The emotion of grief may be triggered by the loss of a loved one or the result of a life circumstance. Many people believe that if you have effectively mourned a loss you will then achieve closure. The notion that one mourns a loss and then gets over it, to the extent that emotions about the loss are not triggered in the future, is a myth.
Similarly, children have such expectations about getting over loss. They seem to believe that one needs to do something in particular in order to achieve that goal. Several years ago, as host of a radio talk show for kids, I asked listeners about the issue of loss. An 8-year old boy told me that his grandfather had died two weeks before and he wanted to know how to get over it-he thinks about him all the time and can’t concentrate on anything else. A 12-year old boy explained that his dog had died and he wanted to know what to do since he couldn’t say good-bye to her and didn’t think that he could ever “fill [his] heart with anything else.” I didn’t ask what he meant by his choice of words, however, I felt its meaning. A 13-year old girl said that she asks her brother about what clothes look good on her because she doesn’t have a mom. Ever since her mother died several years before, her dad, she claimed, tries to be both a mom and dad. But it always feels like something is missing. She asked, “How do I get over my mom dying?”
The misguided notion that grief is a process that allows a final working through of a loss is likely the fault of my own profession–mental health professionals who have promoted this notion in their work with grieving individuals. Clinical data makes it clear that any significant loss, later and repeatedly, brings up longing and sadness. Is it because these people have not achieved closure by traversing prescribed stages of mourning or because they have not “worked through the loss” as some therapists boldly claim? No. It’s because you never get over loss. As time passes, the intensity of feelings about the loss will lessen, you might also find ways to sooth or distract yourself, or you can partially bury grief-related feelings by creating new memories. But you’re not going to get over it because that’s impossible: you cannot erase emotional memory. Besides, it’s not about achieving closure. Instead you have to figure out what you are going to do when your emotional memories are later triggered.
Emotions that have to do with loss are triggered throughout our lives and you will live with them. Usually they are in the form of anniversary reactions, such as the birthday or death day of the lost loved one or any significant holiday in which you might want to be with the person who is gone. Reminders, such as visiting a place you’ve been with the person you lost, will trigger a similar response. In episodes of depression and high anxiety in patients, I always look for anniversary reactions and situation-matching reactions, such as when emotions are triggered and people just can’t understand why they would be anxious or depressed.
Grief can also be triggered by an age-matching anniversary reaction, which is when a person’s age matches the age of a parent when they died. The remarkable power of age-matching anniversary reactions arising from the loss of a parent in childhood was demonstrated to me when I began training as a psychologist over 30 years ago. I had been treating a severely depressed man who, for many months, was not responsive to intensive psychotherapy or medication. Upon discovering with the patient that his depression began at a time in which his age matched his father’s age of death, the depression miraculously lifted. Beneath his depression lay a myriad of fears that he would be like his father, which included dying at the same age of his father as well as guilt that he was not like his father and could live a full life. Although he had been unaware of the age factor, his painful feelings seemed to recreate the trauma of his father’s death, which was too overwhelming for him to feel when he was ten years old.
One of the reasons that grief happens to be triggered by external reminders, such as in anniversary reactions, is because grief is an emotion that sends a vague alert to help you to remember, rather than to forget. Even so, what most people do with grief is attempt to forget–to get over it-which is quite contrary to the purpose of the emotion. Rather than try to forget, one must attempt to remember and cooperate with what your emotion is trying to convey. There are many ways to remember. You can remember what you learned from the person you lost, remember what you enjoyed, and you can cry if you feel like crying. Even if your grief is about a relationship gone bad, there is always something that you can learn by remembering it.
There are related themes of loss that people express, and later grief responses related to those losses, such as the many women and men who have given up a child for adoption. The child’s birth date does not pass by without an emotional reaction, whether or not they recognize it at the time. Similarly, the date a child would have been born for a childless woman who has had a miscarriage can trigger grief. The experience of loss when a relationship ends can be triggered on the former partner’s birthday, on the anniversary of when you met, or on any holiday.
