Grief During the Holidays: Impacts and How to Cope

Welcome to today's presentation on bereavement. I AM your host, Dr. Donnelly Snipes. Bereavement and grief are difficult to deal with whenever they happen. However, during the holidays or on anniversaries, it can be even harder to deal with these things. During the holidays, people are telling you you should be feeling happy, you should be celebrating and filled with holiday cheer. And sometimes that is the last thing that your heart really wants to do. It's important to understand what's going on and the grief and bereavement process and some of the steps that you can take to get through the holidays. It's not going to take away your grief, but hopefully I will be able to provide you a few, few tips to help you get through the next few weeks and into 2021, which I'm sure is going to be a much better year. Let's start out talking about something called preparatory bereavement and that involves grief and mourning of an anticipated loss. If you have a loved one who has a terminal illness or just a loved one who is aged, it is sometimes one of those things that crosses your mind. And the closer you get to when you anticipate that person is no longer going to be with you, the more prominent those thoughts are in your mind. And this one's a little bit easier to deal with than grief and mourning that occurs after a, after a death. But with preparatory bereavement, it's important to acknowledge your feelings non judgmentally. You're going to miss grandma when she's gone. However, it's also important to examine how you want to spend the remaining time. Do you want to spend the remaining time, you know, sad and grieving, or do you want to spend the remaining time creating memories to last the rest of your lifetime? It's a lot easier said than done, but it is something to consider with preparatory bereavement. Now, let's talk. Go to the thing that we really were going to talk about today and that is grief and mourning after a death and how to cope during the holidays. Things can trigger grief any day. You know, it can be the time of day, it can be something that you see, hear, smell. It can trigger a grief moment and that's okay. Grief means that you lost something that was important to you and expecting it to go away completely is probably not really realistic. What you want to strive for is being able to integrate it into your life a little bit more effectively so it doesn't hurt as much. The pain will hopefully dull to sort of a low roar and only flare up sometimes when we are experiencing bereavement. Just like everything else, it impacts us biopsychosocially, it impacts us physically when we are grieving, when we are experiencing bereavement, when our grief is triggered, it impacts our sleep. We may toss and turn, we may have restless sleep, we may have nightmares, we may have difficulty getting to sleep because as soon as we lay down and it's quiet, we start thinking about that person that we lost and the grief just comes on like a tidal wave. It's important during this period to, you know, try to get good sleep. And a lot of people unfortunately try to self medicate with intense sleep aids or alcohol. That is not going to help you get good quality sleep. Sleep now, it's between you and your doctor. The sleep aid thing, the alcohol is probably, I think I'm pretty safe to say is not going to help you in the long run. But what can you do? Well, guided imagery can be super helpful for sleep during this period of time. And you can figure out whatever you want to imagine, whether it is your, your happy place, you know, your cabin in the woods or you know, know, villa on the beach, or whether you want to imagine a pleasant time, a happy time with the person that you lost. Whatever you decide to focus on, you want to put yourself there in your mind's eye and identify as many things and I try to say five of everything that you see, hear, smell, feel and maybe even taste. You know, taste is one of those that's kind of weird, but you want to get your senses really involved in it. The more you have to concentrate to notice the dimensionality of this image, of this vision, the less you're going to be focusing on those intrusive thoughts that are triggering your grief. And a lot of times this can help relax your HPA axis, relax that stress response and help you get to sleep. As cortisol goes down, relax relaxation hormones, melatonin and serotonin go up. So you know, that can be helpful. Practicing good sleep hygiene is also really important during this period because if you've got things working against you to that keep you awake, then guided imagery will help some, but not completely. Your appetite may be different, you may crave comfort foods, or you may not be hungry at all. It's important to remember that grief and bereavement activates that threat response system, that HPA axis, and you are in a fight or flight sort of framework. It's important to make sure that your body has the nutrients it needs in order to keep that body factory running and produce the chemicals and the hormones and the neurotransmitters that are necessary to, for your immune system, for happiness, for relaxation and for energy. So it's important to eat. When that HPA axis is activated, you're in fight or flea mode. So a lot of times your hunger is suppressed because your body, just like you're not supposed to go swimming for two hours after you eat, your body says, we're fighting and fleeing, not time to eat and digest. So sometimes it's important to encourage yourself. I avoid the word force, but encourage yourself to eat. And if you're going over a long period of time where you're not eating, it's important to consult a physician or a dietitian. Pain and inflammation is likely going to get worse. Increase HPA axis. Increased stress means increased inflammation increase. And that's, that's just the way it works. Increased depression means increased inflammation. So pain and inflammation can be going on while you are, While you are going through the holidays, while you're experiencing this bereavement. And it's going to be important to keep that under control because when we're in pain, we tend to have more difficulty dealing with life on life's terms. We tend to be more vulnerable. You've heard me use that word before. We tend to be more vulnerable to upset. If you address pain and inflammation, you