Grief and survivorship

Separation, sickness and death. These are an inevitable part of life and understandably result in much distress and anguish. Most people undergo a transient period of emotional turmoil and transit through the various stages of grief over time. The 5 stages of grief are Denial, Anger, Bargaining, Depression and finally, Acceptance. 

In a “normal” grief reaction, one may experience denial, disbelief and emotional numbing for the first few hours to days. One then develops depressive and anxiety symptoms which can last for several weeks to months. This may be accompanied by feelings of anger, guilt, blaming, and irritability. In 10% of survivors, there could be illusions or hallucinations of the deceased’s voice. Most survivors progress to the final stage of grief within 6 months, where they slowly gain acceptance towards the loss, regain their ability to perform their social and occupational roles. Memories of the good times are retained, while the anguish over the loss diminishes significantly. 

It is important to recognize that we all deal with loss and grief differently, and individual responses vary greatly. It is also worth noting that the above symptoms of depression, anxiety and anger can recur during the death anniversaries or other significant occasions (e.g. birthday, wedding, special occasions and festivals). 

Nevertheless, there are minority cases where the grief reaction is so intense, protracted or distorted, that it severely hampers the ability of the survivor to lead a normal life. We call this an abnormal grief reaction, also known as complicated grief or pathological grief. 30% of those who have such reactions meet the diagnostic criteria for Major Depressive Disorder, and most will benefit from professional help.