Wednesday, June 01, 2016

Depression and the 5 Stages of Grief

Author's Perspective: First of all, it's normal to feel a little depressed after you've just been diagnosed with a disease such as diabetes! Plus, your doctor and other healthcare personnel hit you with so much information about diabetes amangement that it can be somewhat overwhelming; and, that feeling of being overwhelmed creates aniety  and fear, and that can make your feel depressed. So, don't beat yourself up if you feel a little down!

When I was originally diagnosed with diabetes, I was very upset and afraid -- I thought that I was going to die, so I cried and prayed, hoping this was a nightmare. Ironically, the crying helped to release some pent-up emotions, and the praying allowed me to focus and become empowered.

In the meantime, the doctors tried to convince me that I was clinically depressed and needed medication. Luckily for me, my daughter was there with me in the hospital, lifting up my spirits and telling me that I could beat this disease. Interestingly, I was motivated to learn more about diabetes at that time because I didn't want to let my daughter down. Also, there was a lot of conflicting information being offered by the hospital personnel, with a strong focus on drugs as the primary solution.

Thankfully, my daughter bought several books on diabetes and nutrition, and brought them to me in the hospital. This took my mind off the serious health issues I was facing (possible stroke, pulmonary embolism, deep vein thrombosis (DVT), possible blindness and double-leg amputation) and helped me to begin learning about the science of diabetes, drugs, and nutrition.  This learning process reduced my anxiety and stress and gave me hope, and (I think) this prevented me from lapsing into a serious 
state of depression.

Sidebar: Be very careful -- don't let the doctors try to convince you that you need drugs if you're depressed! More than likely, you're just sad or emotionally drained from the shock of being diagnosed with diabetes. Plus, the hospital medical personnel may overwhelm you with all the things you need to do to get your diabetes under control.  One of the major keys here is to find someone who's been where you are and has successfully recovered. Don't depend strictly on just your doctors, friends and relatives! Most of them know very little about diabetes and what you need to do! They mean well, but that isn't going to help you get well! So, empower yourself by educating yourself about diabetes, depression, drugs, and the power of superior nutrition.
Depression and Diabetes
People with diabetes have an increased risk of developing depression. Due to the complexities of trying to manage one's diabetes, you can become overwhelmed, frustrated, and depressed. One of the reasons is due to less serotonin (a feel-good hormone) being produced because of the high insulin and blood glucose levels.

To make matters worse, being depressed can lead to poor eating habits and a sedentary lifestyle, which worsens the diabetes. This may create a vicious cycle where the diabetes and depression worsen over time. 

Many diabetics (including the author) are warned by their physicians that they will eventually experience depression. Unfortunately, their solution is to add more drugs on top of the diabetic drugs.
Many diabetics who experience depression endure both problems with great courage and no hope in sight. Unfortunately they do not have the emotional support or knowledge that will enable them to overcome these problems.
Depression is a mental state characterized by a pessimistic sense of inadequacy and a despondent lack of activity. Unfortunately, many diabetics experience depression for 3 reasons:
  1. The lack of knowledge in being able to effectively control blood glucose levels. This lack of knowledge about the unknown creates anxiety, fear, and stress.
  2. The lack of emotional support, and being overwhelmed by everything a diabetic has to do to manage their diabetes every day – leading to thelack of hope in fighting a disease that leads to amputation, blindness, and kidney dialysis. This can also create fear and anxiety, leading to poor sleep habits. In addition, the loss of a loved one can create an emotional upheaval that may lead to depression -- especially if the diabetic does not go through the 5 stages of grief.
  3. The biochemical/hormonal imbalances created by the excess production of cortisol, reduced production of serotonin, and nutritional deficiencies caused by the diabetes.
The good news is that most cases of  diabetes and depression can be controlled and even defeated without the need for drugs by doing 3 things:
  1. Acquire the knowledge to effectively control your blood glucose levels and prevent or deal with the depression. This will reduce the anxiety, fear, and stress.
  2. Obtain the emotional support, by utilizing your inner spirit and a support system of family members and friends to have hope and not feel overwhelmed; and, achieve a higher quality of sleep and relaxation.
  3. Change dietary and lifestyle to improve the biochemical/hormonal levels, increasing the production of serotonin and decreasing the production of cortisol while providing the necessary nutrients that the body needs to fight the diabetes and ensure proper blood glucose control.

