Madeeha Syed

Navigating The Depths Of Prolonged Grief Disorder: Understanding, Coping, And Healing

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How To Heal From Grief?

Overview

Grief is a natural reaction to any kind of loss. It&rsquo;s something we all experience, but the way it manifests itself varies from person to person. Some people are able to move on quickly, while others find it harder to heal. In this article I&rsquo;ll explain how the stages of grief work and give some tips on how you can help yourself or a loved one through their grieving process. 
&nbsp;

Tips to Heal From Grief

Denial is a defense mechanism. It&rsquo;s a way to protect yourself from the pain of loss, or at least postpone facing it. You may have heard of denial as something that happens during the grieving process, but this isn&rsquo;t quite accurate. Denial doesn&rsquo;t necessarily kick in once someone has died; it can also be an immediate coping mechanism for people who aren&rsquo;t yet ready to admit their loved one is gone.

Denial helps shield you from the <a href="https://merisehat.pk/article/natural-remedies-for-pain">pain</a> of grief by avoiding reality and hiding from feelings you&rsquo;d rather not experience (such as anger and sadness). 
&nbsp;

Anger is a natural and healthy reaction to loss. Anger can help you express your feelings, release negative emotions and show others that you are upset or hurt by what happened.

However, while it is normal to feel angry after the loss of someone or something close to you, there are some things that should be avoided when expressing anger:

Don&rsquo;t direct your anger at anyone else. You may have some pent-up frustrations with people associated with the loss (e.g., family members or friends), but directing your rage toward them will only make things worse for everyone involved.&nbsp;

Directing your anger inward instead by staying home from work or school can also be harmful because it could prevent you from accomplishing goals (such as getting back into college).&nbsp;

It&rsquo;s best not to let anger boil over into lashing out at others unnecessarily; instead, find other outlets for releasing negative emotion such as yoga classes or therapy sessions with a counsellor who specialises in grief counselling. 
&nbsp;

When you are bargaining, you are essentially trying to make the best of an intolerable situation. You may start thinking that there is something you could have done differently or something that will help save your loved one&rsquo;s life. You might even try to bargain with God or a higher power in order to get them back again.

For example, you might think, &ldquo;If only I had spent more time with my husband before he died!&rdquo;, &ldquo;If only I hadn&rsquo;t taken so long buying groceries!&rdquo; or &ldquo;If only I had remembered to call him earlier!&rdquo;&nbsp;

While these thoughts and feelings aren&rsquo;t necessarily accurate (the reality is that death or breakups happens when they happen), they can still be helpful if they allow you some peace of mind and perspective during this difficult time of grieving. 
&nbsp;

Bargaining can also manifest itself as guilt &mdash; for instance, if someone close dies from an illness but another person survives the same illness, there may be some sense that it should&rsquo;ve been the other way around, even though there&rsquo;s no real reason for this feeling beyond just being human (and overthinking things).&nbsp;

If this sounds like how you&rsquo;re feeling right now &mdash; like maybe there was something else r someone else who could&rsquo;ve helped prevent their death (for example) &mdash; it might be helpful for friends and family members who care about your well-being (or just want their own questions answered) not dismiss these thoughts or feelings outright by saying things like, &ldquo;It wasn&rsquo;t your fault&rdquo; or &ldquo;Of course everything would have been different if only...&rdquo;&nbsp;

Instead, they could take those questions seriously while acknowledging how hard they must be on whoever lost their loved ones without belittling them at all &mdash; because sometimes just recognising how painful it must feel helps us move forward without letting ourselves stay stuck in grief forever.&rdquo; 
&nbsp;

The final stage of grief is sadness and acceptance. The loss of someone leaves you feeling helpless. There will be times when you are too distracted by the world and work to think about it but at times, it is common to have a depressive episode and completely lose your pace or focus.&nbsp;

People who are unable to cope and accept tend to go into depression at this stage and numb themselves towards the outside world. The only way to avoid suffering from this illness is to deal with your loss and come to terms with it mentally. This requires your maximum input as your experience life without the person, the need for acceptance and doing things differently now. The only way is the way forward.&nbsp; 
&nbsp;

The stages of grief are not a checklist, nor are they rules to follow. They aren&rsquo;t even in the same order for everyone.

