Navigating Grief and Loss

Within the first few weeks or months after a death you may find yourself riding on a roller coaster of shifting emotions. Most people experience feelings associated with bereavement in unpredictable patterns. Not everyone will experience the same feelings or stages. Here are several common grief reactions:

• SHOCK/DISBELIEF - This is the numbing, disorienting sense that death has not really happened. This reaction can be intensified and complicated if the death is sudden, violent, or unanticipated. Your mind may be telling you "There must be some mistake," or "this can't be true." These symptoms typically last from several hours to several days. 
• ANGER - A common and yet overlooked emotion of grief is anger. Anger can be one of the ways we protect ourselves from pain. You may feel anger at the health professionals who treated your loved one, anger at your family members for not rallying together, anger at your God over what seems senseless or unjust, or even anger at yourself or the person who died. Your anger may cause you to push others away, which in turn, may unintentionally alienate them. 
• GUILT - An important distinction to note is the difference between guilt and regret. Guilt is often associated with having intentionally committed a moral offense or crime for one’s own gain, while regret is an emotion associated with wishing one could have done something differently in retrospect. You may blame yourself for not doing enough or not being more available. You may feel regret over "unfinished business,” such as conflicts between you and the deceased that remain unresolved. You may regret not having shared important feelings.
• SADNESS  - You may experience a deep sense of loss and pervasive feelings of sadness. There may be moments when you can express your sadness and moments when you have no words or tears.
• FEAR - You may feel anxious or panicked. You may have fears about carrying on without your loved one. You may experience anxiety about your own mortality. Fear can be expressed in worrisome thoughts or felt physically; either can make it difficult to sleep or eat.  
• DEPRESSION - You may go through periods of melancholy, or "blueness", that lead to withdrawing or isolating yourself from your friends and family. You may lose interest in your usual activities, and feel helpless or hopeless. Depression can also be experienced as physical symptoms, such as fatigue, indigestion, and bodily aches and pains. Grief can also affect your cognitive function; including feeling distracted, forgetful, irritable, indecisive, or confused.
• ACCEPTANCE - Your emotions may begin to stabilize and you come to terms with your “new” reality. You can understand that your loved one can never be replaced but you feel like you can begin to move forward. It is a time of readjustments and growth. 

Image by psycom.net

Grieving the death of someone does not have a timetable. Mourning a loss may take weeks, months, or even years. For many individuals, the death of their loved one is carried with them throughout their lives. Although there is no "cure" for grief, here are several ways to help you cope with your loss:

• TIME - Take time for yourself. Do not try to juggle all of your responsibilities after your loss.
• CARING - Try to allow yourself to accept the expressions of care from others even though they may be difficult or awkward.
• CONNECTING - Helping a friend or relative suffering the same loss may bring a feeling of closeness to that person.
• PRACTICE SELF-CARE - You may need to give yourself extra amounts of things that nourish and replenish you. Hot baths, afternoon naps, a short trip, a project helping others -- any of these may give you a lift. Grief can be an emotionally and physically exhausting process. Something to look forward to -- like lunch with a friend, a movie the next week, or a trip next month -- helps you get through the time in the immediate future. Do not underestimate the healing power of small pleasures. Sunsets, massage, a walk near the ocean, a favorite food -- all are small steps in regaining your pleasure for life. 
• GOALS - For a while, it will seem that much of life is without meaning. At times like these, small goals are helpful. Sometimes living moment by moment, or one day at a time, is the rule of thumb. As time passes, you may want to work on longer-range goals to give yourself some structure and direction in your life.
• BE PATIENT WITH YOURSELF - Sometimes after a period of feeling better, you find yourself back in the old feelings of extreme sadness, despair, or anger. This is the nature of grief -- one moment you're up, and the next, you're down. Allow yourself to feel what you need to feel. Grief has its own schedule, it is not a linear process.
• HOPE - You may find hope and comfort from those who have experienced a similar loss. Learning what helped them, and realizing that over time they have recovered, may give you the hope and strength to envision that you will eventually heal from your grief. 
• BE AWARE OF DRUG AND ALCOHOL USE - You cannot prevent or cure grief. While alcohol and other substances, including prescription medications, could temporarily provide relief, excessive use may prolong and delay the process of grieving. 
• PERMISSION TO CHANGE YOUR MIND - Grieving often creates uncertainty. You may have difficulty concentrating or find yourself reevaluating your priorities. You may be unsure or uncertain about what you want to do in numerous aspects of your life. When you make commitments or plans, be sure to let people know you may need room to cancel or change your mind. 
• BE PREPARED AROUND HOLIDAYS AND ANNIVERSARIES - For many people holidays, birthdays, or anniversaries of their loved one's death can bring up painful memories or revive feelings of longing and sadness, even for those who believe they have finished the grieving process. Although this is a common reaction, you may still be surprised by the flood of emotions reactivated during this period. You want to be especially aware and gentle with yourself around these times. You may also want to allow more private time for yourself or arrange to spend more time around family and others close to you. 
• REACHING FOR SUPPORT - While your internal resources and community may be helpful in the grieving process, professional help can provide an extra layer of support. If you are experiencing multiple stressors, coping with cumulative grief, or have a prior history of trauma, professional services can help guide you through this difficult process. Signs that might indicate a need for professional help include uncontrollable anger, continuing or worsening bouts of depression, social withdrawal and isolation, suicidal thoughts, or feelings of helplessness, hopelessness, and despair. University Health Services offers free professional grief support through individual or, at times, group services. 