are going to help yourself feel better emotionally and give yourself more resources to deal with the subject at hand. When we're grieving, when we're under stress, our immune system leaves. You know, our immune system is impaired. And you know, during the holidays, especially when we're exposing ourselves to people, even pre pandemic, when we're exposing ourselves to people that we haven't seen, they're bringing in foreign bugaboos, even if it's just from Iowa or something, they have a different biome over there bacterially, if you will. Then we have, we don't have the exact same bugabugas here. And generally when people to get together over the holidays, it can be stressful. So their immune system goes down a little bit and they're exposed to bacteria that they may not be as used to handling. So a lot of people get sick. It's important to do what you can to bolster your immune system during this time, which includes good nutrition and getting plenty of sleep and, you know, getting some of that sunlight, keeping your circadian rhythm set so you can. Vitamin D helps a lot with the immune system. And it's important when you are under stress when you are grieving to recognize that that is going to impact your other health conditions. Diabetes, blood sugar is likely going to become more difficult to control. Even if you're not changing what you eat, the stress and presence of cortisol is going to make your blood sugar more variable. Being aware of those being more mindful Mindfulness is the key. Checking in with yourself periodically throughout every day, not just once a day, to ask yourself what is it that my body, my heart and my mind need right now in order to help me be as resilient to this situation as possible. You know, we've talked before and I'm getting ahead of myself, but that's okay. I always do. About living in the and recognizing that you can experience grief, you can be grieving morning, experiencing bereavement, whatever you want to call it, and have a rich and meaningful holiday. Maybe it won't be your happiest holiday ever, but maybe it will be, you know, and we'll talk about some of the ways to handle the affect with it. So remembering that phrase. Well, two phrases, my two favorite phrases. It is what it is, you know, you. That person has. Is lost. Unfortunately they are gone. And it's going to be important to accept that reality that it is what it is. And living in the and I can experience that. I can be sad that my mother's no longer here and I can still have a good holiday. Which takes us down to affective when we're in the throes of bereavement. And bereavement can last a year or it can last a couple of years or maybe even more. If people have had multiple losses, there is no timetable on bereavement. If it is going on, you know, for a long period of time, multiple years, or even through an entire year and the grief isn't subsiding at all, every day is just oppressively grief stricken. Then it's important to see a counselor, see a physician and talk about that, to figure out how to help you get through that period. But it's important to also give yourself time. And everybody has a different timetable. So effectively, when our HPA axis is already in fight or flight mode, when we're already being hyper vigilant, we are going to be more susceptible to dysregulation. We're already running, you know, as much as we can and it's not going to take much to blow the top off the pressure cooker. It's important to recognize that during the holidays there can be a lot of hubbub going on. And that can be during dinner or, you know, celebrations or whatever, where there may be a lot of activity or people making demands, whatever the hubbub is. It's important to be mindful of how you're feeling so you can notice before you start feeling overwhelmed and end up lashing out at people or wanting to completely withdraw. Dysregulation is expected. It. It's expected that people who are experiencing bereavement will have good moments and bad moments. And, you know, those moments may kind of change regularly throughout the day. That's okay, you know, no judgment, just recognizing. What does this mean? Be curious. Depression happens when we feel hopeless and hopeless and when we experience a loss. Well, that's kind of the pinnacle of hopelessness and hopelessness. We don't have any hope that we can have that again. And we are helpless to bring it back or to stop it. However, the way you look at it can also affect things. For example, my mother passed away. This will be the second Christmas that she's been gone. And my children got to know her quite a bit, but they didn't get to know her as much as I would have wanted. I would love for her to still be in their life, but they're not or. But she's not. What I can do is make her memory ever present in their life. And I did the same thing. My father passed many years ago. And in order to make help them know my dad, we always talk about what Paparan would do. And I share funny stories about Paparan. And the same thing with my mother. They got to know her a little bit more. But it's important to me. While her physical body can't be here, I can keep her memory alive and I can keep her knowledge alive by continuing to invite those memories into my life. Now, that's not necessarily something people can do right away. That may feel, you know, too much, but some people find comfort in it. I remember when my grandmother passed at her wake, we spent hours sitting around and they were telling all kinds of stories and anecdotes about my grandmother and just having a good old time. So depression is a reaction to hopelessness and hopelessness. It's important to focus on what is going on in your life that you do have hope about. You know, going back to that hardiness thing. What things in your life do still exist that make it rich and meaningful? My life is much more rich and meaningful because my parents, you know, obviously they gave me life, but because of what they taught me and because they were in it so just because they can't be here for physically, you know, they are still part of my rich and meaningful life because it's important for me to keep their knowledge and their presence alive. But there's also all kinds of other things that are important in my rich and meaningful life that I can focus on and remember that, okay, I have this loss, and it really sucks over