of those experiencing grief may also experience depression, which can be serious and should be addressed promptly.
So How Do We Cope?
The experience of grieving has been compared to the waves of the ocean: “grief waves” may continue to wash over us for months or even years past a time of loss. Over time, the waves are likely to get smaller and further apart, but they might never go away completely. Our coping strategies help us to prepare for the waves so we can deal with them when they come, and over time we likely will be able to move through them without feeling totally engulfed.
The best coping strategies won’t be the same for everyone, but many people find that one of more of these strategies are helpful:
Engage in mourning rituals. This could be a service of remembrance or celebration, writing a letter to a person who is no longer in your life (even if you can’t send it), making a collage of photos of a beloved person or place, or planting something beautiful to honor a loved one, a community, or even a profession.
Allow yourself the time and space to mourn. Cry, run, scream into a pillow, or take a few hours for yourself when needed. There’s no shortcut for grieving - we just have to go through it.
Wait a few months to make big decisions. For instance, if you don’t have to move, change jobs, or make other big life changes while in the first few months of mourning, then don’t. If you don’t want to clean out that loved one’s closet yet - don’t. It’s okay. Allow time for your emotions to settle down.
Connect with the people and places that bring you meaning: engage with family and friends, deepen your ties with a faith community, take an art or a yoga class, listen to music you love, or spend time in a place that brings you peace.
Join a grief support group. Many people find it helpful to connect with others who can relate to what they’re going through.
Find someone who listens to you supportively and without judgment. For many, this is a friend or family member. However, some people find it helpful to seek more formal counseling for coping with grief. This is completely normal and may help normalize the process and emotions of grieving.
Want to talk with someone about grieving a loss in your life? I’m here. You don’t have to do this alone.
