Why Am I Still Crying?
Recognising And Seeking Support For Prolonged Grief

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“You cannot prevent the birds

of sorrow from flying

over your head.

But you can prevent

them from building

nests in your hair”.

Chinese proverb

Significant loss is a form of trauma. It may cause us to feel stuck, lost in sorrow, removed from those around us and the life we thought we had, uncertain, confused, searching for answers. It almost invariably causes us severe and persisting emotional distress.

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Whether we are bereaved by the loss of a significant person or relationship, the loss of a significant role or the loss of health, we are left bereft of the meaning that that relationship with life, others and the world provided to us and the value we derived from it.

It is at this point that we begin to experience grief.

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As the writer and academic Rachel Naomi Remen noted, “Grieving allows us to heal, to remember with love rather than pain”. When we suffer significant loss, we inevitably experience grief in some form.

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In the normal process of grieving, we adapt and adjust over a reasonable period of time to the loss suffered and so enable ourselves to sufficiently accommodate the changes and address the challenges wrought by the loss, to regain a level of wellbeing and to proceed with our lives.

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The normal grief reaction to significant loss is composed of a number of phenomena which we may experience to differing extents and intensities and for greater or lesser periods of time, depending upon our circumstances, life experience, and the nature of the bereavement suffered.

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Our experience of grief, most particularly in the initial weeks following loss, may often resemble that of depression. There are, though, distinct differences between the normal process of grieving and a depressive episode.

In early-stage grief we will often suffer intense sadness, related low mood and motivation loss, and possibly sleep and appetite disturbance, such as may be present in depression.

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We are not, though, likely to experience severe and persisting disrupted sleep, low energy, significant changes in our eating pattern or other significant physiological symptoms. Neither will we commonly suffer with the distressing and persistent self-critical narratives and suicidal thoughts that may be experienced were we experiencing severe depression.

Prolonged grief

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Sometimes some of us who suffer significant loss find that we do experience significant depression because of our loss. There are many factors that may cause us to develop persisting depression through what is termed prolonged grief.

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These may relate to the circumstances of our loss, the relationship we had with the deceased or other loss, our life history and experiences, our emotional resilience and coping skills, our social support, and other life challenges which we may also be experiencing.

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The following are common symptoms that we may still experience many months or even years after a significant loss has occurred. They are likely due to prolonged grief. If we experience one or more of them, it is good reason to seek grief counselling support.

• We find ourselves unable to refer to the deceased, circumstances or nature of the loss without significant distress; often we will become tearful.

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• We experience a sense of being ‘stuck in time’, as if we have not moved forward from the loss, and that it still seems very recent to us, even years later. We may still talk about not being able to cope with or ‘get over’ the loss, or that we ‘cannot believe’ it has happened.

• We still find significant difficulty in talking about aspects of the loss and may recall not having felt able to seek support or to talk about the loss with friends or family members at the time it occurred.

• We often still find ourselves experiencing the ‘presence’ of the deceased, hear our name called by the deceased, see the deceased in a crowd, picking up the phone to call the deceased, or momentarily expecting the deceased to be the reason for the phone ringing or there being a knock at the door.

• We experience an exaggerated, distressing and extended reaction to our own further loss or witnessing other peoples’ loss, even those we may not know. Losses that should normally be expected to have a limited or transient impact upon us.

• We notice ourselves dwelling overmuch not only upon our own loss but also upon the losses of others and the theme of loss in general.

• We hoard or significantly overvalue (“I don’t know what I’d do if I lost that!”) the deceased’s possessions or objects related to our loss; or the opposite, immediately remove all reminders of the deceased or other loss at the time of or shortly after the loss.

• We experience unexplained and persisting physical symptoms that may resemble the cause of death of the deceased or other health or physical characteristics relating to them.

• We remain preoccupied with anniversaries relating to our loss and may suffer a worsening of our depression symptoms around those times.

• We experience significant personality change or even imitation of the deceased’s personality and behaviour since the loss; something that may also have been remarked upon by others.

• We suffer with health anxiety, phobia or panic symptoms related to the illness or circumstances of the loss of the deceased and with onset around the time of the loss.

Many of us who suffer with one or more of the above symptoms are aware that we may be experiencing prolonged grief. We may often possess a sense even only six months after the loss that ‘something isn’t quite right’, that we are not ‘moving forward’, that we feel ‘stuck’.

It is prolonged grief that is disrupting our attempts to resume and re-connect with life and causes us to remain removed from life’s changes, hopes, aspirations, opportunities, rewards, and happiness.

The way forward

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The journey through significant loss and grief and our re-connection with a meaningful life will be, for all of us, a real challenge. But it is something that, with the appropriate support, we can all achieve. Prolonged grief and the profound life disruption it creates will not go away on its own.

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However, grief counselling can help us to free ourselves, to re-connect with those around us, to hold close, to remember, to cherish, to see more clearly, to find confidence and our best way forward from grief to wellbeing.