here. However, I also have all of these other things that are blessings in my life, and working on that attitude of gratitude can be a little challenging. Anger, guilt, jealousy, and irritability, they're all kind of forms of anger. So I put them all together. This is a normal reaction when you're in that fight or flight response. Anger represents a reaction, a fight reaction to some kind of threat. You can be angry at the person for being gone. You can be angry at the disease that took them. You can be angry at your higher power. You can be angry at whoever you think caused it. You can be angry at the doc. You can be angry at a lot of stuff. It's important, like with any other emotion, like we've talked about, to examine what happened. Well, we had a loss. How do I feel about it? I'm angry. I. All right, what are my beliefs that are contributing to my anger? And then evaluate each one of those beliefs for their facts and for any, you know, cognitive distortions. Am I expecting life to be fair? Well, life's not fair. And if I think, well, it's unfair that this person got taken, well, yeah, it may be. However, you know, what good is being angry that it's not fair? I can't appeal it to somebody and have it. Have the decision reversed. So we want to look at our beliefs that are contributing to our feelings and then evaluating the best course of action to cope with those feelings. What is the best use of your energy to deal with those thoughts and feelings? People may feel guilty that, you know, they have all these. I should have said. I didn't say, I shouldn't have been so mean to that person. Or they may have survivor's guilt. You know, it should have been me that survived and. Or me that died and not that person. There's a lot of different reasons for guilt. Again, same thing. Evaluate the thoughts that are contributing to the feeling and. And then identify of the ones that are valid, of the ones that are based in fact. Evaluate what is the best use of your energy to deal with them. Jealousy can come up, and I do want to talk about that for just a second, because when we're grieving, we can Experience jealousy of other people. You know, you can feel jealous that sue down the road, both of her parents are still alive. You can feel jealous that the people across the street are having a grand old time at their holiday party and you're having, you know, one of the worst holidays of your life. There are, there are. People can experience jealousy of others at this point in time, and that's okay. Jealousy means you're looking at something, somebody has either, you know, parents still alive or happiness and, and going, I really want that. And I'm angry. I don't have it. Okay, well, what do you need? What's the next thing you can do to improve the moment? Irritability is common when, during the holidays period. But when you're experiencing grief, you are more on edge. You're already spun up, so to speak. Going back to that pressure cooker analogy, the heat's already on on the pressure cooker, and it doesn't take much to overload it and blow the top off. Anxiety can happen during the holidays. And you, you can see more anxiety, I think, in children because, and, and some more depression more so than anger a lot of times, not always, but especially in younger children. Younger children may not understand what happened to that person and, or they may be afraid that it's going to happen to other people. So it's important to address that anxiety. And if you're working with children, if you've, you know, your children, your nieces, nephews, whatever they are, same principle applies. Talk about, you know, the thoughts that are contributing to that feeling. You know, what's making. What are you thinking that's making your heart sad, and try to help them hear some of the facts associated with it. Now, that doesn't mean taking away their anxiety. It's not fair to try to take away somebody's pain. It's theirs to hold on to and it's theirs to give away. However, you know, and I'm talking more in this presentation about what you can do for yourself if you choose to give away your pain, what you can do. But when you're working with kids, you know, it is important to help them see options, see what they can try to do if they want to, and if they don't, you know, that's, that's their choice. And people, believe it or not, can experience happiness when they're also grieving and sometimes they feel guilty for feeling happy. What would that person want? Would that person who passed away want you to continue to be miserable or would they want you to enjoy the holidays? Happiness may Be fleeting. You know, it comes and then all of a sudden it's dashed by a wave of tears. And that's okay. It's important to embrace whatever feeling you're feeling. And if you can increase happiness, all the better. You know, if you can do things like tell stories about, you know, funny things that person did or what they would have said or what have you, that can add some a positive spin, a positive memory for people to think about with that person. Cognitively, when we're grieving, hpa, axis fight, or flea, we are not devoting resources to attention to other things, but protection, problem solving, or memory. It's important when you are grieving to write things down, keep a note, keep a list, have, you know, push notifications, whatever you need to do to stay organized, to remember what you need to get at the grocery store. Don't rely on your memory at this point in time. Some people have difficulty, a lot of people have difficulty with meaning after a loss, the meaning of life. And how can this happen in a just world? You know, there are a lot of questions, and that sometimes goes under spirituality, sometimes goes under cognition, whatever, however you want to categorize it. But eventually people need to find some sort of meaning. And that's probably not going to happen over the holidays. But recognizing that that is one of those things that can help you move towards acceptance. Environmentally, people who are grieving are often going to be triggered because sensory triggers abound. You know, you, you may smell this kind of cookies that your, your grandma used to make or see something. I know the first snowfall of the season, this, even this year made me a little bit teary eyed. And just recognizing that having that moment of grief is not necessarily a bad thing. It