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It is likely that we expect grief as a natural reaction to the death of a loved one. Surprisingly to many, grief is also a natural reaction to bad news about our health. 

This article focuses on the grief that can accompany a diagnosis of a serious health condition.

The first reaction to a diagnosis or a change in a health condition may be one of shock and disbelief. The life that was is no longer. There are the changes that the illness causes in a life style - as well as fears of future changes to come. There can be a facing of one's own mortality - perhaps for the first time. We know that this one is not going to go away, but don't want to believe it.

Grief is natural. It shows up in different and personal ways for each of us. Signs of grief can be physical or emotional or both. They can also be painful and disturbing. Although you may not expect it, grief can be healthy.grief provides the time needed to absorb the new reality in your own pace. A time to process emotions and make the needed adjustment. It is a "time off" that can be used to build the strength you need, to be able to face and embrace the new reality.

An illness can present itself in ways that are new to us and need a lot of adjustment and inner strength. In a way it is easier to adjust to physical changes than to emotional ones.

It is helpful to understand the symptoms of grief. Understanding helps coping with the symptoms.

How does a person cope with such an overwhelming situation? There is no one good answer to this profound question. But there are some tips that seem to help. Choose the ones that you believe are right for you -- the ones that feel good and helpful.

If family or friends aren't as supportive of your grieving process as you would like, consider asking them to read tips for caregivers below.

• Physical Symptoms Of Loss/Grief  
  
• Emotional Symptoms Of Grief  
  
• How Emotional Symptoms Of Grief Show Up  
  
• Tips For Coping With Grief  
• Tips For Caregivers When Someone You Love Is Grieving 
  

Physical symptom may include:

• Sleep disturbances, including nightmares, night terrors and over sleeping.
• Loss of appetite which can cause weight loss.
• Fatigue and sleepiness during waking hours, feeling of weakness.
• A choking feeling and/or difficulty in swallowing food.
• Heart palpitation, chest pain and tremor.
• Headaches.
• Blurry vision.
• Paleness.
• Being prone to accidents and falls.

Emotional symptoms may include:

• Feeling of loss and fear.
• Shame and guilt.
• Denial and anger.
• Helplessness.
• Not being able to make sense of the new reality.
• Depression.
• Loss of motivation.
• Thoughts of suicide.
• Anxiety and panic.
• Confusion and disorientation.
• Difficulty in concentration.
• Not enjoying the things we liked to enjoy.
• Acute need to be left alone (which can lead to isolation).
• Unexplained bouts of crying.
• Feeling of being a victim.
• Stress which might be caused by financial problems, a job situation, dealing with insurance companies, and changes in social relationships.
• Emotional numbness and irritability.

Emotions are strong and disruptive in an unpredictable ways. Following are some examples:

Making Plans

All of a sudden we can not make plans the way we used to, even for the near future. We don't know how we will feel even two hours from now, and are not sure we will be able to cope either physically or emotionally. The natural reaction is not to make any plans.

Pain

We might be dealing with chronic pain and do not want anybody to know about it.

Self Image

Our self image has changed and it takes time to get to know the new self.

The Need For Assistance

Simple every day activities become difficult and we might need help even for the most mundane things. Asking for help and accepting it is extremely difficult and can be humiliating and depressing. Depending on the situation, we might need help from others in a way that causes us to lose our privacy and sense of independence.

Shrinking World

The world around us shrinks as the illness takes the foreground. All our thoughts and life evolve around it.

Feeling Like A Burden

We can feel that we have become a burden, not a nice person to be around any more, a person with illness.

Effects on Work

Being ill might affect our job despite legal protections such as the Americans With Disabilities Act. We try as long as possible to act as if we are healthy and keep the illness to ourselves. This might lead to avoiding talking with colleagues and especially with our superiors. It feels lonely.

Financial Implications

The financial implications may be difficult to accept. For example, if time off work is needed for medical reasons that exceeds the employer's sick days or isn't covered by The Family and Medical Leave Act (FMLA), we could not only lose some income, but actually be fired for not being able to perform the job. There may be difficulties because of being Uninsured, or health insurance that doesn't cover all treatments and equipment.

Cultural Stigma

People with chronic illness and disability are often looked down at by society. A person in a wheelchair pays at the supermarket and the cashier gives the change to the person who is pushing the wheelchair. People begin to talk louder and more slowly to you. People stare at physical differences and are not sympathetic or compassionate. It is painful and makes one feel ashamed, angry and helpless. It is a very lonely feeling.