Work is a place where you spend a considerable amount of time in your life. When someone close to you dies, not only do you have to cope with this loss, but you must also adjust to working or returning to work after the death. The early weeks, or months, may be especially difficult. Here are some suggestions to help you through this emotional transition:  

• BE EASY ON YOURSELF - Expect that you may feel more distracted or less productive than before your loss. Realize your mind or reflexes may not respond as quickly in the beginning.
• TAKE TIME TO GRIEVE - Try to set aside time during the day or create ways to remember your loved one. Let people know if you need moments of more privacy or need a place to cry or compose yourself while at work. 
• CONSIDER HOW MUCH YOU WANT TO SHARE WITH OTHERS - For some people, sharing some of their grief and sorrow with their coworkers helps them cope; while for others solace and comfort work best for them. If you choose to share some of your grief with coworkers, select those with whom you feel the most comfortable and who appear to be open to listening to you. When you are grieving, it can be difficult to gauge when or how much to share with people. Be aware that if your feelings are particularly intense or emotional some coworkers may appear uncomfortable with your sharing. This may mean you need to find sources outside of work to express your sadness. 
• BE UNDERSTANDING WITH OTHERS - You may find others being awkward with you shortly after the death. Many are well-meaning and want to be supportive, but may feel uncertain about how to approach you. Some may be afraid of what to say to you. Let people know what level of interaction you'd like ("It's okay for you to ask how I'm doing..." or "I'd rather not discuss this right now; I'll let you know when I can..."). Respect people's limits of being able to attend to your loss while continuing to carry on with their work.
• KEEP YOUR MANAGER/SUPERVISOR/DEPARTMENT HEAD INFORMED - If you have difficulty adjusting to being back at work (feel fatigued, overwhelmed, unfocused, etc.), let your manager/supervisor/department head know. Perhaps they can help you with your work transition: e.g., temporarily adjust your work hours or schedule, shift project priorities, or reduce your workload. Consider ways your manager/supervisor/department head can be an additional source of support at work. 
• UTILIZE CAMPUS RESOURCES - Faculty and Staff: Employee Assistance (EA) offers free, confidential consultations with a licensed mental health clinician. EA can provide referrals to community grief resources as well as licensed therapists who specialize in grief and loss.

For Students: UHS Mental Health offers confidential short-term counseling services that can support you through your grief process. Educational workshops are offered on grief and loss, and time-limited bereavement support groups are available for students. CAPS also provides information about and referrals to other bereavement resources in the community for students.

Coping with the death of someone by suicide is an especially difficult challenge. Family members and loved ones should consider getting expert professional mental health assistance as soon as possible. At UHS, there are professional services available to faculty, staff, and students that provide individual and group assistance when a member of the campus community commits suicide. See the following contact information:

• For students: Counseling and Psychological Services at (510) 642-9494
• For faculty and staff and immediate family members: Employee Assistance at (510) 643-7754
• If you are experiencing suicidal thoughts, 988 Suicide and Crisis Line offers 24/7 access to trained crisis counselors who can help people experiencing mental health-related distress.  988 serves as a universal entry point so that no matter where you live in the United States, you can reach a trained crisis counselor who can help. The 988 Suicide & Crisis Lifeline has a Spanish Language line at 1-888-628-9454 and also utilizes a Tele-Interpreters service which supports over 150 languages. 
• If you have taken steps to end your life, please obtain immediate medical help and dial 9-1-1.

Employee Assistance - Be Well At Work
Room 3100 Tang Center, University Health Services
2222 Bancroft Way, Berkeley CA 94720-4300
(510) 643-7754 

Counseling and Psychological Services: Student Counseling

Room 3284 Tang Center, University Health Services
2222 Bancroft Way, Berkeley CA 94720-4300
(510) 642-9494

Crisis Support Services of Alameda

(800) 273-8255

Hospice of the East Bay
(925) 887-5678

Pathways Hospice
Serving East Bay, SF, and the South Bay
(888) 978-1306

Sutter Care At Home - Alameda Hospice
(510) 263-0900

Circle of Care - For Children experiencing loss and their families
CircleofCare@EBAC.org
(510) 531-7551 x3195 (Hablamos Espaňol)

Women's Cancer Resource Center
2908 Ellsworth Street, Berkeley, CA 94705
(510) 601-4040