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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.

The 5 Stages of Grief:

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.
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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 earlier stages.

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 more real.

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
National Suicide Prevention Lifeline or online at www.suicidepreventionlifeline.org
The Lifeline provides 24/7, free and confidential support for people in distress