Healthy Grieving: Part 2

Yesterday I talked about how important it is to understand the grieving process. You don't want to get stuck in grief, and understanding and embracing our feelings is part of healthy grieving.  The hardest part of grief and loss when it comes to chronic illness is that your health changes from day to day and from year to year.  One day you may be able to get to the grocery store, meet with a friend, and fix dinner.  The next day, you may not be able to get out of bed.  Also, as disease progresses, you find your new normal only to discover that a year or so later, you lose even more of your "normal".  For these reasons, grieving loss of health and loss of your "normal" isn't a one time process. It's a very messy process. This makes it all the more important to understand the grief stages and identify where you are in that process. To review, the fives stages are: denial, anger, bargaining, depression, and acceptance.  Yesterday we discussed denial and anger.

Stage 3: Bargaining: This is a time of asking, "If only I had done....maybe this wouldn't have happened, or maybe if I do...….it will go away." It is a series of "what if" statements.  "What if I.."  "What if my doctor..." This may be the most confusing part of the grieving process to navigate because there is some truth here.  With many chronic illnesses, doctors will say, "Try this".  So, we do not know what will happen until we try.  So what can be done to be as mentally healthy during this stage as one possibly can be? 

• It is important to not focus on the past (If only I had done or not done...maybe I would not be sick.)  This only causes a sense of guilt and gets us stuck in the grieving process. Self anger and self blame NEVER help one's physical health. Stop looking at what you think you could have done differently and commit instead to honoring your body from now forward. 
• Also, oddly when you recognize that your questions are part of the grieving process, it is easier to stop asking them.  Simply identifying that you are grieving helps you not get stuck in grieving.  Ironic, isn't it?

Stage 4: Depression: This stage often feels like it will last forever. Symptoms may include: sadness, a loss of the ability to feel pleasure, changes in sleep, fatigue, change in appetite, social isolation, weight changes, and irritability. 

• Do not tell yourself to snap out of it.  These are normal responses to the loss you are experiencing.  Everything in your life has changed. You may no longer be able to work, drive, walk, do the leisure activities you once enjoyed, or even have the energy to make a meal.  These losses have to be grieved.  
• Do not run from that pain.  
• Do not try to analyze it.  
• Do not judge the depression or yourself.  
• The more you let yourself feel the sadness and hurt, the more quickly it will pass.  
• If you have a loved one who is emotionally supportive, call them.  Talk about what you miss about the old you or your old life.  
• If you do not have support, join a support group either by calling your local hospital to find resources or by joining an online community.  
• Journal about your loss or draw out your feelings on paper, cry, let your family and friends know you are sad.  
• If you find yourself struggling with suicidal thoughts, talk with your doctor immediately and use distraction and self soothing to help you cope. 
• Depression can last from seconds to months when it comes to dealing with chronic health issues. Be patient with yourself in this stage.
• Despite how fatigued you may be, this is the most important time to not socially isolate.

Stage 5: Acceptance.  Acceptance does not mean that you are okay with being sick.  It does not mean you are okay with the losses.  This is a stage where you embrace our "new normal".  Here are some ways that help with this stage:

• Start a daily gratitude journal.  It is easy to see the losses in life; every human being has to be intentional if they are going to see the good in their life.  Research even says that our brains remember negative experiences without having to dwell on them; whereas, in order to get pleasure from positive experiences, one must intentionally dwell on them for at least 15 seconds.  That might not seem long, but try it once; it is longer than you think.  Building a gratitude journal will enable your brain to see and feel the positive that is happening in your life.
• Ask yourself the questions, "What are the good things my illness has taught me or changed in me? and "How is my life better since the diagnosis?" These may seem like odd questions, but those who have had illness for years can attest that good always comes out of bad.
  -Has it taught you to slow down and enjoy the moment, instead of always racing ahead to achieve? 
  -Has it taught you that people matter more than stuff? 
  -Has it taught you that healthy identity is not about what you do but about who you are? 
  -Has it taught you to contribute to your world? 
  
  Good always eventually comes out of bad.  You just may have to change your focus in order to see it.  This cannot be done too quickly though.  Make sure you have gone through the other stages before you attempt this, or you can find it not working and ending up with feelings of bitterness and hopelessness.  
• Encourage others who are struggling with similar health issues.  Genuinely contributing to the well being of others ALWAYS helps one's mental health. This requires empathy, not pity.  It means we communicate that we understand.  It may also mean sharing our own story or sharing knowledge of resources. 
• Acceptance is also a stage where we find new strategies for creating meaning in our life.  If you taught school before you got sick, then you are a teacher.  You do not need to be in front of a classroom to teach.  In fact, these days, you can do that online.  Find a forum where you can teach others about resources you have found.  Maybe even tutor classes online.  Living out who you are in a way that emotionally energizes you does not have to be in a traditional job or in a job at all.  If you are an encourager, you can do this by having a good attitude and calling others to see how they are doing.  Go deep, beyond what you "did" in your healthy life into the "being"/ what was it about who you are that energized you in that role?  There are many strategies for living that out.  It does not have to be the job you previously had. Find ways to contribute to the world that emotionally energize you.
• Stay out of the "what if this gets worse" thinking.  You may have one bad day.  Remind yourself  that if today is not a good day/not one of  your typical "new normal" days, then today is today.  Tomorrow is a new day.  The "what if this gets worse thinking" can pull you out of acceptance and into such terror that you stop really living life. If you start having a month of worse symptoms or your doctor tells you your illness is getting worse, then it is time to let yourself grieve again.  You may experience normal minutes of grief here and there.  "Today I cannot do the social event I had planned; I am angry and sad about that".  This is normal and healthy, but do not let one bad day terrify you into worrying that your whole "new normal" is changing again.
• Own responsibility for what you can do about your health.  Eat healthy, exercise if you can, go to bed at the same time every night and get up at the same time every morning.  Follow your doctor's instructions.

These are the five stages: denial, anger, bargaining, depression, and acceptance.  They are not always linear.  You may find yourself bouncing around in the stages.  They can last seconds or months depending on the level of loss.  You matter, your emotions matter.