“Each person’s grief is as unique as their fingerprint. But what everyone has in common is that no matter how they grieve, they share a need for their grief to be witnessed. That doesn’t mean needing someone to try to lessen it or reframe it for them. The need is for someone to be fully present to the magnitude of their loss without trying to point out the silver lining.” ~ David Kessler

Grief has consumed a large part of my life over the last couple of weeks due to the loss of my beloved horse, Nick.

Angels show up in many forms, and the minute I sat on Nick- Nick O’ Time- for the first time, I knew how special he was–an angel with hooves. I knew he’d be with me for his whole life and that I was blessed to have him help care for me. He was a trusted soul with a huge heart and was always full of love. 

When we entered horse shows, he was solid, unbeatable, and trustworthy. “That’s the time to beat” and “you don’t have any entry fees because you won them” became standard, and we loved to win. But more important was that Nick took care of me. As he aged, it didn’t matter that we didn’t show anymore. As soon as he would hear me come out the door, he would call to me and run up from the pasture.

He knew how much I loved him, too. He was my once-in-a-lifetime horse, and if you knew Nick, you knew how special he was and why he was everyone’s favorite. If you know me, you know he was so very loved by me. When Michael Braiwick found us and shared that he had gotten Nick for his birthday and that Nick had changed his life, I knew exactly what he meant because he changed mine, too. Nick would have turned 34 next week. 

How blessed I am to have been able to love and care for him and him me  since he was 13. Gallop on, my big handsome love, you are the very best Nicholas. There are no words for how much my heart hurts, but I am forever grateful, and my life is so much better that you were in it.

Losing Nick has been exceptionally challenging for me, and I wanted to share my experience on how grief can affect our mental health and what strategies we can implement to cope.

What is Grief?

Bereavement is the experience we go through when we lose someone important to us and the process by which our pain is characterized while we adjust to the loss. Sadly, death and loss are unavoidable parts of life, and we will all inevitably lose loved ones through unforeseen circumstances, illness, and old age. 

Losing someone important to us or who has played a crucial role in our lives can be emotionally distressing – whether that be a parent, child, partner, friend, or pet. We can also experience bereavement at the end of a relationship or when moving to a new location away from friends and family.  

There are also two other recognized types of grief that a person may experience aside from the bereavement following a loss[1]:

• Anticipatory Grief – We feel this when witnessing the decline of someone we love. It is a sense of loss that arises upon expecting their death and has many of the same symptoms as those experienced after our loved one dies. Although it can mentally prepare an individual for the coming loss, it does not necessarily make the subsequent bereavement any easier. 
• Secondary Loss – Secondary loss can occur months or even years after the loss itself. The emotions of grief will arise when thinking of future experiences or enjoying present moments that those people you have lost will not be there to share or see.  

Coming to terms with bereavement is never easy, and it can be extremely challenging to adjust to life without those you have lost. There is no fixed period for grief, and the length of time spent mourning varies dramatically from person to person. People can experience a wide range of feelings and emotions, and it is vital to note that grief is a very personal experience, with no “right” or “wrong” way to feel. These emotions can be highly unpleasant, but it is essential to remember that they are a natural part of the grieving process.

Symptoms of Grief

Grieving is the outward expression of loss. Your grief is likely to be expressed physically, emotionally, and psychologically. Feelings are likely to come and go, and powerful, difficult emotions can appear unexpectedly. While grief is unique to the individual, common feelings include[2]:

• Shock and numbness, often upon first finding out about the death or loss 
• Inability to express emotions, such as being unable to cry or articulate feelings
• Overwhelming sadness
• Fear, panic, or agitation 
• Tiredness and exhaustion
• Anger with yourself or loved ones or with the deceased 
• Guilt and feelings of regret or responsibility
• Feeling unable to cope with the prospect of the future 

Although feelings like this are distressing and unpleasant to experience, these emotions are a normal part of the grieving process, and it takes time for them to subside. However, some individuals may go on to develop a grief disorder where these symptoms do not dissipate. In such cases, severe bouts of depression and anxiety may occur, and a person’s life and mental health become untenable. 

Grief and Mental Health

Bereavement can have a dramatic impact on a person’s mental health. Those already suffering from a mental health condition may notice a decline, and others who have been mentally well may develop a mental health issue [3] due to the grief. 

Most people can accept the loss, process the stages of grief, and start living an everyday life again. However, for some people, the journey to acceptance is much longer, and the feelings that arise from grief can become overwhelming and debilitating. The feelings of sadness, anger, hopelessness, anxiety, and loneliness can become severe for some, and chronic grief can develop into a grief disorder[4] where the individual will require support and treatment. 

Studies have shown that around 10-20% [5] of those who lose a loved one will experience an extended period of complicated bereavement. 