The five stages &mdash; denial, anger, bargaining, sadness and acceptance &mdash; are merely a general guide to help you understand what your loved one might be experiencing during their time of grieving. However, everyone grieves differently and no two people will go through all five stages at the same time or in the same way. It&rsquo;s important to remember that every person needs different kinds of support during times like these: some may need lots of love and affection as they work through their feelings; others will want space from others so they can take care of themselves first before reaching out for support later on. 
&nbsp;

The most important thing that needs to be acknowledged is that there is no shortcut to coping with grief. You cannot skip the stages. However, you can make it easy for yourself to handle your grief and speed up the process. Following are the steps that are age-old practices employed by people to help them cope:

<ul>
	<li>There are people around you who care about you, lean on them. Share your feelings with your friends and family. Hangout with them more to keep yourself distracted.</li>
	<li>Be acceptable for whatever support you are getting. Not many people know what to say or how to act around someone grieving, appreciate their efforts. They are doing it because they care.</li>
	<li>Religion has been a very strong catalyst for people struggling with grief. If you believe in one, resort to your faith. Praying can be very relaxing for the mind.</li>
	<li>A support group or therapy. Both allows you to talk about your experience, how it has affected you without getting a biased answer from the other side.&nbsp; 
	&nbsp;</li>
</ul>

Bottom Line

Grief is a normal part of life and it can be hard to deal with. But remember, there are ways to cope with your feelings and move on from them. If you&rsquo;re struggling with grief or have lost someone close to you, remember that you&rsquo;re not alone. Reach out for help if needed, but don&rsquo;t forget that it may take time before things feel better again!

Umna Salah

Online Consultation

Ismail Munir

Crop Burning And Allergies - Is There A Link?

Introduction

Allergic disorders are not a threat to life in most cases, but they do impair a person&rsquo;s functionality. It eventually has an adverse effect on an individual&rsquo;s physiological well-being and quality of life. However, these implications can be minimised if the <a href="https://www.merisehat.pk/disease/allergies">allergies </a>are detected early and treated appropriately. 
&nbsp;

Understanding Link Between Crop Burning And Allergies

Both indoor and outdoor activities can cause swelling and sinus pain, in addition to watery eyes, nasal congestion, and sneezing. Airborne allergens can cause hay fever or rose fever/ rose cold, which are seasonal or constant persistent allergies.

People with allergies usually have more than one type of allergy, and the most common are indoor/outdoor allergies. The triggers are grass pollen, tree pollen, weed pollen, mould spores, cockroaches, dust mites, cat or dog dander, and rodent urine.

&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Allergies In The United States</h5>
	</li>
</ul>

In the United States, more than 50 million people experience different types of allergies every year and it is the sixth leading cause of chronic illnesses. It is the most common health issue that affects children in the US, and every year 90,000 people visit the emergency room due to anaphylaxis.&nbsp;Medicines, food, insect bites, or stings are the most common anaphylactic triggers.

Furthermore, medicines cause the most common allergy-related deaths. Older adults and African Americans have the highest death rates because of allergies.

Seasonal allergies in the US equal 8% of adults and 7% of children. They usually occur during fall when pollen, trees, and grasses are in the air. Moreover, according to research from 2018, caucasian children are more likely to get hay fever compared to African American children. Allergies of the eyes are usually triggered by the same indoor/outdoor triggers<a href="#accordion">[1]</a>.

&nbsp;

<ul>
	<li>
	<h5>Allergies In The United Kingdom</h5>
	</li>
</ul>

Allergies are rising by 5% each year in the United Kingdom. The first wave of the allergic season started 50 years ago with enormous surges in asthma and hay fever. Currently, we are facing the second wave of allergic diseases, especially fatal food allergies. The figures from the year 2012 indicate that one in forty children suffer from serious allergies in the UK.

During the last decade, the emergency departments in the UK have seen an increase in anaphylactic shocks. More children and adults are being diagnosed with food allergies at present compared to the past.

One in three people is affected by allergic disorders in the UK, which is estimated to be around 20 million people. Although allergies are most common in children, 6-8% of infants have also been diagnosed with food allergies and have experienced anaphylaxis at some point. These numbers are reflected in the admission rates which have doubled. More people were admitted to hospitals with severe allergies seven times more between 2002 to 2012 compared to the 1990s.

