The Grief Process

Grieving is painful but normal after a significant loss like the death of a loved one. Common experiences include:

• Intense sadness, anger, guilt, anxiety or loneliness
• Preoccupation with thoughts and memories of the deceased
• Disbelief, confusion or difficulty accepting the loss
• Physical distress like fatigue, stomach upsets or insomnia

We often cycle rapidly through different emotions in the early days and weeks after loss. But over time, most bereaved people process their grief and find a way forward. Cultural rituals like funerals help us mourn collectively and start to let go.

When Grief Becomes Post-Traumatic Stress

For a minority of mourners, acute grief after a sudden or violent loss can morph into post-traumatic stress disorder. PTSD causes four main types of symptoms:

1. Re-experiencing the Trauma

• Intrusive, frightening thoughts or flashbacks
• Nightmares centered around the loss
• Severe emotional or physical distress when reminded of the event

2. Avoidance

• Avoiding people, places or activities associated with the loss
• Inability to remember aspects of the death
• Emotional numbness and detachment

3. Negative Thoughts and Moods

• Persistent sadness, fear, anger, guilt or shame
• Loss of interest in life
• Feelings of isolation and hopelessness

4. Increased Arousal

• Being on constant alert or edge
• Irritability or aggression
• Difficulty concentrating or sleeping

These PTSD symptoms last at least a month and significantly impair daily functioning. Without treatment, they can persist for years.

Loss Events that Can Lead to PTSD

Any kind of traumatic loss can trigger PTSD, especially with a violent or sudden death. Situations commonly linked to mourning-related PTSD include:

• Deaths from accidents, disasters, war, terrorism or assault
• Suicides and overdoses
• Severe illness or injury with graphic symptoms
• Witnessing a death firsthand
• First responder traumatic loss experiences
• Death of a child or young person

High levels of stress around the time of death and during bereavement also increase PTSD risks. This includes financial strains, family conflicts and lack of social support.

Getting Help for Traumatic Grief

If symptoms like flashbacks, constant anxiety and emotional numbness last more than a month, seek professional PTSD treatment. therapies like psychotherapy, support groups and medication can help manage the symptoms.

Cognitive processing therapy helps identify unhelpful thought patterns related to guilt or blame. Reframing these thoughts can reduce distress.

Exposure therapy slowly exposes the survivor to memories in measured doses so they become less debilitating.

EMDR uses eye movements to reprocess traumatic memories and reactions.

Group counseling connects mourners with others who experienced similar losses.

Medications like antidepressants and anti-anxiety drugs also help manage PTSD symptoms like depression, panic attacks and insomnia.

With time and treatment, the intense pain diminishes and hope returns. The loss can be integrated into the survivor’s life in a manageable way.

Self-Care and Coping Strategies

While undergoing PTSD treatment, these self-care practices also help manage symptoms:

• Talk it out – Speak about your emotions and memories with trusted friends. Don’t isolate yourself.
• Take it slowly – Don’t pressure yourself to recover quickly. Give yourself time.
• Pay attention to needs – Make sure you get enough sleep, nutrition and exercise. Reduce alcohol.
• Try relaxation techniques – Do yoga, deep breathing, meditation, nature walks. Reduce stress.
• Gain perspective – Connect with spiritual leaders or advisors to find meaning.
• Express yourself creatively – Write, draw, cook, dance or sing to process emotions.
• Consider a support group – Bond with others who share your experiences.

Overlap Between Grief and PTSD

PTSD and grief have some overlapping symptoms like sadness, anxiety and sleep troubles. But with PTSD, symptoms are longer-lasting and more impairing. The avoidant behavior and vivid flashbacks associated with PTSD do not occur in normal grief.

Careful professional evaluation is needed to determine whether traumatic stress or regular bereavement reactions are at play. Be honest about your symptoms so you can get appropriate help to move forward on your grief journey.