Grief is a heavy and ever-present topic. How do you deal with the grief of losing someone close? Grief activates the same systems in your body as stress does. It can affect how you function and behave. Grief remains with you for life. It usually eases over time, but it can come back to haunt you in different ways and at different times. You learn to live with it.

Grief work aims to understand the meaning of what has happened and to adapt to a changed life situation. Grief is the price of love and the pain of grief shows that we have lost someone important to us. The following text takes bereavement as its starting point.

What is grief?

Grief is all the feelings, thoughts, bodily reactions and changes in behavior that you may experience in response to a loss or change of any kind. Any major change in life can cause grief reactions. You can experience grief when life doesn't turn out the way you thought it would or when the things you hoped for didn't happen. Grief is therefore a natural part of life, and it is difficult to go through life without experiencing it at some point. Most people have a need to grieve after a loss.

Dealing with grief

Tell others how you feel and what kind of support you need, even though it may feel like no one really understands. Contact a support group. Try writing about how you feel. You can write to the person who has died, for example, and explain your thoughts and feelings. You can also try listening to music, reading books or watching movies about grief. For some people, it helps to see that others feel much as they do.

Try to clarify anything that may be unclear or confusing about the person's death. It is good to take part in ceremonies to say goodbye to the person who has died, such as a funeral. The ritual can help to embody and begin to process what has happened. Some people find it helpful to maintain a sense of presence with the person who has died. Lighting a candle, visiting a special place or saving an object that means a lot. The person who died may have had a blog or social media account that you can continue to post or share on. Grief is a big topic.

Examples of reactions to grief

Some people cry a lot when they grieve, others do not cry at all. Some people want to talk about what has happened, others want to grieve for themselves. The same person may grieve in different ways at different times. Reactions can vary. Here are some examples of reactions that can occur during grief.

• Feelings of unreality.

• Loss and longing for the person who has died.

• Despair and depression.

• Feelings of abandonment.

• Emptiness or meaninglessness.

• Worry or anxiety.

• Anger and irritation.

• Constant thoughts of the person who has died and of death.

• feelings of guilt.

Questions that may arise in grief

You can start thinking a lot about questions of why we exist.
What is the meaning of life?
Why could this happen?
Why am I affected?
How can my life become meaningful again?

Anger and guilt common in grief

You might be angry at the person who died and left you behind, or angry at a doctor who couldn't save them. Or at someone who says something that feels inappropriate or stupid. Guilt is common. Some people feel guilty for being alive when someone they know has died. Others may feel guilty because, for example, they have thought or said something stupid to or about the person who has died. Your feelings and reactions can change quickly.

It can be hard to believe that what has happened has really happened. You may feel numb and cut off from your surroundings. You may not feel anything in particular at all. These feelings can be hard to understand. You may think you should feel sad.

How grief affects you

Grief can affect you in different ways. Here are examples of what you might experience.

• You may feel tired and listless.

• You may have difficulty falling asleep or sleep too little or too much.

• You may have a pain in your head, stomach or elsewhere in your body.

• You eat more or less than you usually do.

• You lose the desire to do things.

• You can get infections more easily.

Concentration difficulties are common in grief

Grief can make it difficult to concentrate or to understand and remember things. You may find it difficult to decide to do things. It may take longer to do things than you are used to. It is also common to feel that the person who has died has come back. There may be brief moments when you think you hear, see or feel the person is with you. You may talk to the person who has died. The grief can feel different depending on what has happened. Perhaps you knew the person was going to die and got used to the idea before it happened. The grief may be felt differently if the person died suddenly and unexpectedly.

Your relationship with the person who died affects the grieving process

Grief can also be influenced by the relationship you have with the person who has died and whether it is an adult or a child who has died. When a child or young person dies, you may also grieve for all the things that person did not have the chance to experience. Everyone grieves differently. It can matter who you are as a person, how old you are, what your upbringing has been like, what you have been through earlier in life, how those around you show grief and what support you have from those around you.