One in four people in the UK have hay fever, and it equates to approximately sixteen million people. Also, the prevalence of allergies such as asthma, food allergies, and eczema in the UK is almost four times higher. Furthermore, allergic rhinitis is poorly managed and does not have enough recognition. The number of people being diagnosed with eczema, food allergies, and allergic rhinitis has increased over the last thirty years. The growing numbers are a cause of concern as allergies often severely restrict the sufferer&#39;s everyday activities<a href="#accordion">[2]</a>.

&nbsp;

<ul>
	<li>
	<h5>Allergies In Pakistan</h5>
	</li>
</ul>

Allergies and diseases related to allergies are very common in all parts of the world and involve all ethnicities. These diseases include allergic rhinitis, bronchial asthma, conjunctivitis, and eczema. However, the data on the prevalence of allergic diseases in Pakistan is limited, indicating a need for further exploration.&nbsp;

In recent times, allergic diseases, especially bronchial asthma is increasing worldwide. But there is no data available about the prevalence of allergic diseases among school-going kids in Pakistan. However, data is available for certain age groups i.e. adults.&nbsp;&nbsp;

To bridge this gap, researchers in Pakistan have conducted surveys to know the prevalence of allergic diseases among kids aged 3 to 16 years of age. They used the same questionnaires for data collection that had been used in Saudi and UAE in 2007. The survey was done in Karachi and distributed among various schools covering 2000 to 3000 individuals. According to the results, the frequency of asthma is 15.8%, while the frequency of allergic rhinitis is 28.5% in school kids. The parameters of the analysis included dry cough, eczema, wheezing, and breathlessness. The survey also highlighted that the presence of a smoker in the family increased the risk of asthma, dry cough, wheezing, allergic rhinitis, and breathlessness.&nbsp;

The study signified that school-going kids in Karachi displayed symptomatic allergies. It had also been postulated that indoor environmental exposure and family circumstances also play a role in increasing the chances of asthma and other allergies in kids<a href="#accordion">[3]</a>. 
&nbsp;

A survey was also conducted among healthcare workers to see the frequency of allergic rhinitis among them. These included doctors, dentists, nurses, technicians, and pharmacists. After the survey, it was noted that 13 individuals missed their work because of allergic rhinitis indicating work absence due to allergies<a href="#accordion">[4]</a>.

&nbsp;

Exposure to pesticides and crop burning in communities can cause allergies according to research. Studies have been conducted to review the effects of agricultural exposure on the respiratory health of kids. These studies were conducted predominantly in industrial agricultural areas.

These studies assessed exposure and its effect on various respiratory health outcomes, for example, asthma, measurements of lung function, and acute respiratory symptoms. It was found that pesticides influenced the respiratory health of children. Furthermore, exposure to agricultural burning influenced the respiratory health of kids and the effect was severely adverse. To summarise, a positive association between exposure to agricultural burning and adverse effects on the respiratory system was seen<a href="#accordion">[5]</a>.

&nbsp;

The burning of crops and their residue is becoming a serious problem in Pakistan, and is a cause of concern for both health reasons as well as climate change. This unfortunate situation is not only limited to Pakistan and applies everywhere else in the world, due to its mitigating effects. It has led to an impairment in the quality of air, heat waves, strong haze, and several health problems.&nbsp;

&nbsp;

The primary database of Punjab was used to assess the extent of the problem in Punjab, Pakistan. The health and environmental effects of crop burning residue were assessed. It was found that crop burning had a drastic impact on households with chronic and non-chronic diseases. Also, the severity of the diseases was seen to increase during the period of crop burning.

This situation can be avoided by adopting sustainable crop management practices. The first step towards this could be raising awareness among farmers and engaging them in this dialogue.&nbsp;&nbsp;

&nbsp;

Key Points

<ul>
	<li>Allergic rhinitis is very common in most parts of the world, which includes Pakistan as well.</li>
	<li>Asthma, a very common allergy is associated with seasonal changes, pet dander, and other environmental factors.</li>
	<li>Respiratory problems due to crop burning are also of great prevalence.</li>
	<li>New policies and meaningful implications should be adopted to promote using the residues of crops in Pakistan to improve the situation.</li>
</ul>

&nbsp;

[1] Warren, C.M., Jiang, J. and Gupta, R.S., 2020. Epidemiology and burden of food allergy. Current allergy and asthma reports, 20(2), pp.1-9.

[2] Gupta, R., Sheikh, A., Strachan, D.P. and Anderson, H.R., 2007. Time trends in allergic disorders in the UK. Thorax, 62(1), pp.91-96.

