Mental Health: Understanding grief and mental wellbeing

Mental health is a state of well-being in which an individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a meaningful contribution to their community.

Mental health is a critical component of individual, family, community and national wellbeing and prosperity. Grief is a natural response to loss.

Loss comes in many forms but in whichever form it comes to us, we feel the pain of loss because of our love and attachment to that which we have lost.

 Loss comes with many questions and with many emotions. Loss will challenge our view of life, shift our paradigms and change our narratives.

What losses can cause us to grieve?

Grief commonly occurs due to death, however there are a range of losses that can also trigger the process and emotions of grief.

1. Loss through death: We grieve a loss through death because we love and are attached emotionally to the one who has passed. Though most of us are aware that death is an inevitable part of our lives, it is still a challenging process each time someone we love dies, you never get used to it. Death is an unwelcome guest, one you can’t turn away, one you begrudgingly make space for and accommodate.
2. Relationship changes and estrangement: Loss of a relationship, of a marriage, changes in the nature of a relationship also trigger a grieving process.

Again we grieve because we have loved, we have lived a life together, shared a life. The changes that result from a separation or divorce can cause us to grieve as we have to detach from someone we have been bonded to emotionally and psychologically. Changes in relationships can also occur when our children have grown and now leave our homes or marry and start their own families. This, though a joyous moment, can be bittersweet as we learn to transition into a different way of loving and caring for them.

3. Changes in sense of purpose and identity: Changes in job status, loss of employment, change in the nature of the work you do, changes in work structure such as having to work from home or having to transition back to the office can also trigger a grief process. Transition phases such as finishing school and retirement can also trigger grieving. Significant financial loss, loss of a home and other significant property can result in loss of security and we will grieve over such losses as well.
4. Changes in health: Severe, life threatening or debilitating illness or injury in ourselves or our family or friends can cause us to grieve. Facing our own terminal illness maybe one of the most challenging grief processes we may have to face.
5. Facing one’s own death: Some of us may have the opportunity to prepare for our own deaths, we may have a chronic or terminal illness or we may be in our old age and start to anticipate the end of our lives. This can be difficult. Facing ourselves, we may reflect on the journey we have travelled in our lives, making amends, seeking and finding peace and contentment that it is well, that our lives have had some meaning and purpose and if not making peace with that too. It is a journey of letting go.

Complicated loss

Certain losses can make it particularly difficult to walk the journey of grieving to healing. They may result in complications in what would usually be a natural response to loss due to the very nature of the loss.

1. Pregnancy loss and still births: Loss of a pregnancy or the loss of an unborn child can be a very lonely loss, grief faced alone because in many societies and cultures, early pregnancy is often kept hidden or secret. This can make it difficult to share the loss of the pregnancy publically and grieve openly. This can lead to a greatly disenfranchised or unacknowledged grief. Some may experience a sense of guilt often wondering if they could have done more to prevent the loss. Pregnancy is often strongly linked to a woman’s sense of self, childbearing often being linked to self-esteem in many women. Furthermore many cultures often encourage couples to try and conceive again as soon as possible in order to get comforted by a new child. This may not allow much time for the healing process of grief to occur and can complicate our grief.
2. Death of a child: death of a young child is always an unnatural loss and is considered one of the most difficult losses in human life. It is a loss of what we believed would outlive us, of the future we dreamt of. It can shake our beliefs of what is right, what is just, what is fair, what is the natural order of things. We can lose our bearings as the predictability of life is shattered. The death of a child can affect the parent’s marriage as spouses struggle to grief and comfort one another. The death can also affect any surviving children who may be overlooked in the wake to such a tragedy.
3. Death of a young spouse: no one marries with the intent of becoming a young widow or widower. In fact society’s view of a widow is often a frail, older woman and a widower, an equally frail older man both comforted and cared for by their adult children and dotted on by grandchildren. No one imagines losing their spouse in their prime of life and left alone in our youth. You may feel out of step with your age mates, out of timing. Young widowhood is altogether a very ill defined role. Such a death comes with its own unique challenges… becoming a single parent, running a household alone, financial pressures and social isolation as age mates are preoccupied with their own families.
4. Loss of parents for a young child: Children will many times outlive their parents but again the expectation is that we will lose our parents when are adults and parents ourselves, when we have our own families and support systems to help us cope with what is a natural process. This is not so when a parent dies young and leaves young hearts not yet ready to face the world without the protection and love of a parent. Loss of a parent in childhood is also the loss of their whole world, they most probably have no capacity of their own to turn to for comfort. Children are heavily reliant on others to help restructure and rebuild from the loss. Without adequate support and sometimes even with all the support provided this can still result in a complicated and prolonged grieving process, a lifetime of grief for some.

How does grief affect us?

Grief is an emotional, physical, behavioural, cultural and spiritual response to loss. Emotionally, when we grieve we may struggle with sadness, despair, anger, frustration, fear, anxiety, regret, guilt. Our emotions may be confusing and conflicted, intense or numbed. Physically, we may feel exhausted, we may struggle to sleep, our immunity may be affected and we fall ill easily, we may struggle with many aches and pains. We may struggle to eat, lose weight or gain weight as we eat for comfort. Socially, we may feel isolated and alone, we may withdraw from others, we may struggle to maintain our remaining relationships. Spiritually, we may struggle to find meaning again, we may question our very beliefs and our value system may be shaken as we ask…what is the meaning of life, what really matters in life.

How can I work through my grief for better mental wellbeing?

1. Accepting and adjusting to the reality of the loss: participate in funeral and memorial processes
2. Acknowledging and processing the emotions of grief: Learning to acknowledge and express how we feel, for this we need emotional literacy, emotional authenticity, vulnerability and emotional accountability
3. Allow yourself to grieve and live at the same time: Alternate between "loss" and "restorative" activities; Loss-related activities (looking at photos of the deceased, crying, talking about the person) and restorative exercises (making plans for the future, spending time with others, eating, sleeping)
4. Remaining connected with others around you: Strong relationships are psychologically protective, allow yourself to be vulnerable to a few close people, allow people to see your pain
5. Finding meaning and purpose beyond our loss: We do not die with our loved ones, as we mourn for the dead let us not give up on living for those still living.

If you think that you or someone you know may be struggling with grief, please contact your nearest health care provider and get help.

•  Dr. Chido Rwafa-Madzvamutse is a consultant psychiatrist. Feedback on WhatsApp: +263714987729; LinkedIn: https://www.linkedin.com/in/chido-rwafa-madzvamutse-53529259/  ; Facebook: https://www.facebook.com/chido.rwafa)