Grief activates the same systems in your body as stress does. It can affect how you function and behave. High levels of stress hormones in the body also affect the immune system. This can make you extra susceptible to infections. Grief sometimes resembles depression but is not the same thing. Grief is not an illness but can still affect how you feel. You may need to stay at home for some time if you are working, looking for a job or studying.

Read more about the options available at efterlevandeguiden.se.

What grief feels like

There are different ways to describe what it feels like to have grief. In the past, grief has been described as something that follows certain phases. Now, research is based on a model in which the grieving person oscillates between two states. One mode is characterized by the loss. The other mode is characterized by the new life without the person who has died. Oscillating between the two modes means that one moment you may think and feel very strongly and find it difficult to cope with the death of the person you are grieving. The next moment, you may think, feel and do things not directly related to the loss or grief.

You can take action on things you want or need to do to create a life that works without the person who has died. Sometimes you may oscillate between the two modes every few minutes. Other times you may be in one mode for longer, perhaps hours, days or weeks.

How does grief affect life?

Learning to live with grief takes different amounts of time for different people. It also depends on the loss that caused the grief. Some people need to talk a lot and get support long after the loss. For many, the first year is the hardest. After that, all the seasons and holidays have passed once and it may be easier to cope with them next time. For others, it is everyday life that is most difficult, with all the routines shared with the person who has died. Some people find the time before a funeral and the funeral itself the hardest, then it can get easier.

Grief lasts a lifetime

Grief lasts a lifetime. But it changes over time. It becomes easier to think about the loss and to learn to live with what has happened. Your experience allows you to deal with the memories in a different way. You may still feel as sad about certain events or days as you did at the beginning of your grief, even after many years. Life may be different than before. Your security and identity may be affected. Other life transitions later in life may feel more difficult. The experiences you gain from what has happened can change you as a person and what you think is important.

Ease your grief

Even if it feels heavy, there are things that can make it easier when you are grieving.

• Eating and sleeping
  Try to eat and sleep at regular times.

• Tell others
  Tell others how you feel, even if it sometimes feels like no one really understands. Others may find it difficult to know what to do or what to say. It's good if you can try to tell them what kind of support you want. Sometimes it can be good to have someone with you even if you don't want to talk.

• Contact a support group.
  Some people find it helpful to talk more with someone or some people who have similar experiences. You can read more about support groups further down in this text.

• Write down your thoughts.
  You can try writing how you feel when you are sad. Both when you are most sad and when you feel less sad. You can write to the person who has died and explain your thoughts and feelings.

• Music, books and movies
  You can also try listening to music, reading books or watching movies about grief. For some, it helps to see that others feel much the same way they do.

• Sorting things out
  Try to sort out things that may be unclear and confusing about the death. This can help you move forward in your grief. For example, you could book a meeting with the staff who cared for the person.

• Ceremonies and rituals
  It is usually good to take part in ceremonies to say goodbye to the person who has died, such as a funeral. The ritual and the memory of it can help make what has happened feel more real.

• Maintaining a sense of presence
  Some people find it helpful to maintain a sense of presence with the person who has died. This could be lighting a candle or performing some other act. It could also be visiting a special place or saving an object that means a lot. The deceased may have had a blog or social media account that you can continue to post on.

• Do things that make you happy
  Grief can feel a little lighter if you can occasionally allow yourself to try to do things that you usually enjoy or that you need to do.

• Physical activity
  It is good if you move regularly. Walking, exercising or doing any other physical activity that is possible for you can help if, for example, you feel restless or anxious, have body aches or have difficulty sleeping. Some people may react to a loss by starting to work a lot or by moving quickly into a new relationship. This may be what they need at the time. For others, it may be better to wait a bit before making big decisions.

• Be patient
  Try to be patient even if your grief is so painful that you would rather not have to deal with it. Be careful with alcohol and drugs so that you do not develop an addiction. Also avoid isolating yourself. 

