MENTAL HEALTH GUIDE
Grief
Everyone grieves differently. The grieving process takes time. Healing happens gradually. It cannot be forced or hurried, and there is no “normal” timetable for grieving. Whatever your grief experience may be, it is important to be patient with yourself and to allow the process to naturally unfold.
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Text “HOME” to 741741
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Grief Overview
Children and adults in grief sometimes feel pressure from themselves and from others to act and feel a particular way and worry that they are coping wrong or badly. Everyone grieves differently, even within a family, and the spectrum of grief reactions is vast and diverse. It is important to support what is comforting and helpful for someone in grief; they are the expert on how they are feeling and what does and doesn’t “work” for them.
What are common symptoms of grief?
Children and adults in grief sometimes feel pressure from themselves and from others to act and feel a particular way and worry that they are coping wrong or poorly. Everyone grieves differently, even within a family, and the spectrum of grief reactions is vast and diverse. It is important to support what is comforting and helpful for someone in grief; they are the expert on how they are feeling and what does and doesn’t “work” for them.
- Shock and Disbelief – Right after a death, it can be hard to accept what happened. You may feel numb, have trouble believing that the loss really happened or even deny the truth. You may keep expecting your loved one to show up, even though you know they are gone.
- Sadness – Profound sadness is probably the most universally experienced symptom or grief. You may have feelings of emptiness, despair, yearning or deep loneliness. You may also cry a lot or feel emotionally unstable.
- Guilt – You may regret or feel guilty over things you did or did not say or do. You may also feel guilty about certain feelings. After a death, you may even feel guilty for not doing something to prevent the death, even if there was nothing more that you could have done.
- Anger – Even if the death was no one’s fault, you may feel angry and resentful.
- Fear – You may feel anxious, helpless or insecure. The death of a loved one can trigger fears about your own mortality, of facing life without that person or the responsibilities that you now face alone.
- Physical Symptoms – Grief may include fatigue, nausea, lowered immunity, weight loss or weight gain, aches, pain and insomnia.
Where should I go for help?
- Know that grief will change over time – Often, people who are grieving will feel pressure to resolve their grief quickly because friends, family and those around them may inadvertently make them feel like their grief is too intense or is lasting too long. This pressure can be detrimental to those in grief, making them feel that they are doing it wrong or that something is wrong with them. Grief never ends; though it changes over time, it continues to evolve as we integrate the loss.
- Think about talking with a professional – enlisting the help of a therapist can assist you with addressing your thoughts and feelings surrounding your grief and loss.
- Join a support group – Grief can feel very lonely, even when you have loved ones around. Sharing your sorrow with others who have experienced similar losses can be healing.
- CHOC Bereavement Support Groups for the Death of a Child
please email griefsupport@choc.org. - Community Bereavement Support Groups
- Compassionate Friends. Nationwide bereavement support groups for families after the death of a child, at any age, from any cause.
- The MISS Foundation. A nonprofit, international organization that provides immediate and ongoing support to grieving families, empowerment through community volunteerism opportunities, public policy and legislative education and programs to reduce infant and toddler death through research and education.
- Jonathan’s Giving Tree. An organization that assists with funding for funeral services for low-income families of children ages 12-24 who have passed away by car accident, unintentional self-medicating or suicide. They provide grief counseling, organize support groups for parents, siblings or families of any economic status.
- New Hope Grief Support Community. A non-profit therapy and grief education program based in Southern California providing grief groups, resources and educational opportunities for bereaved families.
- Empty Cradle. A non-profit peer group for parents who have experienced the loss of a baby through miscarriage, stillbirth or infant death.
- Our House Grief Support Center. An organization that provides essential grief support for adults, teens, children and toddlers, including support groups specific to the age of the griever, length of time since the death and the relationship to the person who died.
- The Dougy Center. An organization helping children, teens, young adults and their parents cope with death since 1982. They provide many resources in Spanish.
- CHOC Bereavement Support Groups for the Death of a Child
How do I know if I need a mental health specialist?
Left untreated, complicated grief and depression can interfere with the way we think, feel and act. Although grief is normal after a death, it deserves attention when problems are severe, persistent and affect daily activities. Seek help if you feel like life is not worth living, if you wish you had died with your loved one or if you feel disconnected for others for more than several months. A CHOC social worker can help you connect with a professional therapist by emailing griefsupport@choc.org or calling 714-509-8521.