Whenever I am bothered by the thought of just how misguided the notion of stages of grieving can be, I remember one patient in particular who wanted help with the depression she had every summer, which at the time she told me was when her 12-year old child had died 25 years before. She sought therapy because she was convinced that something was wrong with her. Every June, for 25 years, she had experienced a grief response. Simply knowing that she wasn’t crazy because of the intense affect that came up for her made it a bit easier the next time June arrived. And, rather than try to get rid of her painful feelings at the time, instead she learned to think about exactly what she would do to remember her son.
Henry Wadsworth Longfellow sums up the lifelong experience of grief in the first 3 lines of his poem, Secret Anniversaries Of The Heart:
The holiest of all holidays are those
Kept by ourselves in silence and apart;
The secret anniversaries of the heart.
Jeg er så sint, irritert, lei! Når skal min stemme og min mening komme fram? Når er jeg god nok til å få ta en beslutning? Dette er egentlig bare for meg selv. Har hele tiden vurdert om jeg skal skrive noe ned her. Om jeg skal ta det på private eller passordbeskyttet, men hva er meningen å gjøre det? Jeg virker bare svak ut hvis jeg gjør det. For da kommer jeg uansett ingen vei med dette. For å være helt ærlig så skjønner jeg ikke hvorfor dere orker å lese igjennom alt. Hva er det som er så interesant med alt dette? Jeg er glad for at dere leser, men forstår det bare ikke. Idag flyttet jeg på meg igjen til min mors hus. Hvor jeg skulle bo alene til i morgen kveld. Hun ringer og spør om jeg har kommet meg bort eller om jeg ble hos faren min. Vi snakket en god stund, men til slutt så forteller hun at min mormor og morfar kommer her på Torsdag. Jeg skjønner at hun vil ha noen her å ferie det. Men hvor kommer jeg i bildet? Og hvorfor akkurat den dagen?
For akkurat den dagen skal jeg har 24 timers blodtrykksmåling og det er min mors bursdag. Det er ikke noe jeg gleder meg til. Jeg har planlagt hva jeg skal ha på meg for at det ikke skal synes. Jeg skal fortest mulig hjem og bare legge meg og håpe på at ingenting gale skjer. Det er den dagen jeg vil bare grave meg langt ned. Jeg er flau over meg selv at jeg må utføre dette. At ting er galt og ikke fungerer helt normalt. Jeg forstår ikke helt hvordan jeg skal klare å holde ut den dagen. Og dette ble bare forsterket når jeg fikk vite at de skulle komme. Så nå er det bare 3 dager igjen til dette skjer, men først så er det legetime. Jeg er nervøs på at de finner noe eller at de ikke finner noe.. Jeg føler meg ikke noe bedre, jeg føler at jeg bare blir verre og verre. Jeg har ikke matlyst og alle sier at jeg må presse i meg mat. Og dette vet jeg selv, men jeg klarer det ikke.
For å være helt ærlig så skjønner jeg ikke helt hva og hvorfor jeg har skrevet noe. Jeg føler det ikke gir noen mening, som dere ser så har jeg ikke vært noe aktiv her. Og fremover så vil det nok være sånt på grunn av at jeg må bli bedre. Jeg må få litt mer krefter og få alt i gang igjen. Men jeg regner med at jeg kommer til å oppdatere i løpet av helgen kan jeg tenke meg.
Jeg føler alltid at jeg må gjøre ting. At det alltid er noe som alltid bestemmer over meg, men jeg vet at det bare er tankene som er inni hodet mitt. Jeg har ikke lyst å ha tankene, men det er ikke lett å få dem vekk. Jeg har tanker som sier at jeg må åpne meg. Jeg må fortelle alle hvordan jeg har det, men for å være helt ærlig så vil jeg ikke det. I starten når jeg blogget så var alle innleggene mine passordbeskyttet. Jeg har et passord som er veldig sårbart og det er et ord jeg aldri klarer å glemme. Men jeg har også innlegg som er bare for meg selv. Der drømmene mine og tankene mine kommer fram. Hvor jeg har skapt et fantastisk verden som jeg aldri klarer å gi slipp. For planen min var ikke å åpne meg for noen. Jeg skulle ha alt for meg selv, og jeg ville ikke en gang fortelle det til noen av vennene mine, for jeg er redd. Jeg er redd for at de skal bli redde for meg og at de skal få et annet syn på hvordan jeg er. Jeg er ikke helt den personen de kjenner. Uansett om det er en del de vet så er det ikke alt. De får vite den positive, men aldri den negative. For det er jeg ikke klar for enda.
