Mystery of grief-stricken hearts

J K Rowling said, “You care so much you feel as though you will bleed to death with the pain of it.”

Five years ago I lost my maternal grandfather who was the real source of joy in my life, a dear friend. We buried him, while I was laying his body in the grave I felt as if I have buried a part of my soul with him. I too used to believe that ‘time heals everything’ but after 5 years the grief remains the same and I feel that only a day has passed. The longing and sense of attachment never faded. So I began to question the possibility of death, we can control the birth then why can’t we control the time of death. We can even choose the time of birth but the possibility of choosing the time and design of death seems impossible.  Why grief prolongs and stays like a scar on a person’s heart?

It’s a tragedy that one day we all will experience the loss of a loved one. According to research every year around 50 million people die worldwide and leave behind an average of 5 persons in the bereaving family. The demise isn’t just the loss of a person but the bereaving family experiences a range of psychological and social reactions.

The bereaved person shows a series of emotions and reactions which include withdrawal from social activities, a deep gloom, misperception about one’s role in life, and spurts of seclusion. In severe cases of sorrow, these types of grief reactions are often very painful and highly impairing. The bereaved person feels if his love towards the deceased person suddenly loses its tangibility which leaves an intense emptiness in the heart of the grieving person.

Luckily, a significant number of people have a number of resources to adjust to their new life without the deceased person.  These people don’t actually get over their loss but they learn to manage. Ironically though, this isn’t true for everyone.  Researches show that a significant number of people fail to recover from grief. Instead, in severe cases, reaction prolongs over the longer term which imbibes social, mental, and physical aspects of a person’s life.

Prolonged grief is just like an inflamed wound which becomes an incurable if not treated accordingly, similarly, prolonged grief can also become incurable if extra help is not prescribed. A complicated mix of individual and background factors can lead to the development of complicated grief reactions.

Seeing the adverse effects of the prolonged relief the World Health Organization (WHO) decided to include a diagnosis for grief identification in 2018 in their classification guidelines for mental disorders. The guideline is also known as ICD-11 (International Classification of Diseases, 11th revision), which will be fully implemented in healthcare systems by 2022.

The diagnosis was named as prolonged grief disorder which is identified by a strong sense longing for the deceased accompanied by emotional distress which includes blame, denial, anger, difficulty to accept the death and the feeling one has lost a part of one’s self and significantly weakened functioning that continues beyond half a year after the loss. Psychologists use these guidelines throughout most of the world. Earlier, the symptoms of this disorder were often taken as signs of depression and experts used to treat by antidepressants, but these drugs have shown a negligible effect in ameliorating grief symptoms.

Consequently, the acknowledgment of prolonged grief disorder will ensure suitable and effective psychosocial treatments. There should be approaches like imparting education to the subject's psychological effects which are about informing the person of the healthy and more pathological versions of grief and discussion regarding therapeutic goals. Doctors suggest exposure of some kind to treat the people who avoid people while experiencing the situation in which they avoid the people or places and things that are attached to the deceased person.

The treatment of exposure can also include remaking or visualizing the entire story of the loss with a different perspective which the patient avoids. The concept of time heals all wounds is partially correct because time is not the solution for deep emotional and psychological wounds. It is essential to see a doctor and receive treatment to aid the healing process.