Loneliness

Talking about illness with friends and family often leaves a person feeling as if no one understands. (Many times they really don't). As Noa G said:
"Symptoms and feelings that we talk about might look bizarre to a healthy person. They don't understand why we don't snap out of them. Why don't we push ourselves a little harder, how come we can't do this or that when it is so easy? Well, it is not easy. It is actually extremely difficult for us. We begin to think about the way others perceive us and contemplate about our self image, about our identity and our dreams for the future. We feel misunderstood as there are no words to describe our situation in a comprehensible way. This again leaves us feeling profoundly lonely."

Medications

Medication can be another loaded issue. There is a strict routine of taking medication that has to be adhered to.

• Medications might have uncomfortable and sometimes frightening side effects.
• One of the more disturbing side effects is the change in intellectual abilities. Memory problems are difficult to recognize and are confusing. How do we remember that we don't remember? Here, again, we need an input from others, and this can be embarrassing and frightening. The situation can create a feeling of discontinuity and instability.

People report a variety of tips for coping with grief. Following is a brief list.  Consider trying what seems likely to work for you. If your first attempts don't work, keep trying. It's worth changing activities until you learn the activities that help and those that don't. 

• Think about the way you have successfully coped with life's stresses. Apply that technique to this situation.
• Set small goals. It makes them manageable. Otherwise, the situation can be so overwhelming that it seems insurmountable.
• Asking for help can be difficult, so try and ask it from somebody you feel comfortable with.
• Allow yourself to feel whatever comes up.
• Talk about the illness and the feelings it evokes. 
  • Talking helps making some sense out of the situation and resolves some of the pain. Experts recommend talking with friends and family.
  • Keep in mind that feelings aren't right or wrong, good or bad - they just are. Don't let other people tell you how to feel. What is important is to allow ourselves to experience what we feel.
• Take a break from people who bring you down. Instead, surround yourself with positive people who care about you.
• Many people benefit from writing a diary. Putting feeling on paper helps because it forces you to focus. The process also externalizes your feelings and thus helps with coping with them. (To learn how to keep a diary, click here.) 
• Make it known when you are tired or need to be alone. It helps those around you to know what you need when you need it rather than guess and give you advice that will irritate you. Keep in mind that as much as you may want to be alone when not feeling well, avoiding people is detrimental. Isolation can cause depression and provoke fear. Try your best not to avoid people.
• Pace yourself. Don't try to do too much. Over activity may cause fatigue and frustration. Acknowledge the fact that things take longer now.
• People have also found the following helpful:
  • Religion or other spiritual practice.
  • Meditation or relaxation sessions.
  • Listening to or playing music.
  • Painting.
  • Gardening.
• If you're feeling angry or frustrated, exercise can be a healthy way to use up "extra energy." Exercise can be as simple as going for a walk or climbing stairs. To learn how to bring exercise into your life on a daily basis, click here.
• Television, particularly comedy or other non-news channels. Television news with all the sensationalist negative stories might be upsetting and over stimulating, so try and watch in moderation.
• Don't reach for a drug or alcohol to eliminate your pain.
• Cry. Crying does not equal giving up or lacking hope.
  • Limit the amount of time you permit yourself to cry. 
  • Choose who to cry with.
• Try Deborah Derman, PH.D's adult coloring book for getting through difficult times: Colors of Loss and Healing.
• Keep in mind that grief will ease over time. Don't try to rush the time. Each situation is different. We all heal differently.
• If the feelings continue after a few months, studies show that support groups can help. If you don't want to talk in public, there are groups that meet on the telephone. There are also on-line groups in which one can read about other people's experiences and write your own.
• If the feelings become too intense, or result in your being unable to function, seek professional help.

Researched and Written by: Noa Guy, a volunteer
New York, New York

Listen.

• Show you care by being present, listening, and not being judgmental.
• Keep in mind that people are unique and that there is no one right way to grieve. Everyone deserves the time and space to go through the process in any way that feels right to them.

Be supportive.

• Include the grieving person in invitations and activities -- even if they have refused you before.

Be patient.

• Try not to push people through their sadness.
• Expecting people to hurry up and feel better will only hurt them more.

Educate yourself.

• Read the information above about loss and grief to understand more what your family member or friend is going through.

Recognize that supporting others is difficult, stressful work.

• It's more than okay to ask for help. It actually is smart!
• If you're close to the person diagnosed, you yourself are probably grieving as well. So be good to yourself. Exercise, eat healthfully, and try to get a full night's sleep. Take needed breaks.
• Be sure to find someone you can talk to.

Information about caregivers courtesy of Rite Aid Drug Quiz Show

Debrah Shulman, Ph.D. (Educational Consultant and President of The Drug Quiz Show, Inc.)