Jeg har en bestevenn som jeg snakket med og var ærlig mot i opp til 2 1/2 år. Men nå etter sommer så er jeg redd. Jeg tør ikke. Jeg fikk tanker om at jeg ikke måte fortelle noe til henne. For jeg visste ikke hvordan det ville ende. Kom jeg til å dø? eller kom hun til å fortelle dette til moren min?
Jeg vet at det som er viktig for meg nå som vil bli bedre og komme meg vekk i fra alt depresjon. Må være mer åpen om alt. Det vil ta tid. Og jeg vet ikke når jeg er klar for å fortelle noe til mine venner. Jeg har ingen anelse om det, men en dag så vil jeg fortelle det. Og jeg vil skrive her om alt. Om hvordan jeg har hatt det. Hva tanker jeg har osv. Men jeg vet ikke når jeg er sterk nok. Jeg er i en veldig sårbar periode hvor jeg reagerer på musikk, film, tekster og alt som er rundt meg. Så fra det ene sekundet så kan alt mørkne helt for meg. Men jeg vet at om noen dager så vil alt være mye bedre igjen.
Så jeg vil bare si tusen takk for alle som har lest. Det betyr utrolig mye for meg. For dette har hjulpet meg og har gitt meg motivasjon til å fortsette med å bli friskere. / So I just want to say thank you so much to everyone who has read it. It means so much to me. For this has helped me and has given me the motivation to continue to get mentally healthier
Her er noen av de bildene jeg har hearted på We Heart It. Det har vært veldig blandende følelser denne uken. Og bildene jeg liker på We Heart It viser dette veldig godt. Jeg hadde mange gode dager, men også etterhvert så begynte det å bli tøffere og mye vanskeligere. Jeg har savnet New York City noe ekstremt denne uken. Jeg aner ikke hvor mange filmer jeg har sitt på de siste dagene hvor det var filmet i New York. Håper virkelig at jeg snart får reise ned igjen og bare være der i mange uker.
Recovery can take time. As well as getting treatment underway, the person has to find new ways to manage, and live with, the changes and challenges of having depression and/or anxiety.
While psychological and/or medical treatment can help with a person’s recovery, there are many other ways people can help themselves to get better and stay well. Below are some practical tips on how to manage depression and anxiety.
- How to stay well
Learn new ways to reduce and manage stress
Stress is common in daily life, but exposure to prolonged stress can start to affect your mental and physical health. Whatever the cause, here are some simple steps that can help you to reduce and manage stress:
- Making major changes in your life can be stressful at any time. If you’re feeling stressed or anxious, it’s probably a good idea to try to avoid moving house or changing jobs. Leave them to a time when you’re feeling better.
- Ongoing stress in personal relationships often contributes to depression and anxiety. Learn how to let people know about your feelings so that you can resolve personal conflicts as they come up. Talking to a counsellor or psychologist can help you find ways to address your problems.
- Learn to relax. To do this, you need to allocate time to do the things you enjoy, such as exercising, meditating, reading, gardening or listening to music.
- Take control of your work by avoiding long hours and additional responsibilities. This can be difficult, but small changes can make a difference.
- Learn to say ‘no’. Create a balance between work and the things you enjoy doing. Don’t allow yourself to be overwhelmed by new commitments.
- Include short-term coping strategies in your day, such as breathing and relaxation exercises. Listen to a guided progressive muscle relaxation exercise.
Eating healthily, exercising regularly, getting enough sleep and avoiding harmful levels of alcohol and other drugs can help a person to manage the symptoms of depression and anxiety.
Tips for eating well
Having a mental health condition can make it difficult to eat well, but keeping things simple can help. Here are some tips:
- Keep a daily timetable and include food-related activities such as shopping, cooking and eating.
