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By Dr David Delvin
Sadly, nearly all
of us have to face bereavement at some time in our lives – and
most commonly in the period when we’ve passed the age of 50.
For
it’s a sad fact that all human relationships have to end some day.
I find it a sobering thought that no matter how much you love
someone, there will come a time when the two of you will be parted
by the death of one of you.
Sorry
to sound so gloomy! But
actually, its best to know about bereavement, and to be prepared for
it when it finally happens.
In the UK – and particularly in stiff upper-lipped England
– people tend not to talk about this subject.
The result – as I can testify from my experiences as a
doctor – is that many men and women are totally unprepared for the
loss of a loved one, and so suffer far more than they should do.
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What
happens when we are bereaved?
When
we are bereaved, we grieve. Everyone does this in his or her own individual way – which
is deeply influenced by nationality and culture.
Look
for instance at the recent stream of tragic deaths in the Middle
East. From simply
watching your TV news, you can see that in that part of the world,
people who are bereaved will scream and shout and (very often) beat
their chests – as their way of expressing their mental agony.
Such behaviour would be considered almost insane in many
parts of Britain – but who is to say that it isn’t a good way of
coping with terrible grief?
The
Scots, the Irish and the Welsh give more outward signs than the
English. All three
Celtic nations are likely to express their sense of loss in talking
about the deceased, and perhaps in singing.
Indeed the Irish still often hold ' wakes' – the
remarkable social events which enable relatives and friends to give
voice to their feelings.
Does
this enable them to cope with bereavement better? I’m not sure. But
what I am sure of is this. If
you suffer a bereavement, the worst thing you can do is to try and
bottle it up completely, and refuse to discuss it with anybody!
Again and again, I’ve seen that course of action lead to
nervous breakdowns and other emotional troubles – sometimes many
years later.
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How
attitudes to bereavement have changed
Curiously
enough, the British attitude of ‘don’t
mention death’ is relatively a recent one.
Until about 100 years ago, death was a constant reality in
people’s lives. Women
regularly died in childbirth, and a high proportion of children
didn’t make it to adulthood.
So in late Victorian times, everyone was well used to regular
trips to the cemetery.
Things
changed dramatically during the 20th Century, as public
health and medical science made great strides.
People started living far, far longer, and death became more
of an unfamiliar thing. Today,
we have a situation which has never existed before in human history;
most of us expect to grow old!
Furthermore most of us are quite an age by the time we lose
our parents – or others whom we dearly love.
So
it’s no wonder that nowadays we’re not much good at dealing with
death, and that when it happens we find ourselves devastated and
unsure of what to do.
So
this month, I’m going to try and deal with some of the problems
which most commonly cause difficulties and distress for bereaved
people. Here goes.
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COMMON PROBLEMS
After
a bereavement, how long can you expect to grieve for?
This is very
variable. There’s no
time limit on grief. And
all sorts of factors may influence it.
For
example, some people live for several years with the knowledge that
the person they love is going to die soon. In that situation,
a feeling of grief often begins long before the actual death.
However, in these cases the actual passing away is often
perceived as ‘a merciful release’.
So sometimes, the subsequent period of grief may be
relatively short.
In
other cases, we suddenly lose someone special – for instance,
through a road accident or an unexpected heart attack.
In these cases, the grieving will obviously begin from the
shocking moment when one learns of the death, and may persist for
years.
But
in general, most people tend to feel that they are able to tolerate
their pain better after about six months.
Life tends to gradually feel better after that.
However,
not everyone recovers as quickly.
So if you are still grieving after a year or two years and
well-meaning friends keep hinting that you should ‘be over all
that by now,’ pay no attention to them!
You’re entitled to get over grief in your own way – and
in your own time.
On
the other hand, be aware of the fact that you may be suffering from
a depressive illness – see below.
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Yes, they very
definitely do. However, attitudes to depression and death have changed a
great deal. I can just
about remember that 40 years ago, bereaved people were never
regarded as ‘depressed’. No
doctor would have dreamed of giving the average bereaved person an
anti-depressant drug.
All
that has changed. These
days, GPs are very willing to try and help with a prescription for
anti-depressant medication – if they think that the bereaved man
or woman is clinically depressed.
Useful ‘markers’ of clinical depression include:
-
Uncontrollable misery that goes on for month after month;
¨
Gross sleep disturbance – often with inability to
stay asleep after about 3am;
¨
Inability to eat or to care for oneself;
¨
Thoughts of suicide.
After
a bereavement, if you have any of those symptoms, I urge you to
contact your doctor for help.
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Personally, I’m
very much in favour of it. It
lets out certain very important emotions and it’s a natural human
reaction.
Yet
there are certain circles in which is not ‘done’ to cry.
For instance, I have known a number of public school-educated
boys who were told ‘not to blub’ when their parents died!
This seems to me quite crazy and only likely to lead to
emotional trouble later on.
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There
are very definitely certain phases that one goes through after a
loved one has died. They
vary a bit from person to person, but most experts say the commonest
pattern is like this:
1.
