People experience many losses in their lifetime. The most common loss is the death of a loved one, but people experience other losses e.g. loss of a relationship, loss of a job or loss of health. Most of these losses result in some type of a grief response. Grief is the entire body’s response to the loss–mind, body and spirit.

A person grieving a loss may feel grief in many different ways–physically, emotionally, spiritually, socially and intellectually. He or she may experience a variety of body complaints that include:

• Fatigue
• Problems sleeping (insomnia)
• General aches and pain
• Backaches
• Stomach pains
• Intestinal symptoms (diarrhea, constipation, pain, discomfort)
• Chest Pressure
• Palpitations
• Panic Attacks
• Increased Anxiety

Many of these physical complaints are potentially serious and require a medical evaluation to exclude a serious medical disorders before determining that the symptoms are due to grief.

The grieving person may also experience common emotional responses to grief that include:

• Anger
• Shock
• Denial
• Despair
• Guild
• Disbelief
• Confusion
• Sadness
• Sorrow
• Longing
• Yearning
• Depression

A grieving person may also experience changes in appetite (eating more or less), increased drug or alcohol use, absentmindedness and problems concentrating.

With so many possible physical and emotional reactions to loss it is easy to see why grief is the entire body’s response to the loss–mind, body and spirit.

I have found a poem written by Norah Leney entitled “Grief” helps to capture some of the physical symptoms a person may feel when experiencing a loss. A short excerpt:

Deep sobs -
That start beneath my heart
and hold my body in a grip that hurts.
The lump that swells inside my throat
brings pain that tries to choke.
Then tears course down my cheeks –

This poem is an effective way to explain the physical and emotional grief response that a person may feel after experience a loss. It is also a beneficial resource for a grieving person to read, so they do not feel so alone in their response to the loss.

TAKE CARE of Yourself

The TAKE CARE acronym was developed that I developed as a useful reminder to help someone grieving people focus on the basics following a loss, a death or other when grieving any significant life changing event.

• Time is needed to handle the grief.
• Avoid alcohol and other medications.
• Keep to some routine or schedule.
• Eat a balanced diet. Focus on healthy foods and water.
• Converse with others, especially those that have “been there” and “survived that.”
• Art projects can keep worried hands busy, whether journaling, building, crafting, knitting or in other ways.
• Rest and Sleep are important to help the body heal.
• Exercise to reduce stress and improve one’s mood.

These are the areas that a person needs to focus on during the initial shock phase, when coming to grips with a loss or death.

When to Consider Medication

For the medical profession, there is a temptation to try and ‘fix’ someone’s grief response to a major loss. Unfortunately, medications, including antidepressants, are often over-prescribed to try and managing grief as something that can be done. Unless the person has true symptoms of clinical depression, antidepressants may not be helpful in managing grief. With time constraints of clinical practice, it is often faster to write a prescription than to do the one thing that the grieving person needs the most-take the time to listen to his or her story of loss.

The best advice for healthcare professionals is to offer the grieving person is his/her presence and be a sympathetic listener. Remind the person some of the basic coping strategies listed above, to TAKE CARE of Yourself.

Prescribing medication should only be considered if the grief response is an extreme one that leads to complicated grief, depression or Post Traumatic Stress Disorder. If the person is experiencing a debilitating grief response then medication may be appropriate along with additional formal grief counseling. The ongoing use of medications is generally not indicated in the treatment of the normal grief response; medicating grief should be the exception rather than the rule.

Regaining Control through Knowledge

I firmly believe that one of the best ways to cope with grief is to understand the normal grief response, which includes knowing about all of the ways that a person may respond to grief emotionally and physically.

As I wrote on the Journey of Hearts site:

Understanding a situation, a condition, a new diagnosis or a disease allows the grieving person to assume control over his/her life and provides a sense of peace from knowing what is going on, or what to expect, rather than continuing to fear the unknown.

Gaining knowledge about the normal grief response is one way to return a sense of control over seemingly random occurrences, e.g. new medical diagnosis, a sudden, unexpected loss, a change in life circumstances or a death. Knowledge can return a sense of control over seemingly random occurrences and aid the grieving in accepting the life change and beginning the transition to a new life.

Resources:

Dyer K. 2004. Understanding the Impact of Loss & Grief on our Patient’s Well Being: Learning How to Take a Loss History. MomMD.com http://www.mommd.com/loss.shtml

Dyer K. 2008. Taking Life Moment by Moment and TAKE CARE. Grief Loss and Transitions Blog. http://grief-loss-info.blogspot.com/2008/04/taking-life-moment-by-moment-and-take.html

Dyer KA. 2002. Acute Grief Response. Loss, Change and Grief. Journey of Hearts.  http://www.journeyofhearts.org/jofh/grief/grief_res

Dyer KA. 2002. General Information on Loss, Change & Grief. Journey of Hearts.  http://journeyofhearts.org/grief/general.html

Leney N. Grief in Remembrances and Celebrations: A Book of Eulogies, Elegies, Letters, and Epitaphs. New York, N.Y.: Random House, Incorporated p. 266.

Dr. Kirsti A. Dyer MD, MS, FT, CWS is a respected physician, an expert in life challenges, loss, grief and bereavement, professional health educator, professor, lecturer and author. She received her Medical and Master’s Degrees from the University of California, Davis.  Dr. Dyer also has expertise in wellness education and health promotion. She teaches college courses in Nutrition and Wellness and a graduate course in Grief, Loss and Bereavement. She contributed the chapter on “Loss and the Workplace: What to Do at Work When the World Crashes in Around You” to the Healthy Profits: The 5 Elements Of Strategic Wellness book. She can be reached through the Journey of Hearts website, She can be reached through the Journey of Hearts website, JourneyofHearts.org or through her blog grief-loss-info.blogspot.com

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