- Learn to prepare simple meals that don’t take too much time or energy to prepare. If you live on your own and aren’t eating proper meals, consider using frozen or home-delivered dishes.
- Make use of the times when you feel good to prepare meals ahead of time (e.g. if you’ve got energy in the morning, make dinner then) or cook large quantities of food and freeze it.
- Find out more about healthy eating by downloading Healthy eating for people with depression, anxiety and related disorders fact sheet.
Tips for getting active
Physical exercise such as walking, swimming, dancing, playing golf or going to the gym can help relieve the tension in your muscles, relax your mind and distract you from negative thoughts and worries. Try to do some physical exercise every day, even if it’s just going for a walk. Keep it simple and enjoyable. Here are some tips to get you started:
- Increase activity levels gradually. Start by planning simple daily activities such as shopping, driving, gardening, writing emails or completing simple household tasks. Completing these activities can increase a person’s self-confidence and build the motivation needed to take on more energetic activities.
- Plan activities that are enjoyable, interesting, relaxing or satisfying. These activities are important in overcoming depression and anxiety. At first, they may not feel as enjoyable as before, but with persistence, the pleasure should eventually return.
- Participate in activities with family members and close friends, and accept social invitations, even though it’s the last thing you may feel like doing. Keeping connected with people helps increase levels of wellbeing, confidence and opportunities to participate in activities.
- Planning a routine can help you to become more active. Make sure some form of exercise is scheduled in for each day. Try to stick to the plan as closely as possible, but be flexible.
- Download Keeping active fact sheet.
Tips for getting a good night’s sleep
Depression and anxiety can disrupt sleep patterns. It’s essential to try to restore a regular sleep pattern to make a full recovery, so here are some tips:
- Try to get up at about the same time each morning.
- If you’re worrying about things during the night, set aside some time for problem-solving during the day.
- Avoid drinking caffeine after 4pm and try not to drink more than two cups of caffeine-type drinks (e.g. coffee, strong tea, cola or energy drinks) each day.
- Avoid using alcohol to help you sleep. As the alcohol is broken down in your body, it causes you to sleep less deeply and to wake more frequently.
- Allow yourself time to wind down before going to bed. If you are working or studying, stop at least 30 minutes before bedtime and do something relaxing.
- Download tips for sleeping well from Sleeping well fact sheet.
Tips for reducing alcohol and other drugs
It’s a good move to try to reduce the use of alcohol and other drugs, as they can cause long-term problems and make it much harder to recover. It’s also a good idea to avoid stimulants, in particular excessive amounts of caffeine and any kind of amphetamine (speed, ecstasy, ice), as these can worsen symptoms of depression and anxiety. Find out more by downloading .How to stay well The recovery process does not necessarily have a clear beginning, middle and end. Some people will only experience one episode of depression or anxiety in their lives, while others may go on to have another episode, or experience recurring symptoms of depression and/or anxiety.
There are some situations or events that can bring on an episode of depression and/or anxiety. These situations or events are referred to as ‘triggers’. Common triggers include family and relationship problems, financial difficulties, changes in living arrangements, changing jobs or losing a job, having other health problems and using alcohol and other drugs. Trying to avoid or manage these triggers can be an important part of recovering. For example, if you can’t avoid a certain situation that you think might trigger an episode, you may be able to manage its impact through stress management techniques or learning how to resolve conflicts early.
Warning signs are signals that a person may be feeling depressed or anxious and it’s a good idea to learn how to recognise these signs. Family members and friends may notice changes in the way a person thinks, acts or feels. Some common warning signs include:
- getting up later
- finding it hard to concentrate
- skipping meals and eating unhealthily
- having disturbed sleep
- feeling irritable, stressed and teary
- withdrawing socially or wanting to spend a lot of time alone.
People can learn to identify their own warning signs by reflecting on what symptoms they’ve experienced in the past.
Getting over setbacks
Setbacks can be disappointing and getting over them can be difficult. When people relapse, it can be easy for them to fall into the trap of thinking that they will never feel well again. However, it’s important to understand there are ways of moving through this stage:
- People shouldn’t blame themselves. Remember that setbacks are bound to happen and feeling disappointed can make moving on difficult.