What is Depression?

Depression is a mental health disorder that can affect the way you eat and sleep, the way you feel about yourself, and the way you think about things. A depressive disorder is more than a passing mood. It is not a sign of personal weakness, and it cannot be willed or wished away.
A depressive disorder involves the body, mood, and thoughts. People who are depressed cannot "snap out of it" and get better. Without treatment, symptoms can last for months or years. Treatments such as antidepressant medications and psychotherapy can reduce and sometimes eliminate the symptoms of depression.
Depression Statistics
Depressive disorders affect 20 million American adults or about 9.5% of the U.S. population age 18 and older in a given year. This includes major depressive disorder, dysthymic disorder, and bipolar disorder.
Everyone will at some time in their life be affected by depression -- their own or someone else's, according to Australian Government statistics. (Depression statistics in Australia are comparable to those of the US andUK.) 
*Note: There is a group in Australia (called GROW) that has had success helping people with depression and other mental disorders. GROW is a community mental health movement of Australian origin that has become an international mental health movement meeting the needs of thousands of people each week, with groups dotted across Australian suburbs and towns and overseas, utilizing a 12-Step Program of Recovery. 

More Depression Statistics
  • Pre-schoolers are the fastest-growing market for antidepressants. At least four percent of preschoolers -- over a million -- are clinically depressed.
  • The rate of increase of depression among children is an astounding 23%.  
  • 15% of the population of most developed countries suffers severe depression.
  • 30% of women are depressed. Men's figures were previously thought to be half that of women, but new estimates are higher.
  • 54% of people believe depression is a personal weakness.
  • 41% of depressed women are too embarrassed to seek help.
  • 80% of depressed people are not currently having any treatment.
  • 92% of depressed African-American males do not seek treatment.
  • 15% of depressed people will commit suicide.
Depression will be the second largest killer after heart disease by 2020 -- and studies show depression is a contributory factor to fatal coronary disease.
Depression results in more absenteeism than almost any other physical disorder and costs employers more than $51 billion per year in absenteeism and lost productivity, not including high medical and pharmaceutical bills.
Types of Depression
Three of the most common forms of depressive disorders are:
        Major Depression
        Dysthymia
        Bipolar Disorder
Even within these types of depression there are variations in the number of symptoms, their severity, and persistence.
Major depression is manifested by a combination of symptoms (see symptom list below) that interfere with the ability to work, study, sleep, eat, and enjoy once pleasurable activities. Some people have a single episode of depression, but many have episodes that recur.
Dysthymia is a less severe type of depression that lasts a long time but involves less severe symptoms. If you suffer from dysthymia you probalby lead a normal life, but you may not be functioning well or feeling good. People with dysthymia may also experience major depressive episodes at some time in their lives.
Bipolar Disorder (also called manic-depression) is another type of depressive disorder. Bipolar disorder is thought to be less common than other depressive disorders. If you have bipolar disorder you are troubled by cycling mood swings - usually severe highs (mania) and lows (depression). The mood swings are sometimes dramatic and rapid, but usually are more gradual. When in the depressed stage, a person can have any or all of the symptoms of a depressive disorder. When in the manic stage, the individual may be overactive, over-talkative, and have a great deal of energy. Mania affects thinking, judgment, and social behavior, sometimes in ways that cause serious problems and embarrassment. A person in a manic phase may feel elated, full of grand schemes that might range from unwise business decisions to romantic sprees. Mania, left untreated, may worsen to a psychotic state, where the person is out of touch with reality. 
Symptoms of Depression and Mania
These lists are not complete, and not everyone who is depressed or manic experiences all of these symptoms. The severity of symptoms varies with individuals and varies over time.
Depression
  • Persistent sad, anxious, or "empty" mood
  • Feelings of hopelessness, pessimism
  • Feelings of guilt, worthlessness, helplessness
  • Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
  • Decreased energy, fatigue, being "slowed down"
  • Difficulty concentrating, remembering, making decisions
  • Insomnia, early-morning awakening, or oversleeping
  • Appetite and/or weight loss or overeating and weight gain
  • Thoughts of death or suicide; suicide attempts
  • Restlessness, irritability
  • Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain
Mania
  • Abnormal or excessive elation
  • Unusual irritability
  • Decreased need for sleep
  • Grandiose notions
  • Increased talking
  • Racing thoughts
  • Increased sexual desire
  • Markedly increased energy
  • Poor judgment
  • Inappropriate social behavior
Some depression runs in families. Researchers believe that it is possible to inherit a tendency to get depression. This seems to be especially true for bipolar disorder (manic depression). Studies of families with several generations of bipolar disorder (BPD) found that those who develop the disorder have differences in their genes from most that don't develop BPD. Some people with the genes for BPD don't actually develop the disorder, however. Other factors, such as stresses at home, work, or school are also important.
Major depression also seems to run in families, but it can also develop in people who have no family history of depression. Either way major depressive disorder is often associated with changes in brain structures or brain function.
People who have low self-esteem, who are consistently pessimistic, or who are readily overwhelmed by stress, are also prone to depression. Physical changes in the body can also trigger mental health problems such as depression.

