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What Constitutes Normal Grief?

 
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In a recent Memorial Day speech, Vice President Joe Biden recalled the tragic loss of his wife and child several decades ago.

He stated that you never really get over a loss like that and was frank in describing how he now understood why people consider suicide during times of immense grief.

Grief has been heavily studied by psychologists. Although there are many theories and we know that different people grieve in different ways, psychologists are not in agreement about what constitutes normal grief.

Instead, grief is best assessed according to the magnitude of the loss. When grief interferes with a person’s daily activities and functioning for an extended period of time, that person may need help from a mental health professional.

Stages of Grief
Mental health professionals often talk of grief as something that comes in stages. Elizabeth Kübler-Ross’s model, during which a person moves from denial, anger, bargaining, and depression to acceptance, is the best-known approach.

However, there are several models of grief. A person may seem fine one day, then have trouble functioning, and then return to normal functioning, bouncing back and forth for an extended period of time.

Extended Grief
Some mental health professionals have recently advocated for adding the diagnosis of “extended grief.” This diagnosis would be given to someone who grieves for six months or more, with symptoms of depression and decreased functioning.

However, many other professionals have railed against this suggestion, arguing that grief is normal and can last anywhere from a few days to many years. Vice President Biden’s speech makes it clear that people can grieve for decades while still functioning at a high level — well enough, in fact, to become vice president.

Grief and Depression
A variety of factors increase a person’s risk for depression, but grief is among the most common causes of depression. While grief is directed toward a specific object of sadness, depression is general sadness that occurs, regardless of circumstances.

Grief weakens coping skills and can lead to isolation. The result is an increased susceptibility to depression after the grief wanes. People whose grief morphs into depression frequently don’t recognize their depression for many months because they assume it’s just a new phase of grief.

What Kind of Grief Is Normal?
Because grief is dependent on a person’s individual personality, the magnitude of the loss experienced, and the support and coping skills available, it can be difficult to judge what constitutes “normal” grief.

Psychologists now believe that “normal” grief may last much longer than we originally thought. A few studies have shown that, after losing a spouse, people are permanently less happy than they were previously, even after they are no longer actively grieving.

Thus the effect grief has on someone may largely be determined by that person’s overall quality of life. A person with a good quality of life can tolerate a reduction in happiness, while a person who already has few friends and a difficult life may be thrown into a deep depression.

Even when a loss seems too big to fathom, mental health professionals can help you with your grief. While grief is different for everyone and no one person’s grief should be stigmatized, some signs that you may not be coping well with grief include:

• Continuing to fixate on the loss a year or more after it occurs

• Inability to do anything but think about the loss

• Inability to enjoy previously enjoyed activities

• Sleep or appetite disturbances

• Thoughts of suicide

• Lack of a support network

• Feelings of worthlessness, hopelessness, or helplessness

Sources:

Kübler-Ross, E. (2007). On grief and grieving (1st ed.). New York, NY: Scribner.

Walsh-Burke, K. (2005). Grief and loss. New York, NY: Allyn and Bacon.

Worden, J. W. (2008). Grief counseling and grief therapy (4th ed.). New York, NY: Springer Publishing Company.

Edited by Jody Smith

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