- Try again. Learning how to manage anything new can be about trial and error. Persistence is the key.
- Focus on achievements. Feeling depressed and anxious can make it hard to see the good side of things. People should focus on what they have gained and use this to move on from setbacks.
- Learn from setbacks. A relapse can help people evaluate their situation and, with the help of a health professional, find new ways to manage their condition. This can make people more able to cope with feeling unwell and may help prevent further setbacks.
Hvorfor er det akkurat meg som skal være syk, men ikke får hjelp? Jeg har vært syk i 3 uker idag og jeg blir bare verre. Jeg kjenner at jeg mister bare mer og mer av håpet for hver dag som går. Jeg føler meg isolert på grunn av at jeg ikke får kommet meg ut. Orker ikke å være på facebook eller ta kontakt med noen.
Jeg blir kvalmen av minste bevegelse og det slutter ikke med det for jeg blir svimmel etter en stund også. Alt har snudd helt på hodet. Jeg jobber på et sykehus som helsefaglærling og her sitter jeg selv syk, men de finner ikke ut av det. Jeg har vondt av å puste i lengden og kan ikke anstrenge meg noe lenger.
Jeg skal ta en del undersøkelser framover. Det blir blodprøver på mandag av alt, blodsukker og på fredag har jeg time igjen hos legen. Den 29 Januar så skal jeg ha 24 timers blodtrykksmåling og har blitt henvist til nevrologisk avd på sykehuset for å sjekke nervene på grunn av svimmelhet. Jeg spiser nesten ikke, jeg vet ikke hva jeg kan spise lenger. Jeg er trøtt hele tiden. Jeg har ikke orket til noe annet enn å ligge i sengen.
As with depression, it’s often a combination of factors that can lead to a person developing anxiety.
Family history of mental health problems
People who experience anxiety often have a history of mental health problems in their family. However, this doesn’t mean that a person will automatically develop anxiety if a parent or close relative has had a mental illness.
Stressful events can also trigger symptoms of anxiety. Common triggers include:
- job stress or job change
- change in living arrangements
- pregnancy and giving birth
- family and relationship problems
- major emotional shock following a stressful or traumatic event
- verbal, sexual, physical or emotional abuse or trauma
- death or loss of a loved one.
Physical health problems
Continuing physical illness can also trigger anxiety or complicate the treatment of either the anxiety or the physical illness itself. Common conditions that can do this include:
- hormonal problems (e.g. overactive thyroid)
- heart disease
If there is concern about any of these conditions, ask a doctor for medical tests to rule out a medical cause for the feelings of anxiety.
Heavy or long-term use of substances such as alcohol, cannabis, amphetamines or sedatives can cause people to develop anxiety, particularly as the effects of the substance wear off. People with anxiety may find themselves using more of the substance to cope with withdrawal-related anxiety, which can lead to them feeling worse.
Some research suggests that people with certain personality traits are more likely to have anxiety. For example, children who are perfectionists, easily flustered, lack self-esteem or want to control everything, sometimes develop anxiety during childhood or as adults.
Everyone is different and it’s often a combination of factors that can contribute to a person developing anxiety. It’s important to note that you can’t always identify the cause of it or change difficult circumstances.
The most important thing is to recognise the signs and symptoms of anxiety and to seek help. The sooner you seek help, the sooner you can recover.
There are different types of depressive disorders. Symptoms can range from relatively minor (but still disabling) through to very severe, so it is helpful to be aware of the range of disorders and their specific symptoms.
Major depression is sometimes called major depressive disorder, clinical depression, unipolar depression or simply depression. It involves low mood and/or loss of interest and pleasure in usual activities, as well as other symptoms. The symptoms are experienced most days and last for at least two weeks. Symptoms of depression interfere with all areas of a person’s life, including work and social relationships. Depression can be described as mild, moderate or severe; melancholic or psychotic.
This is the term used to describe a severe form of depression where many of the physical symptoms of depression are present. One of the major changes is that the person can be observed to move more slowly. The person is also more likely to have a depressed mood that is characterised by complete loss of pleasure in everything, or almost everything.