- If you are experiencing a life-threatening emergency, call 9-1-1.
- To reach the Crisis Text Line, text HOME to 741-741 or visit crisistextline.org.
- To reach the National Suicide Prevention Lifeline, call 9-8-8 or visit suicidepreventionlifeline.org
What to and not to say to a loved one who is grieving?
Most of us are never taught how to react to grief and loss. So, we may not know what to say, or not to say, when a person in our lives is experiencing a loss. Instead, we may fall back on using platitudes or cliches to attempt to console our loved one. Below are some things that we can say, and not say, when a loved one is grieving:
- Rather than saying “I’m sorry for your loss”, try saying “thank you for telling me what happened. I know there are no words to make it better. Just know that I am here and want to support you however I can.” While there isn’t anything wrong with the phrase “I’m sorry for your loss”, the phrase is a common one, so consider that your loved one may have already heard it several times since their loss and that it may have lost its meaning in the process.
- Rather than saying “I know what you are going through”, consider saying “Grief is so unique. Do you feel comfortable sharing with me how this has been for you?” While you might want them to know that you understand what they are going through, by saying “I know what you are going through” will take away the person’s opportunity to share, in detail, about their grief.
- Rather than using a phrase like “let me know if there’s anything I can do to help,” think about specific ways in which you can help your loved one. By giving your loved one options on how you can help, you are alleviating the pressure they may feel from trying to figure out what they need or how you can help them.
- Rather than saying “you’re so strong”, try saying “I know that grief looks different for everyone, especially privately versus publicly, so I am so happy to see you here today.” Assuming that a person is “strong” by attempting to carry out their usual day-to-day activities may send them the message that it is better if they hold their feelings inside or try to hide how they really feel.
Learn more about CHOC’s Pediatric Mental Health Services
At CHOC, we specialize in providing a full continuum of pediatric mental healthcare, including inpatient, intensive outpatient and outpatient program services.
Tips for parents and caregivers coping with grief and loss
The most important factor in healing from loss is having the support of other people. Even if you are not comfortable talking about your feelings under normal circumstances, it is important to express them when you are grieving. Sharing your loss makes the burden of grief easier to manage. Connecting with others will help you in your journey of healing.
Turn to friends and family members.
Draw loved ones close, rather than avoiding them, and accept the assistance that is offered. Often, people want to help but do not know how. Tell them what you need, such as a shoulder to cry on or help with funeral arrangements.
Take comfort in rituals
If you engage in a religious practice, embrace the comfort that mourning rituals can provide. Spiritual rituals that are meaningful to you may include praying or attending services at a place of worship. If you are questioning your faith in the wake of the death, talk to the clergy or spiritual leader in your faith community. If you do not engage in religious practice, find a different kind of ritual to help you feel grounded, like meditation or yoga.
Find a safe outlet
If you are struggling to discuss your grief and loss with your support system or to use faith/religion to cope, consider finding an outlet for your grief, such as spending time engaging in a meaningful hobby, like creating art. Also, consider seeking professional help, such as enlisting the help of a therapist, or going to a support group, to process your grief in a safe space.
Tips for parents and caregivers who have children experiencing grief and loss
If you are the parent of a grieving child, you may also be balancing coping with your own grief. It can be distressing to witness your child grieve, but learning how to hold and honor their grief and how to support and comfort them during this challenging time will help them now and for years to come. Caring for yourself is vital to having the energy and presence to be able to support your child in their grief. In addition to helping your physical and mental health, engaging in healthy self-care practices also helps you model ways your child can take care of themselves throughout their grief/loss journey. In addition to prioritizing your own needs, here are some ideas for how to support your child in coping with grief.
- Be honest. Children who are not accurately informed will often develop their own interpretations of events that can be full of misunderstanding, guilt or shame, and they may begin to grieve in isolation. Honesty lets children know that they can trust you.
- Avoid euphemisms (i.e. “passed away,” “went to sleep,” “lost” a family member). Explain death as the body is not working anymore.
- Find comfort in faith. If you or your child have religious beliefs, be sure the child understands that the body stops working, even if you believe the soul or spirit continues on.
