The Effects of Bereavement on Mental Health

There are few things guaranteed in life, but one of them is that that sooner or later, almost everyone must experience the pain of losing a loved one.

Bereavement is an almost universal experience and one of the single most difficult things any person can face; yet social taboos about death and mental health mean that many people don’t fully come to realise how powerful the effects of grief can be until they find themselves, or a loved one, in the throes of it.

Understanding different ways that grief can play out over time may be reassuring, as you quickly realise that there is no ‘normal’ way to grieve.

It can also help to be aware of potential problems which could arise if someone struggles to come to terms with their loss or develops other issues as a result of their grief.

What Is Grief?

When someone suffers a painful or traumatic loss, such as losing a loved one, it is normal to have a powerful emotional reaction. These emotional responses are what people tend to mean when they talk about grief and are a natural part of adjusting to deeply distressing changes or losses in life. People can grieve all kinds of losses: from a job to losing a pet or the loss of a relationship through a divorce.  

Grief itself is not a single experience, but a combination of strong and sometimes conflicting emotions about the loss someone has suffered. As a result, no two people experience grief in exactly the same way because everyone’s individual reactions and coping mechanisms are deeply personal and subjective.

This can make it hard to help someone who is grieving, especially if they are not very good at expressing their feelings. In any case, it is important to remember that there is no ‘one size fits all’ approach to coping with bereavement, and grief is not something that can be hurried.

The Effects of Bereavement on the Mind and Body

The intensity of emotions and dramatic change experienced by a bereaved person can have a whole range of effects on their emotional and physical well being, which can take a toll on their mental health over time.

Common emotional responses to bereavement include:

• Numbness: Many people say that in the days after losing someone close to them, they feel numb or detached from reality. This can be helpful, as it allows the person to process the magnitude of their loss more gradually, but may not last for very long.
• Denial: It is common to have difficulties coming to terms with the loss. Someone who is grieving may get stuck reminiscing about the times they spent with the deceased person, rather than accepting their new reality.
• Despair: As someone slowly realised that their loved one is truly gone, they may feel despair at the prospect of life without them. The inability to bring them back can leave people feeling powerless. It is possible to start grieving while someone is still alive (for example, if they are dying of an injury or illness), and many people try to bargain through hopes, prayers and promise to try and regain a sense of control and avoid the painful feelings of despair in grief. 
• Feelings of hopelessness: Life is never fully the same after losing somebody close to you, but in the midst of grief, it may feel that life has lost its value. People may feel as though they are ‘stuck’ deep in grief, and give up hope for a return to more manageable emotions.  
• Loneliness: After coming to terms with the loss, loneliness may begin to set in. While grieving, many people experience the physical and emotional void left by the deceased person through intense feelings of loneliness.
• Yearning: It may be difficult to go about your day-to-day life without constantly thinking about how things would be if the deceased person were there with you. 
• Disorganisation: People can feel disorientated and cast adrift by their loss. This can lead people to feel that they’re struggling to manage with routines and responsibilities
• Anger: It is possible to feel angry at the seeming unfairness of your loss, or even at the person who died for ‘abandoning’ you. You could feel angry at yourself for leaving things unsaid, or at the people who you feel could have done things differently, leading up to their death.
• Anxiety and fear: Bereavement disrupts our sense of control and security in life. Anxiety and fear are common feelings in grief, as they try to conceive of other threats to their security about how they could lose others close to them or become more cautious and fearful in their approach to life.
• Regret: Feelings of regret are common in bereavement, but maybe especially strong if the death was sudden and someone didn’t get a chance to say goodbye, or if the person believes that they could have helped prevent their loved one’s death.
• Relief: It is common for people to feel relief when a loved one dies, especially if they suffered due to illness in the period leading up to their death. This is a normal reaction which shows that a person was deeply invested in their loved one’s well being.
• Guilt: As people play things over in their mind, they may develop feelings of guilt about how they could have treated their loved one differently. They may believe if they had behaved differently, their loved one would still be alive. It is also common for people to feel guilty or selfish at their reactions to loss (relief, anger), and again when they try to move on in their life.  

All of these feelings are difficult to deal with, and often leave people feeling depressed. It is important to accept emotions as they arise. Suppressing them or trying to avoid them with drugs or alcohol only delays the grief, and could cause more pain for the bereaved person further along the line.

Many people in mourning may also develop physical symptoms as they grieve, ranging from physical pain to dulled motor skills. These are often indirect results of behaviours people adopt to try and cope with the powerful emotions they experience while in mourning.

The effects of bereavement on physical health could include:

• Insomnia (not being able to sleep)
• Oversleeping
• Diminished motor skills (slower reaction time, impaired physical responses)
• Poor immune system
• Fatigue
• Weight gain
• Weight loss
• Digestive changes as a result of stress or changes to diet

Stages of Grief

Although everyone’s grief may show itself in different ways, experts agree that there are four stages or ‘tasks’ in the grieving process which everyone must work through in order to truly acknowledge their loss and be able to live a more normal life again.

1 - Acceptance that the loss is real. When you first lose someone close to you, it can feel unreal. Many people say they feel numb. This is a survival mechanism; but in order to start grieving, the bereaved person needs to face the reality that their loved one is truly gone.