Sometimes people with a depressive disorder can lose touch with reality and experience psychosis. This can involve hallucinations (seeing or hearing things that are not there) or delusions (false beliefs that are not shared by others), such as believing they are bad or evil, or that they are being watched or followed. They can also be paranoid, feeling as though everyone is against them or that they are the cause of illness or bad events occurring around them.
Antenatal and postnatal depression
Women are at an increased risk of depression during pregnancy (known as the antenatal or prenatal period) and in the year following childbirth (known as the postnatal period). You may also come across the term ‘perinatal’, which describes the period covered by pregnancy and the first year after the baby’s birth.
The causes of depression at this time can be complex and are often the result of a combination of factors. In the days immediately following birth, many women experience the ‘baby blues’ which is a common condition related to hormonal changes, affecting up to 80 per cent of women. The ‘baby blues’, or general stress adjusting to pregnancy and/or a new baby, are common experiences, but are different from depression. Depression is longer lasting and can affect not only the mother, but her relationship with her baby, the child’s development, the mother’s relationship with her partner and with other members of the family.
Almost 10 per cent of women will experience depression during pregnancy. This increases to 16 per cent in the first three months after having a baby.
Bipolar disorder used to be known as ‘manic depression’ because the person experiences periods of depression and periods of mania, with periods of normal mood in between.
Mania is like the opposite of depression and can vary in intensity – symptoms include feeling great, having lots of energy, having racing thoughts and little need for sleep, talking fast, having difficulty focusing on tasks, and feeling frustrated and irritable. This is not just a fleeting experience. Sometimes the person loses touch with reality and has episodes of psychosis. Experiencing psychosis involves hallucinations (seeing or hearing something that is not there) or having delusions (e.g. the person believing he or she has superpowers).
Bipolar disorder seems to be most closely linked to family history. Stress and conflict can trigger episodes for people with this condition and it’s not uncommon for bipolar disorder to be misdiagnosed as depression, alcohol or drug abuse, Attention Deficit Hyperactivity Disorder (ADHD) or schizophrenia.
Diagnosis depends on the person having had an episode of mania and, unless observed, this can be hard to pick. It is not uncommon for people to go for years before receiving an accurate diagnosis of bipolar disorder. It can be helpful for the person to make it clear to the doctor or treating health professional that he or she is experiencing highs and lows. Bipolar disorder affects approximately 2 per cent of the population.
Cyclothymic disorder is often described as a milder form of bipolar disorder. The person experiences chronic fluctuating moods over at least two years, involving periods of hypomania (a mild to moderate level of mania) and periods of depressive symptoms, with very short periods (no more than two months) of normality between. The duration of the symptoms are shorter, less severe and not as regular, and therefore don’t fit the criteria of bipolar disorder or major depression.
The symptoms of dysthymia are similar to those of major depression but are less severe. However, in the case of dysthymia, symptoms last longer. A person has to have this milder depression for more than two years to be diagnosed with dysthymia.
SAD is a mood disorder that has a seasonal pattern. The cause of the disorder is unclear; however it is thought to be related to the variation in light exposure in different seasons. It’s characterised by mood disturbances (either periods of depression or mania) that begin and end in a particular season. Depression which starts in winter and subsides when the season ends is the most common. It’s usually diagnosed after the person has had the same symptoms during winter for a couple of years. People with Seasonal Affective Disorder depression are more likely to experience lack of energy, sleep too much, overeat, gain weight and crave for carbohydrates. SAD is very rare in Australia and more likely to be found in countries with shorter days and longer periods of darkness, such as in the cold climate areas of the Northern Hemisphere.
Here’s my apps on my iPhone 6. I had the iPhone for 1 month I guess. And i’m loving it. So my plan was to show you guys what apps I have on it. I don’t have a lot of apps, because I’m scared to full it up. And I’m taking a lot of pictures. So the most important apps for me now is Spotify, Facebook, Twitter, Instagram, Snapchat and We Heart It. But I want some more and cool apps on it.
So please comment if you have some cool apps