[3] Hasnain, S.M., Khan, M., Saleem, A. and Waqar, M.A., 2009. Prevalence of asthma and allergic rhinitis among school children of Karachi, Pakistan, 2007. Journal of Asthma, 46(1), pp.86-90.

[4] Siddiqui, M.I., Dhanani, R. and Moiz, H., 2020. Prevalence of allergic rhinitis among healthcare workers and its impact on their work: A cross-sectional survey at a tertiary healthcare centre in Pakistan. JPMA. The Journal of the Pakistan Medical Association, 70(8), p.1432.

[5] Van Horne, Y.O., Farzan, S.F., Razafy, M. and Johnston, J.E., 2022. Respiratory and allergic health effects in children living near agriculture: A review. Science of The Total Environment, p.155009.

[6] Raza, M.H., Abid, M., Faisal, M., Yan, T., Akhtar, S. and Adnan, K.M., 2022. Environmental and Health Impacts of Crop Residue Burning: Scope of Sustainable Crop Residue Management Practices. International Journal of Environmental Research and Public Health, 19(8), p.4753.

Staff Writer

Humza Khizer

Vestibular Rehabilitation: Restoring Balance And Reducing Dizziness

Vestibular rehabilitation therapy (VRT) is an effective treatment option for individuals suffering from vestibular or central balance system disorders.

VRT is a kind of <a href="https://merisehat.pk/article/your-guide-to-physical-therapy">physical therapy</a> that involves specialized exercises to improve gaze and gait stability in both children and adults.

Nearly 42% of Americans have experienced dizziness at least once in their lives. Some people experience permanent balance deficits, resulting in functional limitations<a href="#accordion">[1]</a>. According to several studies, customized VRT programs fare better for these patients than generic ones<a href="#accordion">[1]</a>. 
&nbsp;

The vestibular system is a complex network of structures in the inner ear and brain that serve an important role in balance, coordination of eye movements, and spatial orientation. 

When this system is damaged or dysfunctional, a variety of symptoms, such as vertigo, dizziness, nausea, and unsteadiness, can occur. 
&nbsp;

Understanding Vestibular Rehabilitation Therapy

Dizziness can be a sign of a few medical conditions that affect the sense of balance. The individual may also feel muscle fatigue and headache as a result of dizziness.&nbsp; 

According to data from the National Health and Nutrition Examination Survey, people with symptomatic vestibular dysfunction have a 12-fold increased risk of falling<a href="#accordion">[3]</a>. 
&nbsp;

VRT benefits people suffering from the following conditions:

<ul>
	<li>Vertigo</li>
	<li>M&eacute;ni&egrave;re&#39;s disease</li>
	<li>Benign paroxysmal positional vertigo </li>
	<li>Labyrinthitis</li>
	<li>Vestibular neuritis</li>
	<li>Migraine</li>
	<li>Stroke</li>
	<li>Traumatic brain injury 
	&nbsp;</li>
</ul>

Vestibular rehabilitation stimulates and promotes the recovery of the vestibular system. Since the exercises are intended to challenge the vestibular system in a controlled manner, the difficulty level is gradually increased as the patient progresses. This technique helps to improve the vestibular system function and reduce symptoms, like vertigo, dizziness, and unsteadiness that negatively affect daily life<a href="#accordion">[2]</a>. 

A VRT program is developed based on the extent and location of vestibular system damage in an individual patient. The state of the visual and proprioceptive systems, physical strength, motor skills, and cerebellum integrity are all critical to successfully implementing a VRT program. In fact, according to research, patients with cerebellar dysfunction benefit little from vestibular rehabilitation<a href="#accordion">[1]</a>. 

Moreover, cognitive abilities including decision-making and memory are important factors that influence the outcome of a VRT program. Also, the program can do little to help a person who suffers from any psychological or anxiety disorder. 
&nbsp;

Used appropriately, VRT can be very effective for patients suffering from conditions affecting the vestibular system. These advantages include:

<ol>
	<li>Improved stability and balance</li>
	<li>Minimized dizziness and vertigo</li>
	<li>Higher tolerance for head movements and position changes</li>
	<li>Enhanced coordination and spatial awareness</li>
	<li>Decreased likelihood of falls and other accidents 
	&nbsp;</li>
</ol>