Shock and feeling stunned
2.
Denial – a feeling that this can’t possibly have happened
(‘There must be some mistake…’)
3.
Anger or guilt. Anger
may be directed against doctors – or against someone who is
perceived as having caused the death.
Guilt often involves distressing feelings
of ‘If only I’d done more..’ or ‘If only I’d
spotted
the symptoms…’ or
‘ if only I’d been nicer to her…’
4.
Long-lasting sadness. Once
these feelings have resolved a bit, there is usually a long-lasting
feeling of sadness, emptiness and loss.
5.
Lack of identity. Some
months after the death of a partner, it is common to feel a certain
‘loss of identity; - as though you really didn’t count as a
person now that your other half has gone.
6.
Recovery. Eventually,
nearly everyone reaches a stage where life is more or less
‘normal’ again, and where everything ceases to appear miserable.
But this may take a very long time to achieve.
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Summing
up
Bereavement
is never easy. But
most of us can cope with it – given time and support.
Good tips to remember are:-
¨
Talk about your loss – to anyone who is interested.
Don’t bottle it up.
¨
Don’t hesitate to cry.
¨
If you think you may be depressed, consult your
doctor.
Finally,
if things are going very badly, don’t hesitate to contact a
self-help group. Best
known in Britain is Cruise – which is extremely good at
offering support for those who are devastated by the loss of a loved
one. They have about
200 local groups throughout the UK.
Call them on 0870 167 1677.
Some
bereavement issues are dealt with in the Q & A section below.
Good luck.
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Bereavement
Q.
I loved my late wife, but the fact is that she drank herself
to death. Is this the reason that – to my
horror – I now find myself furiously angry with her?
A.
Yes. When the
dead person has brought about their own demise (say by
drink-driving, or by smoking), it’s very common for the partner or
relatives to feel angry with him/her.
You will get over this.
But you could help things but asking your doctor to refer you
to a good counsellor. Some
of them actually specialise in grief counselling.
Q.
My daughter (aged 30) recently lost her only son in a traffic
accident. She is inconsolable. Should
I advise her to have another one as quickly as possible?
A.
No. Bereaved
mothers often resent this well-meaning advice.
She needs time to recover – without all the additional
stresses of pregnancy. Get
a very good book called ‘Dear Isobel – Coming to Terms with the
death of a child.’ It
is written by Georgiana Monckton and is published by Vermilion.
Q.
I lost my wife seven years ago.
I have found someone else and would like to marry her. But the fact is that I am completely unable to have sex with
her. Is this due to
grief?
A.
Probably. Certainly,
I’ve seen it again and again in men who have lost their partners.
The problem is that deep down, they feel guilty about making
love to someone else. Happily most of these poor chaps have
been cured, after a number of counselling sessions.
But quite often they do need a little ‘confidence
boosting’ with Viagra (or a similar drug) for a while.
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Q.
I
read in an Irish newspaper that many people suffer from backache
which is actually caused by an ‘acne virus’.
Is that true?
A.
Afraid not. Most
back aches are due to mechanical strain on the various structures of
the spine and related tissues.
There isn’t a virus which causes acne and acne has no
connection with back pain.
Sorry
if you find this disappointing.
If you’re having a lot of trouble with your back, my advice
to you is to find yourself a good chiropractor or osteopath.
There are many excellent ones in Ireland.
Q.
Since I turned 60, I have been unable to stop sneezing. This has been going on for four months now!
Is it just a sort of long-lasting cold?
A.
No, a cold can’t last that long.
The odds are that you really have an allergy.
I wonder whether you could be allergic to something you were
given for your 60th birthday! (Talc?
Moisturiser? Some
garment, maybe?). Take
a good look at your presents.
Q.
I have recently been diagnosed as having gout.
Will this shorten my life?
A.
No. Gout is a
blooming nuisance. But
it can be successfully treated, and the life expectancy of sufferers
is normal.
Q.
I am a retired lady of 64, and I’d like to extend my social
life. But I have an
ugly mole on my face, which has been there since childhood.
Is it too late to have it removed?
A.
Not at all, ma’am. It’s never too late to have this kind
of thing taken away. Your
doctor may well be one of the many GPs who are capable of removing
this kind of bump. But
if he feels it’s a bit beyond his expertise, he can send you to a
surgeon. May your
social life blossom!
Q.
I’m female, and now aged 70.
Am I right in thinking that I am now completely safe from
breast
cancer?
A.
Certainly not! There’s
a mistaken belief that breast cancer only hits the under 65s, but it's
totally wrong. A huge
number of cases occur in women who are 65-plus. So
please keep on examining your breasts and report any changes to a
doctor. If possible,
try to get the NHS to continue giving you three yearly mammograms.
You may have to press hard for this!
Q.
I’m a senior citizen (male) and have recently become
vegetarian. Is there
any risk that this could give me some ‘deficiency disorder?’
A.
Yes. Vegetarians
readily get anaemic. So
fix yourself up with some iron tablets.
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