For Many Who Are Suffering With Prolonged Grief, The Holidays Can Be A Time To Reflect And Find Meaning In Loss

The holiday season should be filled with joy, fellowship, and ritual celebrations. However, many people still remember their sadness at this time of year and who – or what – they lost.

The added stress of the holidays doesn't help. Research shows that holidays have a negative impact on the mental health of many people.

Although the stressors associated with COVID-19 have eased, the pain of change and loss that many people have experienced during this pandemic continues. This can bring up difficult emotions when you least expect them.

I am a licensed trauma therapist and yoga teacher. Over the past 12 years, I have helped clients and families overcome pain, depression, anxiety, and complex trauma. These include many healthcare workers and first responders who have told me countless stories of how the pandemic has worsened burnout and impacted their mental health and quality of life.

I developed an online program that research shows improves their well-being. And I’ve seen firsthand how much heartache and sadness can accumulate over the holidays.

Post-pandemic holidays and prolonged mourning

During this pandemic, family dynamics, close relationships and social connections have been tested, mental health issues have increased or worsened, and much of society's holiday traditions and routines have been disrupted.

Those who have lost loved ones during the pandemic may not be able to perform rituals, such as holding a memorial service, that slow down the grieving process. As a result, holiday traditions may now feel more painful to some people. Missing school or work can also cause greater feelings of sadness and contribute to feelings of loneliness, isolation, or depression.

Sometimes the feeling of pain is so long-lasting and intense that it interferes with daily life. Over the past few decades, researchers and doctors have tried to identify and treat complex pain that does not improve over time.

In March 2022, a new entry describing complex grief was added to the Diagnostic and Statistical Manual of Mental Disorders, or DSM, which categorizes the spectrum of mental disorders and problems to better understand symptoms and the experiences of people treated for them.

This newly defined condition is called chronic pain disorder. About 10% of adults who die are at risk of developing the disease, and that number appears to be rising as a result of the pandemic.

People with persistent grief disorder experience strong emotions, miss the person who died, or constantly worry about memories of their loved one. Some also have difficulty resuming social interaction and may feel emotionally numb. They tend to avoid memories of loved ones, may lose their identity and feel bleak about their future. These symptoms continue almost every day for at least a month. Prolonged grief disorder can be diagnosed at least a year after a significant loss in adults and at least six months after a loss in children.

I'm no stranger to complicated grief: a good friend of mine committed suicide when I was in college, and I was one of the last people he spoke to before he took his own life. It broke my sense of predictability and control in my life and freed me from many of the existential issues that suicide survivors often face.

How sadness changes brain chemistry

Research shows that pain has a negative impact not only on a person's physical health, but also on brain chemistry.

Pain and increased appetite can disrupt the brain's neural reward system. When grieving people seek to reconnect with their lost loved one, they crave the chemical reward that they felt before the loss when they were connected to that person. This reward-seeking behavior tends to work in a feedback loop that works similarly to drug addiction, which may be why some people fall into the trap of despair due to the pain they feel.

One study found greater activation in the amygdala when viewing death-related images in people experiencing complex grief compared to adults who were not grieving the loss. The amygdala, which triggers the fight-or-flight response to survive, is also involved in managing stress when we are separated from loved ones. These changes in the brain may explain the profound impact that chronic pain can have on a person's life and ability to function.

Recognizing Persistent Grief Disorders

Experts have developed scales to help measure symptoms of long-term exhaustion. If you've been experiencing some of these signs for at least a year, it may be time to see a mental health professional.

Grief is not linear and does not follow a timeline. This is a dynamic and evolving process, different for everyone. There is no wrong way to grieve, so be kind to yourself and don't judge what you should or shouldn't do.

Increasing social support and participating in meaningful activities are important first steps. It is important to address existing or general mental health issues such as anxiety, depression, or post-traumatic stress.

Sadness is easy to confuse with depression because some symptoms overlap, but there are key differences.

If you've been experiencing symptoms of depression for more than a few weeks and they're affecting your daily life, work, and relationships, it may be time to see your doctor or therapist.

Sixth stage of grief

I have found that labeling the stage of grief a person is experiencing helps reduce the impact of grief on them, allowing them to grieve their loss.

For decades, most clinicians and researchers have identified five stages of grief: denial/shock, anger, depression, bargaining, and acceptance.

But “acknowledging” your pain is not good for many people. This is why the sixth stage of grief, called “searching for meaning,” adds another perspective. Recognizing a loss by reflecting on its meaning and consequences can help people find ways to move forward. Recognizing how different your lives and personalities are, while making room for sadness during the holidays, can be a way to ease feelings of hopelessness.

When my friend committed suicide, I began to appreciate more what he brought to my life and used the moments he cherished to honor his memory. After all these years, I can find meaning in mental health awareness. I have served as an expert speaker for suicide prevention organizations, written about loss due to suicide, and am certified to educate the local community on how to respond to someone showing signs of distress or a mental health crisis through crash courses first aid. However, each person's search for meaning is different.

Sometimes adding a routine or holiday tradition can ease the pain and allow you to create a new version of life while remembering your loved ones. Find old recipes or visit a favorite restaurant you like together. You can remain open to what life has to offer while you grieve and honor your loss. It can give new meaning to what and who is around you.

If you need emotional support or are experiencing a mental health crisis, call 988 or chat online with a crisis counselor.

This article was republished from The Conversation, an independent, nonprofit news organization that provides facts and analysis to help you make sense of our complex world.

Posted by Mandy Doria, University of Colorado Anschutz Medical Campus .

Know more:

Mandy Doria's position at the University of Colorado is funded in part by the Colorado Department of Public Health and Environment (CPHHE) for her work on the CO-CARES initiative, which provides free resources to Colorado Department of Public Health and Public Health employees.

Long-term pain, mental illness and how long does the pain last?