2 - Experience the pain of grief. The bereaved person must work through wide-ranging emotions, many of which may be painful: sadness, despair, anger, guilt, regret and fear are all common emotional reactions to loss. To work through this, it is important to acknowledge these feelings and not try to suppress them

3 - Adjust to a new life, in which the deceased is not there. There will come a time when the surviving person needs to adjust to living life without their loved one. Changes may be more or less dramatic, depending on how closely their lives were entwined. Practical adjustments could be learning how to cook for themselves, whereas emotional adjustments could include learning how to ask for support from family or friends. There are often overlaps: for example, raising a child single-handedly calls for both emotional and practical adaption.

4 - Find a place for the loss, spend less energy on grieving and start to move forwards. Eventually, the bereaved person becomes better at acknowledging their grief and coping with their emotions, so that it is no longer all-consuming. Although there is no recovery from bereavement, life may start to regain a sense of normalcy again. They have the energy and coping skills to move forwards and nurture meaningful relationships.

In reality, many people may find that their grief seems to take two steps forward and one step back- so there could be plenty of overlap between the stages as somebody tries to cope with their grief.

Prolonged Effects on Mental Health

If someone is struggling to cope with bereavement, they may seek help from a medical professional or counsellor.

However, even though someone who is grieving may have lots of symptoms in common with somebody who is suffering from certain mental health conditions, grief itself is not a mental illness. It is a natural reaction to loss, and a healing process whose symptoms may get better their own with time, even though some people may get therapy or medication to help the most debilitating parts of their grief.

However, the extreme stress of losing someone close to you can potentially trigger other mental health conditions, or make pre-existing conditions worse. These may not get better with time and could prolong someone's grief or cause them to process it in ways which are self-destructive.

Depression and Anxiety are two mental health conditions which are commonly experienced by bereaved people.

Anxiety Disorders

People with anxiety disorders may worry excessively, have trouble concentrating, develop social Anxiety and have overly tense muscles. They could also experience panic attacks, which are intense episodes where someone may have trouble breathing and feel as though they are dying.

Depression

Grief and depression have very similar symptoms, so it can be difficult to diagnose which one a person is suffering with. In general, grief tends to get better over time, whereas depression may not go away without treatment.

Complicated Grief

Complicated grief is a newly-recognised condition where someone has trouble moving past the early stages of grief. This means they may live with the full-blown emotions of having been recently bereaved for years after the event.

Other Mental Health Conditions

There are lots of ways that someone's mental health can be impacted when they lose a loved one. Grieving is a natural, albeit painful process, but may sometimes give way to other problems which require diagnosis and treatment.

If someone seems to have developed new, destructive behaviours after their loss or can't seem to cope with the day-to-day even a long time after the event; it is important for them to to a doctor to try and find out if there could be something else at play.

Getting the right help for mental health problems can be literally life-saving, and help people to start living a life which feels more normal again.

How Does Insomnia Impact Your Mental Health?

We all need sleep to replenish and rest. While some people might suggest that “resting” is as useful a sleeping, this is not the case. A lack of sleep can lead to:-

• Increase stress levels
• Lack of focus
• Inability to work
• Fuzzy feeling

One of the most challenging medical conditions associated with sleep is high anxiety. The situation is simple. When you are asleep, your anxiety levels fall as you are resting. When you wake up, your anxiety levels are at a relatively low level which leaves a significant buffer between where you are, your regular increase during the day and dangerously high levels.

So, if you have a lack of sleep, you are not able to destress then your anxiety levels, when you wake up, would be significantly higher than they should be. This means there is less of a buffer between you and the “danger zone” hence the reason why many people who have insomnia also suffer from high anxiety.

Financial Pressure Can Be Mentally Challenging

Bereavement is not something that the human body or the human mind is able to cope with naturally. There is a process, as covered above, and there are also many issues to overcome. While not necessarily the most important issue, if you have financial pressure as well as living through the process of bereavement, for some people it can be too much.

Therefore, it is worth considering how you might be able to reduce the pressure for your loved ones. This might include:-

• Life insurance
• Funeral plan
• Debt management
• Savings

If you leave behind a partner and a family, for many people, the financial pressures of everyday life can be too much to cope with. Therefore, the more you can plan ahead with regards to financial issues, the more they can focus on the bereavement process and bring their life back to a degree of normality.

Bereavement in the Workplace

Those who have suffered bereavement are unlikely to be able to focus on work for a prolonged period of time. As a consequence, there are regulations in place with regards to bereavement leave which you should look to take up as soon as possible.

There is no doubt there will be issues to address, stressful times ahead, and you may be of little use in the workplace when your mind is effectively elsewhere. You tend to find that many employers will continue payment of your wages during the bereavement process, but this may vary from employer to employer.

We also know that a number of employers now provide additional support services to their employees. This could involve bereavement counselling, support with mental health and even just somebody to talk to about your issues and problems.

Sometimes talking with a totally independent third party can make a real difference. You can write down all of the issues you have, all the problems to solve and even put together a timetable will allow you to focus and start to tick things off your list. There is help out there, friends, colleagues and family, not to mention support services, make use of them.

Getting Help

To help someone who has been bereaved, listening to them and offering non-judgemental support can go a long way in helping them through their pain.

It is also a good idea to reach out to one of the many bereavements and mental health charities which offer free advice and support to people dealing with grief in the UK. You can find a list of these organisations here. 

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