What is the difference between Grief and Bereavement?

Grief is a term that describes all the feelings, thoughts and behaviour that someone goes through after bereavement.

Bereavement is a term that can be used to describe any event that includes loss – so this could mean losing your job, or a similar event, as well as the death of someone you know.

There's no right way of coping with a death, people respond to a loss in their own individual way.

The way a person responds is dependent on their relationship with the deceased, but it also depends on their own personality, upbringing and previous experiences of loss.

In particular, holidays and anniversaries act as reminders of the loss, and many people experience a  worsening of their grief at these times.

It's common for people to have symptoms that are often used to diagnose depression after bereavement. 

It's less common for people to experience a depressive illness and require treatment for this.

People need strong bonds with other people for their emotional well being, and they try hard to maintain these ties. Loss through death permanently breaks this bond. 

Grief can be seen as a person's struggle to maintain the emotional bond, while also experiencing the reality of loss.

'Grief work' is the process that a person going through grief needs to complete before resuming daily life. It involves separating from the deceased, adjusting to a world without them and forming new relationships.

People grieve not only for the deceased, but also for the unfulfilled dreams and plans for the future that they hoped to share with them.

Grief usually passes through stages, but these stages are not separate, nor do they necessarily happen in sequence.

An initial stage of shock or disbelief when it is difficult to believe that the death has occurred. This stage may last minutes or weeks.

A stage of acute anguish that usually lasts from weeks to months when feelings of depression occur. Planning the future may be difficult.

A phase of resolution after months, or even years.

Normal Grief ? 

This is a term used to describe the typical symptoms somebody experiences after bereavement.

It can include:

   disbelief, shock, numbness and feelings of unreality

   anger

   feelings of guilt

   sadness and tearfulness

   preoccupation with the deceased 

  disturbed sleep and appetite and, occasionally, weight loss

   seeing or hearing the voice of the deceased.

A grief reaction can last for up to 12 months, but can vary within different cultures. The average is probably around six months. An exacerbation of symptoms can also occur briefly on anniversaries of the bereavement and on birthdays of the deceased.

Grief and depression are different. 

It is possible to grieve without being depressed, but many of the feelings are similar.

However, about 33% of bereaved people also have a depressive illness one month after the loss, and 15% are still depressed a year later.

Symptoms that suggest a bereaved person is also depressed include:

• intense feelings of guilt not related to the bereavement
• thoughts of suicide or a preoccupation with dying
• feelings of worthlessness
• slow speech and movements, lying in bed doing nothing all day
• prolonged or severe inability to function (not able to work, socialise or enjoy any leisure activity)
• prolonged hallucinations of the deceased, or hallucinations unrelated to the bereavement.

It is difficult to judge who will or won't suffer depression after a bereavement. However, risk factors thought to increase the chance include the following:

• a previous history of depression
• intense grief or depressive symptoms early in the grief reaction
• few social supports
• little experience of death.

The support of family and friends is invaluable to anyone, especially at difficult times.

Sadness after bereavement is natural: it's normal to want to discuss the deceased and become upset while doing so. Expressing feeling does not make things worse.

If depression is thought to be present then antidepressants are very likely to be used.

Antidepressants will treat the depression, but they do not have any affect on the underlying grief. Untreated depression, however, makes it extremely difficult to grieve effectively.

GPs, counsellors and psychiatrists are aware of the many different normal responses to loss and are reluctant to diagnose a person as mentally ill during bereavement.

They will usually provide support to help the person grieve. A psychiatrist is only likely to be involved if the bereavement is complicated by a depressive illness.

Grief counselling helps mourning by allowing someone to work through the stages of grief in a supported relationship.

The goals of grief counselling include:

• accepting the loss and talking about it
• identifying and expressing feelings related to the loss (anger, guilt, anxiety, helplessness, sadness)
• living without the deceased and making decisions alone
• separating emotionally and forming new relationships
• the provision of support
• identifying ways of coping that suit the bereaved. Explaining the grieving process.