Complicated grief may require care

Sometimes grief becomes complicated. The grief is often intense at first but lessens over time. Some people may experience complicated grief, which means that their grief is not alleviated. The reasons for this are different for different people. Complicated grief is a diagnosis that requires treatment. You may also need help to process what it was like when the person died or the way it happened. This may be the case if the person died, for example, due to an accident, suicide or murder. You can read more in the article on post-traumatic stress disorder (PTSD).

Therapy for grief

Therapy can help you put the pain and loss into words and make all aspects of grief visible. There may be parts you are not aware of, parts that are particularly difficult or forbidden, or parts that simply need to be better understood. Getting help to reconstruct the death and create a whole story is healing. If you are tormented by intrusive images or other sensory impressions around the death, it may need to be processed in a similar way to post-traumatic stress. Therapy can provide concrete tools for coping when it is difficult, approaching the event and adapting to the new circumstances.

It also provides guidance and support on how to take the necessary steps towards regaining value, meaning and joy in life. Therapy can provide a forum for reflective conversations about the existential questions often raised in grief. Finally, supportive individual or group counseling may also be helpful in normal and uncomplicated grief. This can be particularly valuable if the social network is poor. Just as there are as many ways to grieve as there are people, therapy must always be tailored to the unique needs of the individual.

Grief and relationships

Grief can affect our relationships in different ways. Some people feel they can support each other and find ways to deal with the loss together. Some feel they have their own grief that is too private to share with others. Some feel more vulnerable. This may depend on what has caused the grief. Vulnerability can make you say things you don't mean, or blame a loved one, for example, for what has happened. Vulnerability can also make you avoid other people. For others, vulnerability makes them seek more support and be more cautious in the way they talk to each other. Seek support if you feel that you are unable to support each other but need support. Sometimes it may be possible to share your grief with other people around you.

The important thing is that you, as a caregiver, show that you care and don't think you have to have a solution to the situation the person is in. Ask how things are and don't be afraid to interrupt. It is common for the grieving person to want to talk about the person who has died and tell you how they feel. Listen, and try not to give advice. You can also talk about other everyday things or just be quiet, if the person seems to prefer it.

You can suggest that you do something together. Maybe you can help with some everyday chores. It could be cooking, cleaning or going shopping. Make contact yourself and preferably several times, even if you have been rejected before. Make concrete suggestions about when you should spend time together.

Working through the grief ahead

Grieving is a time- and energy-consuming process that has no time limits. We all grieve in different ways and the expression of grief can also change within an individual from time to time. It is important to allow the grief, however it appears. Usually, people oscillate between loss-oriented behaviors and future-oriented reorientation work, which aims to adapt to the new circumstances. To move forward, both processes are equally important. Gradually, life starts to regain its colors and one experiences meaningfulness and joy of life again. Some may feel guilty or fear forgetting the person who died.

But remember that you can both grieve and move on. Grief produces all kinds of somatic, emotional and cognitive reactions and they can change rapidly. Sometimes you may be afraid of your own reactions, thinking you are going mad, seriously ill or that you will never get back to a functional life again. Sometimes the grief is so painful that it feels like you won't survive, but you will! The best thing you can do is to be gentle with yourself and lower your standards.

It is not uncommon to wonder if there is any meaning to life at all. It can help to do things that feel meaningful instead. Moving on requires an accepting approach to what has happened. This means recognizing reality as it is, not that you need to think that what has happened is okay.

Saying goodbye to the person who has died and understanding closure is important for healing. Therefore, funerals and other forms of ceremonies are important. For many, seeing the deceased is de-dramatizing, and the peaceful atmosphere becomes a nice memory. If you have any doubts about the death, it is good to clear them up as far as possible. Moving on requires both emotional and rational acceptance of the death while maintaining a presence with the person in your life. The loss of the person may never go away, but the pain will ease over time. It can be felt in different ways and at different times. Once the most difficult time is behind us, many people experience a deeper connection with themselves, life and what is really important. Some feel a greater sense of gratitude and appreciation for life.

