Andrea Gilats was completely destroyed when she lost Tom, her 20 -year -old husband, through cancer. For two years she wrote him daily letters. But when the months turned into years, her overwhelming grief did not fades as expected. Instead, it consumed her life for almost a decade.
“I had the feeling that my world had broken apart. I couldn’t imagine a future without it and just get through every day, felt like climbing Mount Everest,” said Gilats, author of After Effects, a memoir about her grief experience. “I felt like a robot when I lived every day without relieving this intense emotional pain.” Gilats lost a third of her body weight because she couldn’t eat.
What she didn’t know at the time was that she had complicated grief or, as experts now describe a longer mourning disorder (PGD), a recently recognized mental health that affects up to 7 out of 10 bereaved.
What is a long time?
We all mourn when we lose someone we love. It is one of the most universal human experiences, and for most people grief is gradually soft over time. But for some like Gilats, the pain remains and becomes weak.
A longer mourning disorder or a complicated mourning disorder is characterized by an intensive longing for the deceased person, dealing with the thoughts of them and a significant functional impairment. People with longer grief can experience identity disorders and have the feeling that they have died part of themselves. They often feel stuck and cannot imagine how they can live their life without their beloved people.
“If you got to know someone with longer grief three or five years after the death of a loved one and you got to know someone three months after the death of a lover, you could not recognize the difference,” said Katherine Shear, Ph.D.
In contrast to typical grief, which of course develops over time, a longer grief holds people and prevents them from adapting to their loss. “It is a persistence of grief, intensive, employment, impairment, grief,” said Shear.
PGD was officially added to the diagnostic and statistical manual for mental disorders in March 2022, which gives millions of validation for millions suffered from this disease. For adults, the diagnosis requires that at least one year have passed since death, while for children and adolescents there are six months.
It is important to understand that extended grief is not the same as depression, even though they can occur together. Depression is about losing the ability to experience positive emotions. In contrast, people with a longer grief can still enjoy when they talk about their deceased loved one or remember positive memories – the problem is that everything focuses on the absence of this person.
“There is sadness, but it is mainly the longing and longing and busy thoughts and memories of the died person,” said Shear. This distinction is crucial because it influences the treatment approaches.
Who is most at risk of complicated grief?
The research of Shear identified several risk factors that can make someone more susceptible to a longer grief. The factors include a prehistory of mental illnesses, especially mood and anxiety disorders, she said.
In addition, your relationship with the beloved person who has died can also play a role in whether you experience longer grief. “If you had a really positive relationship with the person who died, and especially if it is very unique when it is the only person in the world that were really close, it makes it really more difficult,” said Shear. Parents who lose children and spouses who lose partners are among the most endangered.
Circumstances of death are also important. Sudden, unexpected deaths, especially those that affect violence, trauma or young people, rather lead to a longer grief. Studies show that almost half of those who can be developed by unnatural deaths, including accidents, suicides, murders and disasters, PGD.
The scissors also identify earlier trauma as an additional risk factor for the development of a longer grief and find that people who had earlier trauma or traumatic childhood trauma are exposed to increased risk. This connection becomes particularly worrying when examining the inequalities of trauma exposure.
Studies consistently show that black adolescents and adults have a higher rate of trauma exposure and PTBs than their white colleagues. And studies show that Hispanic and non-Hispanic Black Young people appear in comparison to non-Hispanic whites in the course of their lives of mood disorders and exposure to several types of violence.
These differences are based on systemic factors, including structural racism, unequal housing policy and what researchers call “racist trauma”, which caused mental and emotional injury caused by encounters with racist bias, discrimination and hate crimes. The Covid pandemic has further tightened these vulnerabilities, with color communities experiencing disproportionate mortality rates, which can increase the risk of longer grief.
Read: The mental and physical charge of racist trauma >>
Find a way forward
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The good news is that a longer mourning disorder can be treated. The shot developed a longer treatment with grief, an approach to help people adapt to their loss and at the same time maintain a connection to their deceased loved one.
The treatment works on two traces, explains Shear: People help to accept the reality of loss, while they realize that their relationship with the deceased is continued in a different form, and to help them combine with their own values and interests again in order to rebuild a meaningful life.
This could include practical steps, such as the persecution of long -cherished dreams (one of the patients of Shear opened the antique business that she always wanted while someone else learned how to make chocolate sculptures), daily rituals of self -care and strengthening relationships with living family and friends. The therapy also deals with avoidance behavior and thought patterns that people get stuck in their grief.
Three studies financed by the National Institute for Mental Health showed promising results: 7 out of 10 participants who received specialized mourning intervention, a sensible improvement in their symptoms compared to interpressions (IPT) for depression, a proven form of discussion therapy for depression, which showed progress less than 1 out -3 participants.
A study that was carried out showed that antidepressants alone do not help to significantly extend the mourning symptoms, and they are much less effective for grief than with depression. While the shear saving that more research is required for conclusive results, these results indicate that a longer grief requires its own therapeutic approach instead of being designed for other diseases.
“Grief is actually a form of love,” remarked Shear and referenced the insight of author CS Lewis that grief represents the persistent bond with those we have lost. The goal of a longer mourning treatment is not to “get over” the loss, but to learn to wear it while they still live completely.
When do I get help?
For those who ask themselves whether they need help, Scher suggested to look for these signs:
- Do not feel able to imagine a life without the deceased person months or years after the loss
- The feeling that death happened yesterday, even if a significant time has passed
- Lose social support because others tell them that they “continue” or even start avoiding them
“In my case, I had a colleague whose husband died three months before mine, so we mourned at the same time,” recalled Gilats. “But after about two years I noticed that she was much better. She seemed to have adapted well. She seemed to make the best of her situation and she was happy. Then I realized that something was wrong. I was stuck in my grief and she continued.”
Nine years after the death of her husband, Gilat decided to deliberately concentrate on activities in order to distract himself from the pain. Finally she found consolation in yoga and a new purpose as a yoga teacher. Then she became the author and wrote three books.
If you have to struggle with persistent, overwhelming grief that affects your daily life, you know that you are not alone and that help is available. Scher suggests planning a consultation with a therapist who can help you determine whether you have a big grief.
In addition, Gilats said: “Try to do some of the things you have always enjoyed. These hobbies and activities will now be good friends. I remember one day I realized that I was talking more, and soon afterwards I realized that I could actually feel happy again.”
Now Gilats says she is no longer in her grief. Her experience offers hope for those who are in the middle of them.
“I still think of my husband every day and I still miss him, but now I can enjoy my memories of him and our marriage,” she said. “Today I thank you that I have spent 20 wonderful years with the man I will always love.”
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