The experience of grief

You may feel a range of strong emotions, such as sadness, anger, guilt, anxiety and depression. Sometimes people are overwhelmed by the intensity of their feelings or find that their mood changes quickly and often. These are natural reactions to the experience of loss and may take some months to settle. Physical reactions to grief can also affect your emotions.

Try to develop a sense of your personal coping style (the things that work best for you). Remembering how you have coped with difficult situations in the past may help you feel more able to cope now with your emotions. Explaining how you are feeling to family and friends can help them understand your behaviour at this time.

Numbness

When someone dies, you may feel nothing at first. This may be because you can’t believe it’s true or you’ve had a shock. It may feel like the person who died will suddenly walk through the door again.

This numbness can be helpful during the first days and weeks after a loss, when you may be making practical arrangements, such as planning and attending the funeral. Don’t feel you have to push yourself past this emotional numbness. It will start to fade in a few days or weeks, although it may return from time to time. The reality of your loss will become clearer as time passes.

Sadness

Sometimes you might feel like the sadness will never go away. You may long to see the person so much you don’t know what to do with yourself. You may find it hard to control the crying, with tears sometimes coming when you least expect them. This could mean you avoid going out because you can’t predict or control the crying. You might also feel unable to cry, even though you are terribly sad.

Anger

Many people feel very angry when they are grieving. You may feel angry with your god, the person who has died, the fact of death, yourself, those involved in caring for the person who died, even the person behind you in the supermarket queue, or for no obvious reason.

Anger that comes and goes is a natural part of grief. Some people find it helpful to express their anger in a safe environment, such as with a trusted friend or counsellor. Others find that physical activities such as gardening or exercise provide an outlet for their anger and help clear their mind.

Relief

You may feel relief that the person has died, especially if they have been unwell for a long time. Sometimes it’s a relief that it has happened at last, that the death you have been worrying about for months is finally a reality you can deal with. You may also feel glad that their suffering is over.

If your relationship with the person was challenging or complicated, you may experience a mix of emotions at their loss. Along with sadness, you may feel relief that you are free of the stress. It’s hard not to feel guilty about this. When a person dies, we are often expected to focus on their good points and not criticise them – but a cancer journey is bound to show all sides of people. The person who died was human, with good traits and bad ones,  and you are too.

Guilt and regret

You may feel guilty about the things you did or didn’t do. You may wish you had behaved differently towards the person in the recent or distant past or made different decisions about their care, or you might feel that there are things you left unsaid. Try to remember that no-one is perfect. Often, talking about your feelings with someone else helps.

Sometimes people feel guilty when they find themselves joking and laughing, feeling happy at times, or getting on with life. But it is normal to experience a range of emotions as you learn to live with the loss – it doesn’t mean that you didn’t care about the person or that your grief is not genuine. Light-hearted or joyful moments can help to counter the lack of control that grief can bring and help you release some of the physical tension that often comes with grief.

Tips for coping with your emotions

• Accept that your feelings are normal and natural given the loss you have experienced. You might sense pressure from yourself or others to behave in a certain way, but everyone has their own style of coping.
• Be patient with grief. You may feel that after a certain time you should be coping better, but your adjustment to the loss is likely to be gradual and may take longer than you and others expect.
• If you feel angry, find safe ways to show your anger – do some exercise, write, paint or draw. Think about the ways you’ve coped with anger in the past. What worked? Once you have released some anger, do something relaxing to help calm yourself.
• Research has shown that regular physical activity can help with feelings of anger, stress, anxiety and depression.
• Try reflecting on your caring role – you may feel you are stronger than you realised and proud of how you have supported someone as they were dying. Even the small things you did showed how much you cared.
• Forgive yourself for the things you didn’t say or do. Some people find it helps to write a letter to the person who died and then tear it up or burn it. Other people want to keep the letter as a reminder of the things they loved about the person who died.
• Forgive yourself for any wrongs you feel you did to the person who died. People often feel that they should not have become frustrated or “snapped” that one time when they were tired. Understand that becoming tired and short is fairly common when caring for someone.
• Take your mind off your grief for a little while – read a book, play a game online with a friend or watch a movie.
• Try complementary therapies, such as meditation or art therapy, to help you manage your feelings.

Fear and anxiety

People often become very fearful when they have a major loss in their life. You may be afraid of what the future holds and how you will cope, feel terribly worried about other people you love, or fear for your own health.

Little things that were no trouble to you before can unsettle you, and you may feel very worried even if you can’t put your finger on any particular worry. Even day-to-day activities such as leaving the house to go for a walk, doing the shopping or going back to work can fill some people with fear.