Research demonstrates that stroke, heart attack, cancer, Parkinson's disease, and hormonal disorders such as diabetes can cause depression. The depression can contribute to the person's medical problem, as they can become apathetic and unwilling to care for their physical needs. A severe stressor such as a serious loss, difficult relationship, or financial problem can also trigger a depressive episode. A combination of genetic, psychological, and environmental factors is often involved in the onset of depression.
Depression Connection to Illness
Depression can “somatize,” or become expressed in the body.
80% of people who see physicians are depressed.
Studies are increasingly linking more illnesses to depression, including: osteoporosis, diabetes, heart disease, some forms of cancer, eye disease and back pain.
Depression in Diabetics
One of the first warnings that your doctor may give you about being diabetic is that you may become depressed – but, not to worry, since many diabetics develop depression. Unfortunately, your doctor will usually refer you to a psychiatrist, who puts you some depression medication. Most doctors are unaware that most diabetics can overcome their issues with depression by simply managing their blood glucose levels better. High blood glucose and insulin levels trigger excess cortisol production and reduce the production of serotonin (the feel-good hormone). This, in turn, will make you feel depressed.
Depression in Women
Studies suggest that women experience depression up to twice as often as men. Hormonal factors may contribute to the increased rate of depression in women; such as menstrual cycle changes, pregnancy, miscarriage, postpartum period, pre-menopause, and menopause. Women may also face unique stressors such as responsibilities both at work and home, single parenthood, and caring for children and for aging parents.
Many women are particularly vulnerable to depression after the birth of a baby. The hormonal and physical changes, as well as the added responsibility of a new life, can be factors that lead to postpartum depression in some women. Some periods of sadness are common in new mothers; but a full depressive episode is not normal and requires intervention. Treatment by a sympathetic health care provider and emotional support from friends and family are important in helping her to recover her physical and mental well-being and her ability to care for and enjoy her baby.
Depression in Men
Men are less likely to suffer from depression than women, but three to four million men in the United States are affected by the depression. Men are less likely to admit to depression, and doctors are less likely to suspect it. More women attempt suicide, but more men actually commit suicide. After age 70, the rate of men's suicide rises, peaking after age 85.
Depression can also affect the physical health in men differently from women. One study showed that men suffer a high death rate from coronary heart disease following depression. Men's depression may be masked by alcohol or drugs, or by working excessively long hours. Rather than feeling hopeless and helpless, men may feel irritable, angry, and discouraged.
Even if a man realizes that he is depressed, he may be less willing than a woman to seek help. In the workplace, employee assistance professionals or worksite mental health programs can help men understand and accept depression as a mental health disorder that needs treatment.
Depression in the Elderly
It's not normal for elderly people to feel depressed. Most older people feel satisfied with their lives. Depression in the elderly is sometimes dismissed as a normal part of aging; causing needless suffering for the family and for the individual. Depressed elderly persons usually tell their doctor about their physical symptoms; and may be hesitant to bring up their emotions.
Some symptoms of depression in the elderly may be side effects of medication the person is taking for a physical problem, or they may be caused by a co-occurring illness. If a diagnosis of depression is made, treatment with medication and/or psychotherapy will help the depressed person return to a happier, more fulfilling life. Recent research suggests that brief psychotherapy is effective in reducing symptoms in short-term depression in older persons who are medically ill. Psychotherapy is also useful in older patients who cannot or will not take medication.

