Depression During the experience of processing grief, there comes a time when the bereaved’s imaginations calm down, and they slowly start to look at the reality of their present predicament. Bargaining no longer feels like an option, and they are faced with what is happening. They start to feel more abundantly about the loss of their loved ones. Anticipatory grief occurs when death is expected, for example, when a family member or friend is suffering from a terminal illness. It helps the family, but may not help the dying person, and does not always occur. Normal/common grief Types of grief Anticipatory grief Normal or also referred to as, common grief, begins soon after the death of a loved one. This is the type of grief experienced by most people. The bereaved do not require specialist counseling but would benefit from reassurance, acknowledgement of their losses, and access to information. Common symptoms steadily diminish as the victim accepts the reality of loss and continuously integrates it. Most of the bereaved people will experience periods of sadness and sorrow triggered by a memory, a song, a reading, or a sight. These triggers are referred to as grief pangs or grief bursts. Grief and bereavement involve a process that follows well-defined stages. The stages, however, do not always occur in order. Complicated grief There is no established correct or wrong grieving process. Everyone responds differently to death, and it's common to feel like one is riding on a rollercoaster of various emotions. How a person responds to death can be affected by a lot of things, such as the type of relationship the mourner had with the person, the gender, cultural background, and age of the bereaved. However, research has shown that there are abnormal bereavement patterns that differ from the typical grieving process. Abnormal bereavement is the basis of the nature of Complicated grief and encompasses the following: ● Chronic grief: grieving that lasts for a prolonged or extended period. Emotional distress does not appear to be substantially reduced. Over time, it does not seem to stop or lessen in frequency. An individual who has this experience continues to feel intense distress. The loss of this person Normal vs. complicated grief Normal grief differs from the complicated grief in that normal grief is not chronic, not as severe, is not impairing or life-altering, and is not perceived by the bereaved person as a serious threat. Individuals with complicated grief are often focused on the circumstances surrounding the loss in addition to the loss itself. There is an obsession with the demise and the desire to reunite with the deceased, lack of certainty about identity, failure to acknowledge the loss, anhedonia (inability to experience pleasure from activities usually found enjoyable), resentment, difficulty in developing trust, and a sense of being "stuck" in the mourning process. These symptoms are present day by day, cause depression or functional disability, and continue after bereavement for more than six months. Individuals with complicated grief may experience loss of self-worth and self- esteem, feel emotionally detached from others, struggle with
Acceptance This is the final stage of grief when people dealing with loss come to a place of acceptance. It does not mean that they no longer feel the pain of loss. However, they are no longer resisting the reality of their situation and are not struggling to make it something different. feels as fresh as when it first happened, given the passing of some time. ● Delayed grief: grief that is not fully experienced until quite a while after your loss. It can be described as a devastating sadness that hits a bereaved person out of the blue. It may begin a few weeks or months, or even years after the loss of a loved one. ● Inhibited or absent grief : involves inhibition of the normal behaviors that are associated with bereavement. Many who do not allow themselves to directly experience the pain of grief may develop some form of physical symptoms or disease. During this type of grief, it is common for the mourner to choose to grieve some aspect of the deceased and not the other. ● Distorted grief: a response where the grieving person experiences an intense, extreme, or atypical reaction to the loss such as self-destructive actions or extreme changes in behavior. Hostility and anger towards themselves and others are common. Symptoms of complicated grief A person suffering from complicated grief may display the following symptoms: ● Indefinitely missing for the deceased. ● Obsessing over the manner of death of the deceased. ● Intense grief and anxiety which does not get better over time. ● Difficulty in developing trust with others. ● Depression. ● Alienation and detachment. ● Challenge pursuing interests or hobbies. ● Eagerness to join the deceased. ● Recurrent feelings of loneliness or isolation. ● Problems in social, occupational, or other forms of life (Wakefield, 2017). As these symptoms are also often indicative of grief, a person must show such symptoms over a prolonged period to be diagnosed with complicated grief. moving on from the suffering, and may feel that doing so will signify betrayal to the deceased. To distinguish between normal and complicated grief, The American Psychiatric Association proposed a diagnostic criterion. According to the 5th edition of the Diagnostic and Statistical Manual of Mental disorders (DSM-5), the diagnosis assigned to individuals who experience abnormally disabling or prolonged response to bereavement is Persistent complex bereavement disorder. Persistent complex bereavement disorder, previously known as complicated grief disorder, causes individuals to experience an intense longing for a deceased loved one, usually for a prolonged time. Longing emotions are frequently followed by harmful thoughts and behaviors, as well as general difficulty in restoring normal life (American Psychiatric Association, 2013).
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