Monday, August 15, 2011

Grief Depression and Insomnia

Hundreds of mourners gathered Monday, August, 15, 2011, at the Indiana State Fairgrounds to remember five people killed when high winds caused an outdoor stage to collapse onto an audience awaiting the start of a country music concert. Four of the victims died at the scene: Alina Bigjohny, 23, of Fort Wayne; Christina Santiago, 29, of Chicago; Tammy Vandam, 42, of Wanatah; and 49-year-old Glenn Goodrich of Indianapolis. Nathan Byrd, a 51-year-old stagehand from Indianapolis who was atop the rigging when it fell, died overnight.

[caption id="attachment_1493" align="alignright" width="300" caption="Indianapolis Fairgrounds Tragedy August 13, 2012"][/caption]

My heart and prayers go out to each family and friends of the deceased. A tragic death is much more shocking then caring for and watching a loved one pass from an illness. You start to go through the grieving process with them while they are alive and by the time they are ready to pass both of you are in the acceptance stage. Though there may be a time of mourning, a lot of people are grateful that their loved one no longer has to suffer. A tragic, sudden death is often a loss that does not make sense. The defines a Sudden Loss as one that occurs without any forewarning. A Traumatic Death is one that is sudden, unanticipated, violent, mutilating or destructive, random and/or preventable, involves multiple deaths or one in which the mourner has a personal encounter with death.

Family and friends of the victims now realize that life is not always fair and that sometimes bad things happen to good people. With a sudden death many feel shaken, unsure and vulnerable; their safe world they once knew no longer exists. The mourner’s grief response is intensified since there was little opportunity to prepare for the loss and say good-bye. This type of loss generates feelings of shock, anger, guilt, depression, despair and hopelessness. The most common symptoms of grief and major depression include insomnia (not being able to fall asleep easy, can’t stay asleep during the night, wake-up too early and afternoon sleepiness), lack of appetite, withdrawal from people/everyday activities and feelings of sadness and loss.

Marital and family relationships can become strained along with grief, depression and insomnia. Stress and anxiety lead to many nights where they toss and turn rehashing the event thinking about what they could have or should have done to prevent the tragedy and wondering why they survived when others have died. Since the Indianapolis event was public these mourners also have to deal with the intrusion by the media, replaying the tragic event, over and over.

Symptoms of grief are considered abnormal if they last longer than two months especially if they involve thoughts of suicide or intense hallucinations. Major depression is one of a number of mental disorders that may be associated with the death of a loved one; anxiety disorder and post-traumatic stress disorder are also prevalent. Anxiety disorder includes restlessness, difficulty sleeping, racing heart, sweating, shortness of breath and unneeded worrying. If these symptoms are present after the death of a loved one, they should seek help from grief counseling, especially if they last more than two months.

Post-traumatic stress disorder (PTSD) symptoms most commonly occur if the person witnessed the death or were themselves in danger at the time of the loved one’s death. These are; avoidance which include feeling of detachment, lack of interest and thoughts of having no future, hypervigilance or hyperarousal causing extreme awareness, easily startled, unable to focus, angry and having difficulty sleeping and reliving the event to the extent that it interferes with daily activities and physical reactions that remind you of the loss.

Intense symptoms of grief that last more than 14 months is often distinguished by difficulty acknowledging the death of your loved one, or disbelief; continuing to act as though your loved one is still alive — like setting a place for them at the table; and extreme distress from grief with little hope for the future. Anyone struggling with this type of grief should seek help from a therapist who has experience working with grief and loss, and they would also likely benefit from a consultation with a physician or psychiatrist about their grief symptoms and/or join grief support groups.

It is possible to get past grief and severe depression and start living again. Seek out these support groups in your area — their doctor or local hospital should be able to recommend one. Though they may feel alone, there are many people available to help. What can you do? The best thing you can do is spend time with that person, and listen to them work through their grief. Avoid saying phrases like 'with time, you'll get over this'. This is false comfort and denies the person their need to mourn properly. Offer practical help, such as cooking dinner or shopping for food - when a person is grieving, it is usually hard to focus on everyday tasks. It can be helpful to be aware of the five stages of grief and remember that intense emotions and swift changes in mood are normal.

The five stages of grief:


In the denial stage we refuse to believe what has happened. We try in our mind to tell ourselves that life is as it was before our loss. We can even make believe to an extent by reenacting rituals that we used to go through with our loved one. Making an extra cup of tea for our loved one who is no longer there, rushing back to tell someone that you have met an old friend. Flashing back to times and conversations in the past as though they were here with us now. They can all be part of this stage.


They get angry. The anger can manifest itself in many ways. They blame others for their loss. They can become easily agitated having emotional outbursts. They can even become angry with themselves. Care must be taken here not to let them turn this anger inwards. Release of this anger is a far better way to cope with grief in many experiences.


Bargaining can be within or if they are religious with their god. Often they will offer something to try to take away the reality of what has happened. They may try to make a deal, to have their loved one back as they were before the tragic event occurred. It is only human to want thing as they were before.


Depression is a very likely outcome for all people that grieve for a loss. This is what I would consider the most difficult stage of the five to deal with. There can be a feeling listlessness and tiredness. They may burst helplessly into tears and have feeling like there is no purpose to life any more. Feeling guilty, like everything is their fault. They may find they feel like they are being punished. Pleasure and happiness can be difficult to achieve even from things and activities which they have always enjoyed. There can even be thoughts of suicide. There are many different ways in which this stage of grief can manifest itself. If they at any time in this stage they feel like self inflicting harm, please do seek professional counseling. Self preservation is a must.


The final stage of grief. It is when they realize that life has to go on. They can now accept their loss. They can regain their energy because sleep has been restored. Goals can be set for the future. It may take some time to get here but they will.

Grief professionals often use the concept of "Grief Work" to help the bereaved through grief resolution. One common definition of Grief Work is summarized by the acronym TEAR:

T = To accept the reality of the loss
E = Experience the pain of the loss
A = Adjust to the new environment without their loved one
R = Reinvest in the new reality

This is Grief Work. It begins when the honeymoon period is over, the friends have stopped calling, everyone thinks you should be over it and everything is supposed to be back to normal.

It is important for the grieving person to take care of him/herself following a sudden loss. He/she is dealing with an event that is beyond their control. One way of helping is to do things that help re-establish the person’s sense of control over their world. It is also important for them to focus on the basics they need for day-to-day survival. Have them maintain a normal routine. Even if it is difficult to do regular activities, try to anyway. Putting more structure into a daily routine will help one to feel more in control. They should get enough sleep, at least plenty of rest. It may be helpful for them to keep lists, write notes or keep a schedule. Have them try and get some regular exercise, even if it is just taking a walk on a nice sunny day. This can help relieve stress and tension and the vitamin D is good for them. Help them keep a balanced diet and watch out for junk food or high calorie comfort food binges. Have them drink plenty of water and drink alcohol in moderation. Alcohol should not be used as a way of masking the pain. Let them do what comforts, sustains & recharges. Remind them of other difficult times and how they have survived them; drawing upon their inner strength. Remind them to take it one hour at a time, one day at a time.

Moving beyond intense feelings of grief and severe depression after the death of a loved one will take effort. It helps to know where to turn for help if they can’t manage on their own. The content provided in Grief Depression and Insomnia is for information purposes only, intended to raise the awareness of different solutions for you or your families sleep problems and should not be considered medical advice. For medical diagnosis and treatment, please see your qualified health-care professional.
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