The Body, Mind & Spirit Connection
depressive disorder involves the body, mind, and spirit, and affects your mood and thoughts. People who are depressed cannot "snap out of it" and get better. Since depression affects the Body, Mind and Spirit, then, the solution must encompass the Body, Mind and Spirit.

The Body, Mind and Spirit work in harmony to make you the best that you can be in this life. If one of these three elements is “sick” or out of balance with the other two, then, your entire being will be sick.

Unfortunately, most of traditional medicine focuses on the Body by addressing and suppressing the symptoms and never fixing the underlying root cause of the unhealthy cells. Traditional medicine tends to overlook the importance of the Mind and the Spirit and its role in healing the Body. Man also tends to focus on the Body by taking drugs to relieve pain or by feeding his food cravings to satisfy hormonal hunger – both of which may be driven by emotions such as depression.

Consequently, there are psychological and psychosocial factors that may exert substantial influence on the biochemical control in diabetic patients. These factors have been shown to increase the risks of poor glycemic control, “brittle diabetes”, and diabetic ketoacidosis. Depression has been identified as one negative influence of poor glycemic control among pediatric and adolescent patients. And, depression has been observed to affect family members of patients with Type 2 diabetes and influence family dynamics toward the condition.

As with any disease, after several years of fighting the good fight, you can become physically drained because your physical body has continued to weaken despite everything that you’ve done to fight the disease.

Consequently, you also become emotionally and spiritually drained; and, as a result, you lose hope and “give in” to the fact that the best you can do is to live with the disease – that you’ve done everything possible to fight the disease. This can be very disconcerting and difficult to overcome emotionally.

Also, despite the support from your family and friends, you feel very alone and afraid at times. There are horror movies that can scare you, but I can truly tell you that there is nothing, absolutely nothing scarier than knowing that your doctor cannot help you and your time is limited. Only a strong belief in a Power that is greater than yourself can give you the hope, the confidence and courage to fight for your life instead of giving in to the inevitable life of kidney failure/dialysis, amputation, and blindness.

Once you accept the fact that we live in a spiritual universe and that we are all spiritual beings, you will find yourself equipped with an instrument through which you can exert influence over your body and your blood glucose control. But, how do you go about tapping into your inner spirit and belief system? The following section will give you some ideas to get started. Anything and everything is possible if you have faith and you take responsibility of your health problems and follow up with the necessary actions; and, resist the negative influences that will discourage you from making yourself a healthier person.

How does food help or prevent us from getting to this inner spirit? There is no universal agreement about the relationship of food to the human body, mind or spirit. However, I believe that we can agree that “dead” food definitely harms the Body. And, since food can make us happy or console us when we’re sad, we can make the case that food also harms the Mind and the Spirit. Food is an ever-present reminder that there is more to life than just filling stomachs. Our minds and spirits crave for more meaning.

Now, we can conclude that the inverse of those statements is true -- that the Body, Mind and Spirit affect the food we select to eat. If you have a positive mental attitude and truly believe that food can help you improve your health, then, it will because you will acquire the knowledge to make better food choices. The following section provides some guidelines that will help you to build and use your Mind and Spirit to improve the health of your Body.