means that that person was important to you and your heart is, is filled. And you know that memory, Envision it warming your heart. Even if the tears are coming out of your eyes, envision it filling and warming your heart can be helpful. But also noticing if there are a lot of sensory triggers, you know, sometimes it's important to get a break from them. My stepfather experienced a loss, a significant loss on Christmas Eve. And henceforth and forevermore after that happened, he would not have a Christmas tree in his house. And you know, that was one of those things that was extremely triggering for him to have it around. And he didn't swear off Christmas completely, but the Christmas tree was too much for him. And sometimes it's important to set boundaries and say, I can't do this this year, maybe next year. And relationally, when we Lose someone. You know, we are not designed to be alone. We're not designed to live in isolation. So a lot of times when we experience grief, when we experience loss, we may crave other people, we may crave support, or we may not. And we want to get away from other people because it hurts too much to think about caring about anybody else. Eventually you need to process that. But during the holidays. The holidays are sort of like a trip. I. I envision them as a treading water period. It's. There's a lot of stuff going on. You've got a lot of energy going six different directions. And it may not be a time where you're going to make a lot of progress on coping with your bereavement, but staying mindful, staying in the moment and taking it day by day, making sure that you're taking care of your physical health so it can support your emotional health and support your energy is really important. And having a couple of outlets for social support can be really helpful during this period. Bill of Rights for grief Just real quick, and then I'll go on to some of these questions. People have the right or I have the right to know the truth about the loss and have my questions answered honestly. I have the right to talk about the loss as much as needed, to be heard and treated with dignity and respect, or just to be silent. I have the right to disagree with your perceptions or conclusions. I have the right to grieve any way I want as long as it doesn't hurt me or other people. I have the right to feel all of my feelings and to think all of my thoughts of my own unique grief. Grief. I have the right to have guilt about what I could have done or should have done. You know, we have the right to feel all of our feelings. I have the right not to have to follow those stages of grief as outlined in a book. I have the right to be angry at death, at the person who died, at God, the universe, myself or other people. I have the right to have grief bursts where, you know, you're going along, you're doing fine, and all of a sudden it just hits you. And I have the right to not be taken advantage of. Everybody is going to deal with grief in their own way. And it's important to recognize that, you know, if you have a loss, especially a loss that's recent, maybe you lost a family member and then you're getting together for a family reunion and people want to talk about it and it may be too much to hear that, so it's going to be important to figure out how to set those boundaries, to be mindful of when you notice that something's going on that's triggering your grief, triggering your upsetness, and have a plan for how to deal with it. It's important to recognize that things are not going to change overnight. Grief takes a long, long time. And unfortunately, you know, they say time heals all wounds. Well, you know, time makes it easier to deal with changes. You know, it's kind of like if you are in an accident and maybe you lose the. Lose the use of your arm, well, that may not ever come back, but you learn how to live and have a rich and meaningful life, even even though that arm doesn't work. That's that living in the and that we keep talking about. And it's important to recognize that. And with COVID 19, a lot of people are experiencing grief because they lost loved ones this year. And it's going to be important for them to notice their triggers and develop a plan for keeping themselves safe emotionally, physically, interpersonally during this time. And that may mean turning off some of the news. You know, I am a big proponent of that right now. It may mean setting rules and limits for what is okay to talk about over holiday dinners. Um, and for some people, unfortunately, it is. It does mean that they are going to be isolated. They are going to choose to stay at home during the holidays. And being alone during the holidays is difficult on any year. But this year especially, we're going to have a lot more people that their tradition, what they get joy from is spending time with family. And they feel like they can't. They feel powerless. So it's something else. They have to grieve. They. They're grieving the loss of their freedom. And it's going to be important to reach out to those people as much as they will allow you or want and make sure that they feel included. And I suggested in one of the classes last week, you know, even if grandma can't be with you because she was, you know, she figured it wasn't safe for her to travel. Making sure she's there on FaceTime with you so everybody can to her, you know, prop her up at the dinner table on FaceTime and talk with her and include her in what's going on, if that is something that would make her happy and, you know, reach out and virtually touch people to make sure that they are getting their basic needs met and they are not feeling isolated and completely hopeless and powerless. Are there other questions now? I have not chosen the topic for tomorrow. So if y' all have any particular topic you want for the last show before Thanksgiving, please feel free to let me know in the comments. I would be happy to do a show on whatever you would like to learn more about. And remember, at the top of the chat I did give you a link to the grief videos that I have on the YouTube chat YouTube site the grief Playlist that goes in depth into different tips and tools and strategies for coping with grief. You. All righty everybody. Have a wonderful day. Thank you again for being with me and giving me an hour of your time in the morning and I look forward to seeing you tomorrow.