Conclusion

Vestibular rehabilitation is a safe and efficient therapy for vestibular disorders. Many people can significantly improve their balance and dizziness symptoms under the guidance of a skilled physical therapist. 
&nbsp;

Key Takeaways

<ul>
	<li>Vestibular rehabilitation is a specialized physical therapy that helps people with balance disorders and dizziness.</li>
	<li>The vestibular system in the inner ear plays a crucial role in maintaining balance and orientation.</li>
	<li>Vestibular rehabilitation is a highly efficient treatment for a variety of vestibular disorders, including BPPV, vestibular neuritis, Meniere&#39;s disease, and more.</li>
	<li>Vestibular rehabilitation typically involves a combination of exercises and techniques tailored to the patient&#39;s needs.</li>
	<li>Vestibular rehabilitation is safe and effective when performed by a skilled physical therapist.</li>
	<li>If you are experiencing balance problems or dizziness, speak to your doctor about whether vestibular rehabilitation may be proper for you. 
	&nbsp;</li>
</ul>

[1] Philip E Zapanta M. Vestibular rehabilitation. Overview, Vestibular Rehabilitation Therapy, Vestibular Rehabilitation Therapy Program.

[2] Whitney SL, Alghwiri A, Alghadir A. Physical therapy for persons with Vestibular Disorders. Current Opinion in Neurology. 2015;28(1):61-68. doi:10.1097/wco.0000000000000162.

[3] Agrawal Y, Carey JP, Della Santina CC, Schubert MC, Minor LB. Disorders of Balance and Vestibular Function in US Adults: Data From the National Health and Nutrition Examination Survey, 2001-2004. Arch Intern Med. 2009;169(10):938–944. doi:10.1001/archinternmed.2009.66.

Neelam Asad

Grief Counseling

If you have watched the Netflix horror series, The Haunting of the Hill House, which unleashes a nightmare and tragedy of the worst kind, you would have a fair idea of the struggles of a family that is affected by trauma.&nbsp;

&nbsp;

In the show, the protagonists were just kids when they moved into a haunted house, and the whole experience was so terrifying that they were unable to process it even well into their adulthood.&nbsp;

&nbsp;

That might have been a fictitious drama, but unfortunately reality is no different; grief is forever etched in our memories, making us question our sanity. The series documents that even though the pain is shared by all, it is still impossible to discuss. This is exactly how grief works for many people &ndash; it stays bottled inside because people don&#39;t know how to deal with it.&nbsp;

&nbsp;

Grief, when not addressed, can take a great toll on a person&#39;s <a href="https://merisehat.pk/article/Mental%20Health">mental health</a>. So, the best way to deal with grief is to confront it and work on ways that help you to respond to it.&nbsp; 
&nbsp;

Understanding Grief And Ways To Cope With Loss

Grief is a response to any form of loss. You might have lost a loved one, a pet, or a job, or you might have failed in class. There are numerous reasons for which one experiences grief and everyone responds to it differently<a href="#accordion">[1]</a>.&nbsp;

&nbsp;

Bereavement is basically grief revolving around losing a loved one<a href="#accordion">[1]</a>.&nbsp;

&nbsp;

Bereavement and grief exhibit a range of emotions from feeling immensely sad to being angry at the circumstances in which you experienced the loss. Everyone grieves in their own way. What&rsquo;s important to remember is that this is a natural response to loss, and there&rsquo;s no need to hide it or feel ashamed of it.&nbsp;

&nbsp;

It is human to feel all the &lsquo;negative&rsquo; emotions &ndash; hurt, sadness, guilt, anger, even yearning for the loved one &ndash; since these emotions are part of the grieving process.&nbsp;

&nbsp;

People dealing with grief always tend to be preoccupied with their thoughts, as they try to make sense of their loss. Sometimes, the thoughts might be reassuring and relaxing, like their loved ones lived a good life and it is best for them that they don&#39;t have to endure anymore pain due to their extreme illness. Another time it would be like their loved one left too early and it wasn&#39;t the right time<a href="#accordion">[1]</a>.

&nbsp;

Now the issue of grieving is that varies from person to person. Some people are comfortable to share their feelings with the people they trust, while some people keep their emotions to themselves and engage themselves in different activities to remain busy. Bottling up your emotions is really an attempt to deceive yourself that you can forget the event if you could just ignore those feelings or not feel its impact.