Silence is more important than words and listening without giving advice or encouraging comments is healing. Encountering grieving people can bring up feelings you think you can't handle. Unfortunately, this can lead to withdrawal and silence, which is not what the grieving person needs. Grief reduces the ability to take initiative, and here you need to take courage and take responsibility for the contact. Another person's suffering can give rise to an impulse to say and do the right things.

When the worst has already happened, there is nothing you can do to take away the pain. Warmth and care are key, but not treating the grieving person as fragile to be treated with kid gloves. You can ask the grieving person how you can be of support, or ask if what you just did was helpful. It is not uncommon for both coping and problem-solving skills to be impaired in the grieving person. Providing practical support with everyday tasks is as supportive as it is emotional.

Acceptance and patience

If you meet a person in mourning, you need to have acceptance and patience for all expressions of grief. Don't take statements and attacks personally, but see them as an expression of the grieving person's pain. Initially, ruminating may serve the purpose of putting together the picture of what has happened. After a while, however, a diversion from rumination in favor of more constructive and forward-looking reasoning may be necessary. Finally, be present for a long time, much longer than you think. Many people find that as soon as they start to feel better and become more active again, support and interest from those around them wanes. For those who have lost a significant person, it can be warming if you pay attention to important dates, anniversaries and holidays.

There are many similarities between the needs of adults and children in grief. Children's understanding of death is generally different from that of adults, and children process loss according to their age and frame of understanding. The younger the child, the more they will express their grief in ways other than words. How children react to grief is highly individual but some common reactions are: Worry, anxiety, increased need for closeness or difficult to comfort. Vigilance, separation anxiety and fear of abandonment. Difficulty sleeping, nightmares, stomach ache or other pain. Anger, self-destructive or attention-seeking behaviors, withdrawal, isolation or difficulties at school, sadness, longing and missing, guilt, self-reproach or brooding, painful memories, magical thoughts or fantasies.

Supporting a child in grief

Children need adult support to understand the meaning of death and regulate their grief reactions. Adults can help children put their experiences into words, but also support them in other forms of expression such as play, music, drawings and other creative activities. To reduce anxiety and rumination, children need to be involved in what has happened. Let the child's own questions and concerns guide the information you provide and be honest about what you know and cannot answer.

What the child is mature enough to ask about, he or she is also mature enough to receive a sincere answer. Tell the story in a factual and concrete way without paraphrases or metaphors. Use the child's own words and provide only the details they need to understand. Children's reactions to a death reflect not only their own grief and loss but also their parents' reactions. As a parent, you can certainly show and tell that you are affected by what has happened, but you need to be able to convey that you are able to meet the child in their grief, otherwise they may hold back questions or reactions.

If a parent dies

When a parent dies, the child needs the other parent. Naturally, the surviving parent may need support and relief to be able to provide this support. If both parents die at the same time, the support of someone the child feels safe with can be life-changing. In general, extra adults can be a great support for the whole family by providing everyday activities, play and conversation. Children often rest from their grief and may at times seem completely unaffected by what has happened. When the ground is shaking after a loss, it becomes particularly important for safety that as much as possible returns to normal as quickly as possible.

As a parent, it can be helpful to avoid unnecessary separations from the child and make an extra effort for a while to provide reassurance and presence. In general, it is good for children to make the loss real by participating in goodbyes, rituals and funerals. How this is done, like any other support, needs to be tailored to the individual child. However, allowing plenty of time to prepare beforehand and reflect together afterwards is helpful.

Professional help for children in grief

For grieving children, parental support is the most important and usually sufficient. However, parents can get advice and support from professionals on how to deal with their child. There are an increasing number of books for children and young people who are grieving. Furthermore, bereavement groups for children can be a good option for those who need extra support. It is only when grief reactions do not ease over time or even intensify that professional help is needed. If the child was present at the time of death, found the deceased, is troubled by memories, has significant changes in behavior, or has thoughts of no longer wanting to live, these are warning signs that professional help may be needed.