Spiritual health allows you to focus on your inner faith and the belief that you must respect and protect what you put into your body to maintain a healthy balance with the mind and spirit. This supports Apostle Paul’s requirement to glorify God in our body, as well as our spirit:
“Know ye not that your body is the temple of the Holy Ghost . . . therefore glorify God in your body, and in your spirit, which are God’s.”  [1 Corinthians 6:19-20]

Discord between your Spirit and Mind usually leads to illogical behaviors and rationalizations. For example, as their reasoning for eating what they like even if it is bad for their health, I am amazed at the number of people who have told me “Well, you gotta die of something.” This type of rationalization is due to a disconnect between that person’s spirit and unconscious mind, leading to a negative effect on their body.

It is also a disconnect between the spirit and conscious mind that is created as a defense mechanism when the person can’t really explain why they’re doing something that they know is harming their body. Research has shown that a diabetic who is not healthy emotionally will not respond positively to treatment, even though they may have the best care and medicine. Discord between the mind and body is a critical factor. Diabetics know that if they worry too much their blood sugar will go “sky high” and stay high until they stop worrying.  


Treating Depression
Medical science's answer to depression is psychiatric drugs and/or years of psycho-therapy.

There are several types of antidepressant medications used to treat depressive disorders. These include newer medications, the selective serotonin reuptake inhibitors (SSRIs), the tricyclics, and the older monoamine oxidase inhibitors (MAOIs). The SSRIs - and other newer medications that affect neurotransmitters such as dopamine or norepinephrine - generally have fewer side effects than tricyclics. Sometimes your doctor will try a variety of antidepressants before finding the medication or combination of medications most effective for you.

Classes of Antidepressants
Tricyclic antidepressants were the first line of treatment for major depression from the 1960s through the 1980s. We now know that these medications affected two chemical neurotransmitters, norepinephrine and serotonin. Tricyclics are as effective in treating depression as the newer antidepressants, but their side effects are somewhat more unpleasant.

They are no longer the first medication tried for most depressed patients.
Tricyclic antidepressants such as imipramine, amitriptyline, nortriptyline, and desipramine are used when newer medications are not effective. They may also be used at night to improve sleep. Some of these medications are also used to treat neuropathic (nerve-related) pain.

Monoamine oxidase inhibitors (MAOIs) are older antidepressants that are effective for some people with major depression who do not respond to other antidepressants. They are also effective for the treatment of panic disorder and bipolar depression. MAOIs approved for the treatment of depression are phenelzine (Nardil), tranylcypromine (Parnate), and isocarboxazid (Marplan). These medications can have severe side-effects in some situations, so patients must follow directions very carefully. Because substances in certain foods, beverages, and medications can cause dangerous interactions when combined with MAOIs, people on these agents must adhere to dietary restrictions.

Selective serotonin reuptake inhibitors (SSRIs) were the first of the newer medications that have been introduced beginning in the early 1990s. It has been thought that these medications work by increasing serotonin (a neurotransmitter) between nerve cells. Neurotransmitters are chemicals that pass a nerve impulse from one cell to another. SSRIs include fluoxetine (Prozac), sertraline (Zoloft), fluvoxamine (Luvox), paroxetine (Paxil ), citalopram (Celexa), and escitalopram (Lexapro). While these medications did not cause some of the bothersome side-effects of older medications, many people noticed a loss of sex drive when taking SSRIs.

New medications in the late 1990s, like the tricyclics, affect both norepinephrine and serotonin but have fewer side effects. These new medications included venlafaxine (Effexor) and nefazadone (Serzone). Nefazadone was later taken off the market in the U.S. because cases of life-threatening hepatic failure were reported in patients.

Newer medications include mirtazepine (Remeron) - which can be sedating, and bupropion (Wellbutrin) - which tends to be more activating. Wellbutrin has not been associated with weight gain or sexual dysfunction but it can't be used with anyone at risk for a seizure disorder.

Sidebar: Medical science is very successful in handling trauma and emergency treatment, but not with their treatment of illnesses and diseases such as high blood pressure, chronic fatigue, obesity, depression, heart disease, cancer and diabetes. Their treatment protocol for these diseases is drug therapy to suppress the symptoms instead of fixing the underlying root cause and get rid of the disease. If the drug therapy doesn’t work or it stops working, the only other option is surgery.