&nbsp;

People who are going through a period of grief could be identified through these symptoms<a href="#accordion">[2]</a>:

<ul>
	<li>Feeling numb or in shock - this one is the initial reaction to loss when people are unable to comprehend it&nbsp;</li>
	<li>Feeling tired and exhausted&nbsp;</li>
	<li>Feeling overwhelmingly sad&nbsp;</li>
	<li>Crying a lot</li>
	<li>Feeling angry</li>
	<li>Feeling guilty&nbsp;</li>
</ul>

&nbsp;

Individuals don&#39;t experience these symptoms all at once and then just move on; rather, they keep struggling with these emotions from time to time.&nbsp;

&nbsp;

Based on how people approach grief, grieving can be classified into 2 major types<a href="#accordion">[1]</a>:

1.&nbsp;Instrumental Grieving: This type of grieving involves redirecting emotions to problem-solving strategies, to control and minimise the emotions linked with the loss.&nbsp;

2. Intuitive Grieving: This form of grieving involves acknowledging and experiencing the emotions by sharing the feelings about loss, by trying to find old connections linked to the loss, or simply by considering death.

&nbsp;

Elizabeth Kubler-Ross in 1969 defined the 5 stages of grief<a href="#accordion">[1][3][4]</a>.

&nbsp;

The 5 stages of grief include:

<ul>
	<li>Denial: During this stage, individuals are in denial about their loss. In other words, they don&#39;t come to terms with, or don&#39;t process, what has happened to them. This temporarily protects them from experiencing the surge of emotions that are associated with grief.&nbsp;</li>
	<li>Anger: While individuals are going through this stage, they experience bouts of anger that is either directed at themselves, at others, or towards the deceased.&nbsp;</li>
	<li>Bargaining: When individuals have gone through denial and anger, they start bargaining for their loss. For instance, individuals who have been diagnosed with cancer might question why they got the disease, whether it could be prevented in some way or the other.&nbsp;</li>
	<li>Depression: During this stage, individuals tend to isolate themselves as they enter the downward spiral of depression. In this phase, individuals are usually quiet, and are enduring the overwhelming sadness and grief on their own.&nbsp;</li>
	<li>Acceptance: Once an individual comes to terms with what has happened, it means that they have reached the stage of acceptance.&nbsp;</li>
</ul>

&nbsp;

These stages of grief are not in any linear order, as people transition from one stage to another at their own pace. However, it has been observed that each individual goes through at least 2 of these 5 stages.&nbsp;

&nbsp;

Most individuals eventually learn to cope with loss and manage their grief, and move ahead in life. But some people continue to struggle to resume their normal life, a condition which is referred to as &lsquo;complicated grief&#39;.&nbsp;

&nbsp;

Around 15% of individuals who have lost a loved one experience complicated grief. In this condition, individuals experience grief for more than a year. The intensity of their grief is so severe that it hampers the productivity of their day-to-day life<a href="#accordion">[4]</a>.&nbsp;

&nbsp;

Symptoms of complicated grief include:

<ul>
	<li>Feeling hopeless and empty&nbsp;</li>
	<li>Feeling extreme sadness and intense pain</li>
	<li>A strong yearning to be reunited with the loved one</li>
	<li>Avoiding things that bring back memories of the loved one&nbsp;</li>
	<li>Losing sense of one&rsquo;s own identity&nbsp;</li>
	<li>Inability to enjoy the happy memories of the loved one</li>
	<li>Losing interest in activities and no desire to make plans</li>
	<li>A sense of detachment from friends and family&nbsp;</li>
</ul>

&nbsp;

There is no denying that grief is largely unaddressed due to cultural restraints where people aren&#39;t supposed to mourn over their loss after a specific period of time. It&rsquo;s expected that they would &lsquo;act their age&rsquo; or be mature and move on. It&rsquo;s both harsh and unfair to expect people to act a certain way right after they have confronted the greatest tragedy of their life.&nbsp;

&nbsp;

Individuals who are grieving have poor mental health, and are unable to return to normal routine even if they want to. They are in dire need of professional help. They cannot just &lsquo;toughen up&rsquo; on their own, and require counselling or therapy to process their loss. They have to re-learn coping strategies to sail through their loss in a healthy manner.&nbsp;&nbsp;

&nbsp;

According to a meta-analysis, around 10% of people experience prolonged grief disorder or complicated grief after losing a loved one and these individuals need additional assistance to help themselves come out of the phase of bereavement<a href="#accordion">[3]</a>.