- Check the level of understanding. Encourage questions. Be prepared for children to ask a lot of detailed questions and to ask for frequent clarification.
- Make sure the child know that the illness/death is not their fault.
- Share you own feelings. Give permission to feel sad, angry, etc.
- Reassure the child of your continued presence and support.
- Unless the child adamantly states that they do not want to attend a funeral or memorial service, it is important to give them the opportunity to attend. Prepare your child for what to expect and provide them with choices about how they would like to be involved.
- Maintain routine and consistency. Uphold rules and expectations that were set prior to the loss your child experienced. By helping your child maintain a consistent routine, you are assisting them with finding a sense of “normalcy” despite their loss.
Another way that you can help support your child or loved one during their grief journey is by using Awareness-Reflection-Questions (ARQ), a communication framework, to assist them in feeling validated and better understood in their grief.
- Awareness: Cultivate an awareness of your own experiences with grief and how they shape your expectations. You can also be aware of significant days and transitions for the child (i.e., birthdays, Mother’s Day, the anniversary of the death, etc.)
- Reflection: Reflect what the child says and does – this enables them to better understand what they think and feel (“You’re really sad because it’s your Mom’s birthday, and you miss her”).
- Questions: Decide if it’s helpful/comforting to ask a question that allows the child to share more of their experience: “when you feel sad, where do you feel it in your body?” “What did your Mom love to do on her birthday?” “What do you love to do on your birthday?”
Tips for youth coping with grief and loss
There are a variety of ways in which kids and teens may react to and deal with a loss. Grief can feel overwhelming and kids and teen may not know how to deal with a loss. Remember that it is normal to feel grief after a tragedy or loss and that over time you will learn to cope with it. So, if you are a kid, or teen, dealing with grief, here are some steps you can try to cope with your loss.
- Face your feelings. In order to heal, acknowledge the pain.
- Express your feelings in a tangible or creative way. Write about your loss in a journal. Make a photo album celebrating the person’s life. Get involved in a cause or organization that was important to the person you lost.
- Manage your physical health. The mind and body are connected. When we feel good physically, we also feel better emotionally. Combat stress and fatigue by getting enough sleep, eating healthy foods, and exercising. Avoid alcohol and illicit substances to numb the pain of grief.
- Seek support – Grief can come with many challenging emotions. Consider reaching out to your friends, family, teachers, school counselor, or any person in your life, that you trust, for support. Discussing your grief with a trusted person can help you manage all the feelings surrounding your loss.
- Keep a routine – carrying on with your day-to-day activities, as much as possible, can help create a sense of normalcy in your life.
- Don’t be afraid to ask for professional help – if you notice that even after trying to talk to a trusted person, keeping a routine, and honoring your grief as well as your loved one, you are struggling to manage the loss, consider talking to a mental health professional, like a therapist or counselor. A mental health professional may be able to teach you additional coping tools for managing your grief and loss.
Learn more about CHOC’s Pediatric Mental Health Services
At CHOC, we specialize in providing a full continuum of pediatric mental healthcare, including inpatient, intensive outpatient and outpatient program services.
Grief recommended reading
Related guides
For more information on other mental health conditions, please visit our other mental health guides.
Additional Resources
Mental health books
- Something Very Sad Happened: A Toddler’s Guide to Understanding Death – Bonnie Zucker and Kim Fleming
- The Memory Box: A Book About Grief – Joanna Rowland and Thea Baker
- Why Do I Feel So Sad?: A Grief Book for Children – Tracy Lambert-Prater
- The Invisible String – Patrice Karst, Joanne Lew-Vriethoff
- Healing Your Grieving Heart for Teens: 100 Practical Ideas (Healing Your Grieving Heart series) – Alan D Wolfelt
- How to Carry What Can’t Be Fixed: A Journal for Grief – Megan Devine
- When a Friend Dies: A Book for Teens About Grieving & Healing – Marilyn E. Gootman
- When a Child Dies – Claire Aagaard
- The Unspeakable Loss: How Do You Live After a Child Dies? – Nisha Zenoff
- Beyond Grief: Snapshots of Life after Loss – Gracelyn Bateman and Melody Lomboy-Lowe
The guidance on this page has been clinically reviewed by CHOC pediatric experts.
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