Grief

Grief knocks you off balance emotionally, physically and mentally. If the death had been expected, you tell yourself you should be able to cope, but you can't. You think you're over it, and you're not. You think you should feel all right because you have family and friends looking out for you - but you don't feel all right because no-one can replace the person who has died.

When you are bereaved you have to cope with a world which seems to have fallen apart. In practical terms your life may have changed dramatically. You may have much less money, or you may be better off financially. You may be eating and sleeping alone for the first time, or be faced with household jobs which you used to share with the person who died. Losing a close family member or an old friend can mean that you have no-one who shares your childhood memories and family jokes.

Yet the biggest changes are probably inside you. When someone close to you dies it can seem as though everything you took for granted has gone, that you have lost your sense of identity and self-worth. You may feel you have lost almost everything and haven't much left to fall back on or look forward to. And you may feel like this even if you have loving friends and family around you.

Your feelings

At first you may be too shocked to feel anything much, even if the death had been expected. Many bereaved people say that, in their initial shock, they felt a sense of numbness and disbelief.

As you get over the shock and you begin to grasp the reality of what has happened you may go through some of the most powerful feelings you have ever had, feeling high or excitable one minute, in despair the next. You may think you are going mad because you can't control your emotions, can't concentrate, can't organise yourself to make a phone call or make a cup of tea. It may seem as though everything you knew has gone and that nothing will ever make sense again.

You may feel that you don't care whether you live or die because the person who died was so important to you that you cannot imagine existing without them. Your loss may feel overwhelming and you are likely to be reminded of it constantly. You are likely to miss the person who died in all sorts of ways, physically as well as emotionally.

Your thoughts

You are likely to find it hard to concentrate, and may feel confused and forgetful. Your thoughts may constantly return to the person who died, with painful questions and fears running through your mind. Alongside this you may have a sense of relief if they died at what seemed the right time for them.

As you think more about the person and your relationship with them, as you talk about them and listen to what relatives, friends and acquaintances say, you are likely to start building a fuller picture of them than you had before. As it grows, you will probably find this picture becomes a part of your life, a source of comfort which is more than just a memory.

Your body

You will probably notice physical changes. You may have difficulty getting to sleep, and your sleep may be disturbed by vivid dreams and long periods of wakefulness. You may lose your appetite. People react physically in many different ways - some feel tense and short of breath, others feel edgy and restless, others feel very slow and lethargic.

You are likely to feel exhausted, especially if you had been providing care for the person who died, or had been through an anxious time before they died. Strong emotions and dealing with all the things that need to be done after a death can also make you feel tired and drained.

The stress of grief makes enormous physical demands upon you. You may be more susceptible to colds or other infections, or become more accident-prone. It is very important to take extra care of yourself - try to eat well and take extra rest even if you can't sleep. Take some gentle exercise if you can. Be kind to yourself - don't try to do too much while you are grieving.

Getting used to the death

Getting used to a death seems to happen in fits and starts and is often not as simple as it sounds, especially if you had shared your life with the person who died or had known them since childhood. Or you may have lost a younger relative, perhaps your daughter or son, or grandchild. When a young person dies it reverses the natural order of life and death and can seem particularly unjust.

You may switch between talking rationally about the death, the illness, the will, then have a surge of hope as you think you see the person who has died in the street or hear them whistling their favourite song.

Allowing your feelings to come out can help you to get used to your loss. Talking about the death and about the person who died, dealing with the practicalities of your new situation and trying to think of the present as well as the past can all help you get used to the reality of the death and get through some of the anguish you may feel.

As you do this you will probably, slowly, begin to find a way of living without the person alongside you but very much with you in your thoughts and memories.

Difficult times and feelings

Emptiness and depression: Feelings of depression and meaninglessness can hit you when the reality of the death begins to bite and you realise that the person who has died will not come back. Then, perhaps having felt better and as if you were moving on, you may hit rock bottom and life can seem endlessly bleak and empty. Surprisingly, although it may feel almost unbearable at the time, this seems to be a period when some inner healing takes place. Afterwards people generally say they feel lighter, more in control of their lives and better able to look forward.

Depression is a natural response to a bereavement, and usually lifts of its own accord. But if it doesn't, and life seems an endless, pointless struggle, you could be clinically depressed. Clinical depression can be treated and there are different ways of getting through periods of depression, both with and without anti-depressant medication. Ask your doctor for help and advice. Help the Aged produces an information sheet Beating the Blues (PDF) which looks at the difference between feeling down and being depressed, and explains how to get help.

If you have any thoughts of suicide, do talk to your doctor, or to someone you trust. Remember you can phone the Samaritans, day or night, on 08457 90 90 90.

Anger: Some people don't feel angry after a bereavement, but if you do it can be the hardest feeling to cope with. You may feel anger at the injustice of your loss; anger at the lack of understanding in others; anger at the person who died because of what they are putting you through.

Bereaved people are usually angry because they feel hurt and unhappy. You probably feel angry at yourself and at the person who died - the person you need most, who has left you to feel abandoned, frightened and alone.

These feelings are normal and you can probably get rid of your anger in a way which doesn't hurt you or someone else. Some people have a shouting session, dig the garden or write their thoughts on paper and then destroy the pages. Don't bottle up your feelings - try to think about the reasons for your anger. If you don't do this, whatever is upsetting you will almost certainly continue to trouble you; it won't disappear. It can help to talk about your feelings with someone who isn't emotionally involved in your own loss.

Fear: You are likely to feel fearful and anxious. This is very natural - your familiar world has been turned upside down and you are likely to feel you have little control over your life or over the thoughts and feelings churning inside you. Feeling out of control is likely to leave you feeling vulnerable and afraid. But you will probably notice that as you get used to coping, and start to get on top of life again, you will become more confident and less afraid.

You may also have fears about important practical issues. How will you cope with less money coming in? How will you manage household tasks? If you have worries like this it usually helps to get some practical advice. More information on finding out about practical and financial help is given in the Practical Concerns page in this section.

Mixed feelings: It is usual to have mixed feelings when someone dies. You may find yourself thinking of times you wish had been different, or wondering what might have happened if you or the person who died had made different decisions. Mixed feelings of regret, guilt or anger are not easy to deal with.

The important thing is to try to reach a point where you are realistic about the past and can accept it for what it was. This can be hard if the relationship had turned sour or was always a mixture of good and bad.

When a difficult relationship ends with death the problem is that any chance of mutual understanding or reconciliation has gone. But if you try to avoid dealing with upsetting thoughts and feelings you run the risk of becoming angry, bitter or depressed. In a situation like this it usually helps to get a better understanding of the relationship you had with the person who died, of what was good about it and what was not, to work out what each of you contributed to it.

Don't be too hard on yourself or anyone else. No-one is perfect and most people try to do the best they can with the situation they are in. Eventually you are likely to reach some acceptance of the past and move towards a more fruitful present.

Memories of other losses: A bereavement may trigger memories of earlier losses which you thought you had got over. Perhaps you did not realise at the time how much you were affected, or circumstances made it difficult for you to talk about your feelings. You may now remember these unhappy times with great clarity and this can be extremely distressing.

For example, some people are only now beginning to grieve for losses that happened in the war years. Similarly, people who had a stillborn baby or a miscarriage, or a child who died, or whose brother or sister died young, may only now start to grieve openly. Fifty or more years ago it was often customary not to talk much about such deaths and children's feelings were often overlooked, so you may have gone through life with an unspoken burden of sorrow.

You may feel that you need to mourn for these losses, and talk about your experiences, before you can come to terms with your more recent loss.