&nbsp;

There are different therapies that can help you cope with your grief. Some of them are listed below<a href="#accordion">[3]</a>:&nbsp;

&nbsp;

Cognitive Behavioural Therapy (CBT)

CBT is a very effective therapy for people dealing with depression, anxiety, and post-traumatic stress disorder (PTSD). Your therapist helps you identify the negative aspects of your behavior that are hindering your way to recovery. After analysing those thoughts and feelings, your therapist will simplify the healing process, ensuring you address your emotions in a different manner by reinterpreting and reframing your behavior.&nbsp;

&nbsp;

Acceptance And Commitment Therapy (ACT)&nbsp;

ACT is another therapy that helps you cope with grief. According to a research paper published in 2016, supported by the American Counselling Association, ACT is quite useful in treating prolonged and complicated grief by introducing you to mindfulness techniques to cope with your experiences.

&nbsp;

Young children react to grief in a different manner than adults as confirmed by the American Academy of Child and Adolescent Psychiatry<a href="#accordion">[3]</a>.&nbsp;

&nbsp;

Preschoolers might respond to grief differently because they consider loss as something that is reversible and temporary. However, kids aged 5-9 may comprehend grief slightly like adults.&nbsp;

&nbsp;

Children who are experiencing grief can be counselled through<a href="#accordion">[3]</a>:

<ul>
	<li>Play Therapy: Therapists use stuffed toys, dolls, and puppets to play with children, encouraging them to ask questions about whatever is disturbing them. The therapist essentially helps them communicate about their emotions.&nbsp;</li>
	<li>Art Therapy: This therapy helps the child to portray their feelings through art. The therapist asks the child to draw the person they miss or are grieving. This serves as an insight into the emotional state of the child.&nbsp;</li>
	<li>Narrative Therapy: There are children&#39;s books that address grief and losing a loved one. A therapist might read such stories to children to help them understand that death is a part of life, and how they should deal with it and move forward.&nbsp;</li>
</ul>

&nbsp;

Grief is a strong emotion and individuals who have to deal with a loss of a loved one, a pet, or are going through unpleasant experiences such as a divorce, losing their job, or getting diagnosed with a terminal illness find it very challenging to make sense of their emotions.&nbsp;Most of the time these individuals struggle with their thoughts, and it is a difficult process to deal with grief. Everyone copes with it in their own way. However, when grieving becomes prolonged and complicated, professional help should be sought to help the person get out of that phase and resume living.&nbsp;

<ul><li>Grief is the response to loss, either of a loved one, pet, or job.</li><li>Bereavement is the response to loss of a loved one.</li><li>There are five stages of grief and every individual deals with grief in their own way.</li><li>Symptoms of grief range from shock and numbness to anger and crying spells.&nbsp;&nbsp;</li><li>When grief becomes prolonged, it is referred to as complicated grief.</li><li>A therapist might help individuals who are not able to cope up with their loss, and for whom grief is hindering their day-to-day functioning.&nbsp;</li></ul>

[1] "Grief, Loss, and Bereavement - Good Therapy." 5 Nov. 2019.

[2] Get help with grief after bereavement or loss - NHS.

[3] Understanding Therapy for Grief and How It Can Help - Healthline." 22 Mar. 2021.

[4] "What Is Grief Counseling? - WebMD."

Nawal Adnan

Grief is a natural response to loss, a universal human experience that often accompanies the death of a loved one. While grief is a complex and challenging emotion, it typically subsides over time as individuals adapt to the loss and find ways to move forward. However, for some, the grief process becomes overwhelming and unrelenting, leading to a condition known as Prolonged Grief Disorder (PGD). In this comprehensive article, we will explore PGD, including its definition, symptoms, causes, diagnosis, and treatment options, shedding light on this often misunderstood and debilitating condition. 
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diagnosis and healing strategies

<h5>I. Defining Prolonged Grief Disorder</h5>

Prolonged Grief Disorder, also referred to as Complicated Grief or Persistent Complex Bereavement Disorder, is a mental health condition that occurs when the process of mourning becomes prolonged and intense, significantly impairing an individual&#39;s ability to function and adapt to life without their loved one. 
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<h5>II. Symptoms Of Prolonged Grief Disorder</h5>