Some common symptoms of grief disorder include[6]: 

• Prolonged sadness, depression, and bouts of crying daily
• Extreme preoccupation and focus on the loss
• Neglect of daily responsibilities 
• Neglect of self-care
• A lack of motivation to interact with people and desire to self-isolate
• Detachment from friends and family
• Intense emotions such as fear, anxiety, and pain 
• Psychosis
• Self-harm or suicidal ideation

Grief Disorder is also known as Complicated Grief Disorder or Traumatic or Prolonged Grief.[7] This is a relatively new diagnosis first referred to in the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 2013. This new acknowledgment that highlights many of grief’s common symptoms—depression, anxiety, bitterness, anger, nihilism, and a powerful pining for the deceased–allows for medical intervention and treatment in the early stages of a grief disorder.  

As with all mental health disorders, early intervention is essential for helping the person maintain and live a happy, healthy life.

Those most at risk of developing a grief disorder:

• Have a pre-existing, underlying mental health disorder that is exacerbated by grief
• Are genetically predisposed to mental illness
• Experience problems coping with difficult emotions in a healthy manner
• Use substances

Coping with Grief

Finding a way to cope with feelings of grief is vital for your mental health. As grief is a natural process that we all experience, the best solution is to allow your grief to exist and to trust that it will get easier over time rather than try and suppress it or escape from it through risky behaviors such as substance use. Of course, this is easier said than done, so here are some tips to help you live with grief:

• Establish a support network – By reaching out to caring friends and family who can understand your loss, you will not feel so alone in times of difficulty. Support groups are also helpful and allow you to be in the company of those who are experiencing similar challenges.
• Express your feelings – Do not bottle your feelings up or suppress them. Instead, express them as they arise. Tell other people how you feel, as it will help you work through and articulate the grieving process. 
• Self-care – Get plenty of rest, eat nutritious foods, exercise, and be aware of developing a dependence on alcohol or other substances. 
• Postpone major life changes – Hold off on making any big decisions such as changing jobs, moving house, starting a new relationship, etc. It is essential to give yourself space to adjust to your loss. 
• Be patient – There is no quick fix to grief. It can take months or years, but trust that it will get easier.
• Seek help – If the grief is too overwhelming and or you are experiencing thoughts of self-harm, seek professional assistance and treatment[8] to help you process and work through your grief. 

Everyone deals with grief and loss uniquely, with different stages and periods of time. If you feel that you or a loved one has or is at risk of developing a grief disorder, please seek help today. Even the most painful grief feelings and symptoms can be managed with professional assistance. You do not need to struggle alone.

If you are concerned about any issues discussed in this blog, please contact Heather R. Hayes & Associates.  Call 800-335-0316 or email info@heatherhayes.com today.

  [1] Bertuccio, Rebecca F., and Megan C. Runion. Considering Grief In Mental Health Outcomes Of COVID-19.. 2021.

[2] Bonanno, George A., and Matteo Malgaroli. “Trajectories Of Grief: Comparing Symptoms From The DSM‐5 And ICD‐11 Diagnoses”. Depression And anxiety, vol 37, no. 1, 2019, pp. 17-25. Wiley, doi:10.1002/da.22902. Accessed 22 Apr 2021.

[3] Wilkinson, Stephen. “Is ‘Normal Grief’ A Mental Disorder?”. The Philosophical Quarterly, vol 50, no. 200, 2000, pp. 290-304. Oxford University Press (OUP), doi:10.1111/j.0031-8094.2000.00186.x. Accessed 22 Apr 2021.

[4] OTT, CAROL H. “THE IMPACT OF COMPLICATED GRIEF ON MENTAL AND PHYSICAL HEALTH AT VARIOUS POINTS IN THE BEREAVEMENT PROCESS”. Death Studies, vol 27, no. 3, 2003, pp. 249-272. Informa UK Limited, doi:10.1080/07481180302887. Accessed 22 Apr 2021.

[5] “About Complicated Bereavement Disorder”. Psychology Today, 2013, https://www.psychologytoday.com/gb/blog/get-hardy/201309/about-complicated-bereavement-disorder-0.

[6] Horowitz, Mardi J. et al. “Diagnostic Criteria For Complicated Grief Disorder”. FOCUS, vol 1, no. 3, 2003, pp. 290-298. American Psychiatric Association Publishing, doi:10.1176/foc.1.3.290. Accessed 22 Apr 2021.

[7] Hughes, Virginia. “Shades Of Grief”. Scientific American, 2013, https://www.scientificamerican.com/article/shades-of-grief/. Accessed 22 Apr 2021.

[8] Bryant, Richard A. et al. “Treating Prolonged Grief Disorder”. JAMA Psychiatry, vol 71, no. 12, 2014, p. 1332. American Medical Association (AMA), doi:10.1001/jamapsychiatry.2014.1600. Accessed 22 Apr 2021.