Humans are primarily social animals and the death of a loved one typically triggers a powerful grief reaction. Although individuals differ considerably in their reactions to a loss (both with regards to symptoms and time-scales) a grief reaction broadly corresponds to a sequence of stages:
1. Disbelief: A sense of unreality, or a denial that the person has actually died. Searching behaviour, where the bereaved “sees” the deceased loved one in the street or when they expect him or her to walk through the door, would be common examples of this stage
2. Anger: Annoyance, even rage, about the loss directed at God, the deceased person, or the world at large.
3. Sadness: As the reality of the death sinks in, profound sadness is commonly experienced, often described as a physical pain at the core of the survivor’s being.
4. Acceptance: Eventually, some sort of ring-fence is put around our grief so that we can continue with our lives without our grief impacting continually on our functioning.
Although often extremely painful, and negatively impacting on a person’s level of functioning, grief is a normal reaction. Contrary to the assertions from the latest edition of the DSM psychiatric diagnostic system, grief is not a mental disorder or mental illness, but a process that needs to be negotiated and worked through. Most of us will have emerged from the main paralysis of bereavement within 12 to 24 months after the death. Some behaviours following the death may delay or complicate the grieving process if they continue for too long, for example refusing to talk about the deceased, avoiding any reminders of the deceased (such as photographs or the grave), or refusing to disturb the deceased’s belongings.
While grief in itself is a natural response to loss, it can sometimes elicit more serious mental health problems such as depression and agoraphobia. People who have unfortunately been deprived of good attachments (positive, affirmative relationships) in their lives or who have always been overly dependent on just one person might be particular vulnerable to the death of a loved one. Thus, it is no coincidence that rates of depression are higher in older people who commonly have to endure multiple losses.