Depression and despair

When the reality of the loss sinks in, you may find your sadness overwhelming or feel like your life has lost meaning. A loss of enjoyment in life and a lack of direction are common, especially for people who take a long time to come to terms with the loss.

Managing your emotions

If any of the feelings described in this section continue for what you consider an extended period of time, it may be a sign of depression. If these feelings are making it hard for you to cope with daily life, talk to your general practitioner (GP), a grief counsellor or Cancer Council 13 11 20.

For some people, the grief feels so unbearable that they feel that they can’t go on. If this happens to you, it is important to seek professional help from a specialist grief counsellor. Lifeline provides 24-hour crisis support on 13 11 14.

Not everything experienced after a death is negative. While grief can certainly be painful and disruptive, there are often small joys and connections with others. Many people experience positive growth and discover that they have a natural resilience or develop greater compassion for others.

Grief often affects the ability to think clearly. Because of the intensity or unpredictable nature of your grief, you may find it hard to get your thoughts in order or focus for long periods. You may even wonder if you are losing your mind.

Many people find they become confused and forgetful. Even getting a simple task done seems like a big hurdle. You may feel very indecisive or you might make impulsive decisions. If you can, it is better to put off any major decisions for a few months after a bereavement until you can think more clearly.

Tips for managing jumbled thoughts

• Try not to make any significant changes for a while and take your time with decisions that do need to be made. People may hurry you to sort out
  clothes and personal items or decide where you will live long term. Don’t be rushed – you are already having to adjust to a huge change.
• Ask a family member or friend to help you sort out paperwork. If you have school-age children, a fellow parent could help you keep up with school activities. Writing lists or using a calendar can also help you keep track of things.
• If you are working, talk to your employer about how much time off you need, or negotiate a temporary reduction of hours or less demanding tasks. Ask them to ensure that your job will be there for you – this will give you peace of mind.
• Keep a journal. Putting your thoughts on paper can help you process the experience.

Grief is experienced in your body too. The shock of the loss, even if you were expecting it, can trigger the release of adrenaline and other chemicals in your body. This can make you feel anxious or make it hard to switch off anxiety. Other physical responses to grief include headaches, nausea, unexplained aches and pains, and a tight feeling in the chest and stomach. Grief can also affect your immune system and you may be more likely to catch infections.

Physical reactions caused by the emotional strain of grief can, in turn, affect your ability to manage your emotions and think clearly. It is a good idea to talk to your doctor about any physical issues that are worrying you or making it harder to cope.

Sleep issues – Many people who are bereaved find that their sleep patterns change. Some people find it hard to get up in the morning and end up oversleeping, which can leave them feeling even more exhausted. Others struggle to fall asleep and/or stay asleep, or have long periods of being awake during the night.

Exhaustion – Don’t be surprised if you have no energy and feel constantly tired. Adjusting to any major change is exhausting, and too little or too much sleep can make you feel even more tired.

Changed appetite – It is common to have either little appetite or an increased appetite after the death of a loved one. Some people also experience an upset stomach, which may last for some time or come and go. Changes to your appetite or weight can make you feel distressed.

Tips for looking after your physical wellbeing

• Get some exercise every day. A walk in the morning can shift your mood, clear your head, raise your energy levels for the day and make it easier to
  sleep at night. You might also like to try swimming, playing a team sport or even dancing. Housework such as vacuuming or mowing the lawn can help if you’re feeling tense.
• Try to maintain regular sleeping hours by going to bed and getting up at set times.
• Don’t panic if it is hard to sleep. Get out of bed and do something relaxing, such as reading a book, listening to music or a podcast, or having a bath, and then try going to bed again. Practise slow, deep breathing while in bed – this will slow down the mind and allow the body to relax.
• Check with your doctor before trying sleeping tablets or natural sleep remedies.
• Talk to your doctor about seeing a counsellor or psychologist for some simple strategies (such as relaxation exercises or tracking and adjusting your night-time routines) if your lack of sleep is ongoing.
• Limit caffeine and alcohol. This will help you sleep better and improve your general wellbeing.
• Encourage yourself to eat a healthy, balanced diet. If you have lost your appetite and are barely eating, try to snack frequently on nourishing, easily digested foods.
• You may find you are eating unhealthy foods or eating large amounts of food for comfort. A poor diet can affect your mood, so explore other ways to help yourself feel better, such as getting fresh air and exercise in a park, listening to music, or having a bath or massage.
• Try meditation or relaxation to help with the anxiety. There are many recordings, videos and smartphone apps to guide you through different  exercises. Listen to Cancer Council’s online relaxation and meditation recordings or call 13 11 20 to request copies.