PGD is characterized by a set of distinct symptoms that distinguish it from normal grief. These symptoms often persist for an extended period, typically six months or more, and can include:

<ol>
	<li>Intense Longing: A persistent and intense yearning or longing for the deceased person, accompanied by emotional pain.</li>
	<li>Preoccupation With The Deceased: Intrusive thoughts, memories, and dreams of the deceased individual that interfere with daily life.</li>
	<li>Difficulty Accepting The Loss: A persistent disbelief or inability to accept the reality of the loss, even months or years after it occurred.</li>
	<li>Emotional Numbness: Feelings of emotional numbness, detachment, or a sense of emptiness, making it challenging to experience joy or engage with others.</li>
	<li>Social And Occupational Impairment: Difficulty maintaining relationships, engaging in daily activities, or fulfilling occupational responsibilities.</li>
	<li>Emotional Dysregulation: Intense emotional reactions, such as anger, guilt, or extreme sadness, that are disproportionate to the situation or inconsistent with cultural norms. 
	&nbsp;</li>
</ol>

<h5>III. Causes Of Prolonged Grief Disorder</h5>

While anyone can experience PGD, certain factors may increase the risk:

<ol>
	<li>Sudden Or Traumatic Loss: A sudden or traumatic loss, such as a car accident or suicide, can intensify grief and increase the risk of PGD.</li>
	<li>Lack Of Social Support: A lack of a support system or social isolation can hinder the grieving process and contribute to the development of PGD.</li>
	<li>Unresolved Issues: A history of unresolved conflicts or a strained relationship with the deceased person can complicate the grieving process.</li>
	<li>Personal Vulnerabilities: Certain personal factors, such as a history of mental health issues, may make individuals more susceptible to PGD. 
	&nbsp;</li>
</ol>

<h5>IV. Diagnosis And Distinction From Normal Grief</h5>

PGD is a clinical diagnosis made by mental health professionals, such as psychologists or psychiatrists. To distinguish PGD from normal grief, clinicians often assess the duration, intensity, and impact of the symptoms. A diagnosis of PGD typically requires the presence of these symptoms for six months or more and a significant impairment in daily functioning. 
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<h5>V. Treatment For Prolonged Grief Disorder</h5>

PGD is a treatable condition, and several therapeutic approaches have shown promise in helping individuals cope with and heal from prolonged grief:

<ol>
	<li>Grief Counseling: Traditional grief counseling provides individuals with a safe space to express their feelings, process their grief, and learn coping strategies.</li>
	<li>Cognitive-Behavioral Therapy (CBT): CBT helps individuals identify and challenge irrational thoughts and beliefs related to their grief, facilitating healthier emotional processing.</li>
	<li>Mindfulness And Relaxation Techniques: Mindfulness practices can help individuals manage overwhelming emotions and develop greater emotional regulation.</li>
	<li>Support Groups: Joining a support group for those who have experienced similar losses can provide a sense of community and validation of one&#39;s feelings.</li>
	<li>Medication: In some cases, medication, such as antidepressants or anti-anxiety medications, may be prescribed to alleviate symptoms of depression or anxiety associated with PGD. 
	&nbsp;</li>
</ol>

<h5>VI. Coping Strategies For Prolonged Grief</h5>

In addition to professional treatment, there are several coping strategies that individuals can employ to manage PGD:

<ol>
	<li>Self-Compassion: Practice self-compassion and allow yourself to grieve without judgment. Understand that it is okay to feel the way you do.</li>
	<li>Routine And Structure: Maintain a daily routine and structure, as it can provide stability and a sense of control during a difficult time.</li>
	<li>Healthy Lifestyle: Prioritize self-care through regular exercise, a balanced diet, and sufficient sleep.</li>
	<li>Memorialization: Create meaningful rituals or memorials in honor of the deceased to keep their memory alive in a positive way.</li>
	<li>Seek Support: Lean on friends and family or seek professional help when needed. Don&#39;t hesitate to reach out for support. 
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</ol>

Prolonged Grief Disorder is a challenging and often overwhelming condition, but it is not insurmountable. With the right support, understanding, and treatment, individuals can navigate the complex terrain of grief and move towards healing and recovery. It is crucial to recognize that healing from PGD is a unique and individual process, and there is no specific timeline for when grief should subside. Each person&#39;s journey is valid, and seeking help is a significant step toward finding hope and a sense of purpose in life once again.