Going Mental - Good Grief
It probably depends on the individual as to how badly they are affected
emotionally and how well they can handle the position that they have been placed
in. For someone who has "it" together, just talking to a spouse, parent, or
friend might be all that they need. For someone who isn't sure or can't get a
clear picture of what's happening to them or how to deal with it should talk to
their neurologist and seek help. There are many support groups specifically for
multiple sclerosis (MS) and more than a few mental health professionals ready to
listen. If you feel that you need to see someone, know that it doesn't mean that
you are crazy, but simply human. How an individual deals with grief or loss is
as individual as each person is.|
Grief over any kind of loss is a normal and healthy process. Those with MS can
grieve over changes caused by the disease, beginning with a new diagnosis that
alters their life and their self-image and then again whenever the disease causes
a significant loss or change. The grieving process is the first step to learning
how to adapt to the changes in one's life and move forward. Given the many
symptoms and changes that MS can cause, many people with MS can expect the normal
grieving process to ebb and flow over time. As far as what "normal" grieving is,
that is strictly up the individual.
The Kübler-Ross model, by Elisabeth Kübler-Ross, tells us that there are five
discrete stages on how people deal with grief and tragedy: Denial, Anger,
Bargaining, Depression, and Acceptance.
Stage 1 - Shock and Denial
Shock and denial are typically the first reactions of people experiencing
unplanned changes. At this stage in the loss cycle, it's normal for
people to feel confused and afraid, and to want to place blame. However,
many people are just numb when facing an unplanned change as if they
were on automatic pilot. It's very common for people to avoid making
decisions or taking action at this point. People are often unable to
function or perform simple, routine tasks during this stage.
Denial can occasionally be healthy for a short time, but prolonged
denial can have devastating consequences for the person and for the
situation. Denial of something that has happened or of the pain and fear
being experienced is a way in which people protect themselves when faced
with a painful situation. Continued denial of the pain and fear,
however, will block them from doing something about it.
Stage 2 - Anger
Anger is a feeling that is often intensely felt during this time. Anger
is identified by feelings of second-guessing, hate, self-doubt,
embarrassment, irritation, shame, hurt, frustration, and anxiety. People
usually understand more clearly what is happening, but they may look for
someone to blame at this stage. If there's no one on whom to focus the
anger or blame, a feeling of helplessness may take over and the anger
may be turned inside. Some people take it out on themselves by taking
responsibility for a situation over which they have had little control.
People are often afraid that if they let themselves acknowledge the
anger they feel, they will immediately need to express it and act on it
in a way that they will regret later. However, by not admitting to
themselves and others close to them the loss and pain they feel, they
will be blocked from doing something about the situation. It will also
prevent them from moving on. Some people get stuck at this stage.
To express anger in a positive way, people need to change how they view
the situation. It's also helpful to talk to others about it or write
down their feelings in order to figure out what they need to do to make
the feelings less intense. Another option is to turn the anger into
energy through an active sport or brisk physical activity or to express
it through playing a musical instrument.
Stage 3 - Depression and Detachment
The third stage of the loss cycle, depression and detachment, is
characterized by feelings of helplessness, hopelessness, and being
over-whelmed. People often feel down, lack energy, and have no desire to
do anything. Withdrawal from activities and other people is common.
Because it's also hard to make decisions at this stage, ask a family
member or friend to help you if important decisions need to be made.
Stage 4 - Dialogue and Bargaining
The fourth stage, dialogue and bargaining, is a time when people
struggle to find meaning in what has happened. They begin to reach out
to others and want to tell their story. People become more willing to
explore alternatives after expressing their feelings. They may, however,
still be angry or depressed. People don't move neatly from one stage to
another, but rather the stages overlap and people often slip back to
Stage 5 - Resignation and Acceptance
At this stage, people are ready to explore and consider their options.
As the acceptance stage progresses, a new plan begins to take shape or,
at the very least, people are open to new options.
Getting Back to "Normal"
A person's "normal" state of functioning becomes disrupted by a sudden
income loss. It's possible to return to a purposeful state of
functioning after going through the stages described above and after
exploring options and setting a plan. People then begin to feel secure
and in control and have a more positive self-esteem. People get renewed
energy to tackle life again but in different ways than before the sudden
income change. It's perhaps better to think of the end of the grief
cycle as returning to a meaningful life rather than returning to a
"normal" life. "Normal" now won't be the same as "normal" was before.
The 5 Stages of Grief and MS
As far as shock and denial goes, you might be scared, but remember that fear in
the right amount can keep you alive. If you take a good look at your magnetic
resonance imaging (MRI) pictures, look at the tremors you might have, or the
fact that you can't feel your arm, and this should take care of some of the
denial aspects. It's hard to deny what is clearly in front of you, the cause
and the symptoms. If you are still in denial after what you have seen, then get
a second opinion from another neurologist, and given some time it should become
Anger can pop its nasty little head out, and if it does, you might be thinking
that this really sucks! Yes, it sure does, but this is the reality that you are
faced with and life does go on. You will have to make changes in your life and
they might not be the ones that you wanted or expected, but it's not the end of
the world. Change is inevitable every single day whether or not you have MS.
When you realize this, you might be able to move beyond the anger and grieve as
you should. Make sure to get it all out of your system because you have to move
on and live your life.
You might find that you become quiet for a while and just need a bit of time to
think it all out. You might even feel that you need to yell at a wall out of
frustration, do it because it won't mind. Just remember that if you feel like
talking to someone, there are so many choices whether personal or professional
that are willing to listen to you.
Depression and guilt kind of go hand in hand. You might wonder how anyone could
face this and why in the world did it happen to you. The simple fact is that you
did nothing to get this disease and nothing to deserve the burden that you now
carry. Just remember that anything that might be weighing you down can be moved
with just the right amount of leverage. If all of this stuff is too much for
you, then simply break it all up into smaller issues and it all may just be a
bit easier to deal with.
You didn't ask for this, so try not to have any feelings of guilt, just do
the best that you can. Nobody is asking for you to find a cure for MS or come
up with the solution to world peace. Your main concern is to make sure that you
have "it" together. Once you have "it" together, you might find that your days
are better and a cure may seem a bit more close. Save any guilt for having an
extra slice of chocolate cake, MS isn't worth it.
Grief and Depression
Grief can sometimes be difficult to distinguish from depression. However,
they differ in several ways:
Grief over a recent change or loss is generally time-limited
and resolves on its own. Clinical depression is more persistent
and unremitting, with symptoms lasting at least two weeks and
sometimes up to several months.
A person experiencing grief may at times be able to focus on
life's activities and gain enjoyment from them, while a person
who is depressed may not.
Although grief generally resolves on its own without treatment,
counseling, self-help groups, as well an understanding and
supportive environment can help. Depression requires treatment
by a mental health professional. Self-help groups and other
types of emotional support are important but not sufficient.
For 24/7 suicide prevention in the U.S. call 1-800-273-8255
The Lifeline provides 24/7, free and confidential support for people in distress