You may behave differently while you are grieving. Some people keep themselves extremely busy, while others may sleep a lot or find it hard to complete even simple tasks. Many people avoid reminders of the person who died because of the intense emotions. These different behaviours are normal, but can make it difficult to settle into a routine.

Some people use alcohol or other non-prescribed drugs to dull the emotional pain. Risk-taking behaviours, including unexpected sexual behaviour, can also be part of grief. While these behaviours may give short-term relief, they often only delay the experience of grief and can lead to more serious problems.

Tips for establishing helpful behaviours

• Try to live day to day rather than looking too far ahead or looking backwards.
• Balance rest and activity. Set small goals and congratulate yourself when you reach them.
• Have an alternative plan ready in case you’re not up for a planned activity.
• Try not to judge yourself too harshly. Your usual expectations for yourself may be unrealistic while you are grieving.
• Decide on a daily routine that includes getting up and dressed by a certain time. “Going through the motions” can help you maintain healthy habits and self-esteem.
• If you or others are concerned about your use of alcohol or other drugs, ask your GP for help and support.
• Have regular treats, e.g. a bunch of flowers, a massage, listening to music, or visiting a barber or coffee shop.

Your beliefs may be challenged as you question the meaning of the loss. Some people find comfort and strength in their spiritual beliefs and in connecting with other members of their faith. Other people feel abandoned or betrayed at a time of great need. If your faith has been important to you, this can be one of the most unsettling aspects of grief.

You may find that your search for answers eventually leads to spiritual growth. Whatever your beliefs, it can be helpful to explore questions about life and death with someone you trust, such as a family member, friend or counsellor.

Tips for exploring the spiritual impact

• Draw on your spiritual resources in whatever way is best for you. For some, this will mean praying or going to a place of worship. For others, it will be a walk on the beach or in the bush, or listening to inspirational music – whatever reminds you of a different perspective on life and a larger way of seeing your situation.
• Talk about your feelings with a spiritual care practitioner (pastoral carer, chaplain or religious leader). There will usually be one on the palliative care team. You can also ask the hospital social worker if there is someone you can talk to. Accept that having doubts or concerns may be part of a process leading to a stronger sense of your own spirituality.
• If it feels right to you, follow the mourning customs of your religion or culture. Some people find these provide a reassuring structure for their grief.

Grief affects how you interact with the world, your sense of identity, and the roles you have within your family or social circle. You may find that your friendships and family relationships change.

A sense of presence – It is common to feel a sense of closeness to the person who died. People often report that they see, sense or dream about the person who died, especially in the first few weeks. Some people find this deeply comforting; others find it frightening and unexpected.

Loneliness – People often feel intensely lonely. If your caring role was a major part of your life, you may feel lost without it. It can take time to settle into a new routine. After some time has passed, you may still feel your loss very strongly, but everyone around you may seem to have moved on. This can be hurtful and make you feel alone even when you are surrounded by people, and you may withdraw from those around you.

Abandonment – You might feel abandoned and rejected by the person who died. Or you may feel neglected by the friends you thought would be there for you. You may be surprised by who offers the best support – often it’s someone who has experienced a major loss themselves.

Conflict – Strong family feelings and difficulties often arise at the time of death and afterwards. Because everyone grieves in their own way and in their own time, it is easy to have disagreements with family members and friends after someone dies. There may also be conflicts over the person’s will and who gets their treasured possessions.

Tips for managing the social impact

• Know that you are not alone. Loss is part of being human. Find someone you can talk to who will listen and be understanding, or ask your GP about
  bereavement counselling.
• Read firsthand accounts of other people who have experienced grief. Find stories online, through bereavement support groups or at your local library.
• Join a support or grief group if there is one available or consider an online group. Call Cancer Council 13 11 20 to find a group.
• Talk with the friends, family and staff who provided support while the person was dying. Often it can be helpful to talk about that time with the people who were there with you.
• Ask others for assistance – it will make them feel valued and useful.
• Take small steps to re-enter your social circle. At first, mix with people you feel comfortable with and who understand you well. Even if you are just sitting and listening, you are connecting to others.
• When you feel ready, try to rejoin a social group or take up a new activity. Recognise that the first time you return to an activity, such as going to the shops, club, school or work, is likely to be the hardest. It tends to get easier with time, but asking someone to come along with you can make the initial steps feel less daunting.
• Aim to be gentle and forgiving with others and yourself. Grieving family members and friends may seem angry or irrational. Try not to take it personally. Keep in mind that you are vulnerable too and have the right to protect yourself. Let someone else support them for a time.