Unfortunately, many people put their faith in these drugs that were created by man instead of the foods that were created by God. And, as long as we continue to believe that man is smarter than God, we will be trapped with poor health and our dependency on these man-made foods and drugs. As a result, we become a 
victim of disease, instead of a victorof wellness.
Alternative Strategies for Treating Depression
Depression is a common symptom due to deficiencies in Omega-3 EFAs and folic acid. At least eight studies have shown that patients with depression have lower levels of Omega-3s and folic acid than other populations.

The worse the depression, the lower the levels of Omega-3s and folic acid in the blood. The most common problem is affective disorder (BMJ, 1980; 281: 1036-42). Depressive illness has been shown to begin at the point where patients become deficient in folic acid (Biol Psychiatry, 1989; 25 (7): 867-72).
Though drugs are often considered the first line of treatment for depression, a dietary change might be all you need, says James Gordon, a psychiatrist who advocates non-drug approaches to depression. Especially if you're fighting diabetes, you can "kill 2 birds with one stone" by eating various super foods such as wild salmon, green vegetables, dark fruits, chickpeas, walnuts and getting some sunlight (for Vitamin D).

In addition to eating more super foods, it may be even more important to avoid the refined, processed foods such as bread, pastries, fried foods, rice, coffee, fast foods, and alcohol.

Lifestyle changes such as getting quality sleep every night, exercising every day, doing volunteer work, and reducing the stress in your environment can also help with depression.

Key Point: The key to defeating depression is to break the "cycle of depression" and ensure that you are not depressed because you didn't go through the 5 stages of grief after losing a loved one or going through a similar emotional event. (Refer to the Death to Diabetes Blog for more details).
Note: For more information about depression and how to defeat it (without drugs), read the author's experience with depression, and get the Defeat Depression ebook.

Note: If you have an autoimmune disease, PCOS, or thyroid issues, get the How to Treat Autoimmune Diseases, PCOS & Thyroid Issues Naturally ebook.

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The 5 Stages of Grief  

If you are dealing with depression due to the loss of a loved one, you have probably gone through the 5 stages of grief. And, if you're still feeling depressed because of this loss, you may not have gone through all 5 stages of grief.
Defeat depression without drugs.

Grief is a natural response to loss. It’s the emotional suffering you feel when something or someone you love is taken away. The more significant the loss, the more intense the grief will be. You may associate grief with the death of a loved one—which is often the cause of the most intense type of grief—but any loss can cause grief.

The reaction to loss can encompass a range of feelings, thoughts, and behaviors, and is experienced differently by each person according to his or her culture, background, gender, beliefs, personality, and relationship to the deceased or loss. Feelings common to grief are sadness and yearning. Guilt, regret, anger, and a sense of meaninglessness can also be present. Some may also a feel a sense of relief and liberation. Emotions can be surprising in their strength or mildness, contrary to the expectations of the griever; they can also be confusing, such as missing a painful relationship.

Grief, like death, is a natural part of life. Understanding what to expect and engaging in coping strategies can ease you through the pain of the grieving process and open up your path to personal self-renewal.

Every person grieves differently. Just as no two lives are the same, so will each death, and each grief experience, be unique. Your experience may dramatically differ depending on how close you were to the person who has passed, for example, or the circumstances of their death­—sudden or gradual. However, there is plenty of available information to help you come to terms with your individual grieving process and learn how to cope with your grief.

Most people have heard of the five stages of grief, also known as the Kubler-Ross model. Elisabeth Kubler-Ross was a groundbreaking psychiatrist who ignited public conversation about death in a time when the subject was largely taboo. Her 1969 book, On Death and Dying, introduced the world to the five stages of grief: denial, anger, bargaining, depression, and acceptance. Though the stages were originally intended to reflect the experiences of those dying, Kubler-Ross later extended their definition to encompass the experiences of anyone who has suffered a loss or tragedy.

The 5 Stages of Grief
Denial: This stage is often experienced as a state of shock. You may feel numb, disoriented, or overwhelmed. Some report a trance-like state or a sense of unreality. Though confusing, these feelings help us to slowly come to terms with the reality of the loss, rather than dealing with all of our emotions up front.

Anger: Anger can be directed at anyone who you feel has blame in your loss. You might feel anger toward your family and friends, your loved one who has passed, or the doctors who were unable to save them. You may also be angry with yourself or the world. This anger is a manifestation of the pain of your loss; it can be understood as a measure of your love for the person.

Bargaining: You may find yourself asking “what if” questions, thinking about what could have been done to save your loved one, and perhaps bargaining with God or the world: “If I could have just one more day with them…”  Bargaining is often accompanied by guilt. This is basically our way of negotiating with the hurt and pain of the loss.

Depression: Depression and sadness are the most recognizable, commonly-accepted symptoms of grief, yet all too often grieving persons are expected to “snap out of it” and act normal. It’s important to understand that after the loss of a loved one, depression is a perfectly normal emotional response. During this stage, you will likely withdraw from normal activities and feel as if you are in a fog of sadness. You may find it difficult to go on without that person in your life.

Acceptance: This is the point where we accept our new reality, one in which our loved one is no longer present. Acceptance does not necessarily mean that you’re “okay” with your situation; it simply means you recognize that the person is indeed gone, that your situation has changed. Acceptance is also when we begin to pick up the pieces and reorganize our lives to fit in with this new reality.

The five stages of grief are not linear; they can occur in any order, and possibly more than once. While the Kubler-Ross model is the most widely recognized, there are many variations, typically ranging from three to seven stages. They may have slightly different titles—“guilt” instead of “bargaining,” for example. 

When researching these, it’s easy to feel inundated with information regarding exactly what “stages” you will experience. Keep in mind that these are broad guidelines to help you understand your grief, not to-the-letter definitions. The goal of these models is to help you accept that though your feelings and reactions can be scary or overwhelming, they are a normal part of grieving, and allowing yourself to experience them will ultimately aid you in healing.

Recovering from Grief
Most people accept that someone has died, but accepting the reality of the loss involves waiting for the numbness, shock, and sense of unreality to subside. To work through the pain of grief is to think one’s thoughts, feel one’s emotions, and to do what our bodies need to do about the grief we experience. This may be memories of the deceased, pangs of guilt or longing, and crying or being with other people. 

Adjusting to an environment where the deceased is missing is a further step in acceptance, where the bereaved begin to rebuild their world, picture of the future, and sense of meaning in the absence of the deceased. People can establish new routines or adapt previous ones. To emotionally relocate the deceased acknowledges that our relationships are not severed by death. The physical presence of the departed may be missing, but we can continue to relate to them through our memories, feelings, and rituals.

Myths about Grief
MYTH: The pain will go away faster if you ignore it.
Fact: Trying to ignore your pain or keep it from surfacing will only make it worse in the long run. For real healing it is necessary to face your grief and actively deal with it. 

MYTH: It’s important to be “be strong” in the face of loss.
Fact: Feeling sad, frightened, or lonely is a normal reaction to loss. Crying doesn’t mean you are weak. You don’t need to “protect” your family or friends by putting on a brave front. Showing your true feelings can help them and you. 

MYTH: If you don’t cry, it means you aren’t sorry about the loss.
Fact: Crying is a normal response to sadness, but it’s not the only one. Those who don’t cry may feel the pain just as deeply as others. They may simply have other ways of showing it. 

MYTH: Grief should last about a year.
Fact: There is no right or wrong time frame for grieving. How long it takes can differ from person to person. 

Source: Center for Grief and Healing

Things to Know:
Everyone grieves differently: what you should expect is a variety of intense emotions, as well as physical symptoms, which can come about in any order. It’s important to understand that what you are experiencing is normal.

It is always better to talk about your grief and deal with it directly than to ignore or suppress it.

A support system that assists you with your emotional and practical needs can help ease the grieving process.

Many people find comfort in ritual, such as memorial services or end-of-life celebrations, which can be healthy outlets to come together and openly mourn with others.

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