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Mental Health

Reactions to trauma and loss

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Authors: BC Centre on Substance Use, Moms Stop the Harm, BC Bereavement Helpline, and BC Coroners

 

This is a chapter of the workbook Gone too Soon: Navigating grief and loss as a result of substance use.

Everyone reacts to trauma and loss differently and there is no right or wrong way to react. You will likely notice that you are having both physical and emotional reactions. These reactions may come and go and they may be different from minute-to-minute and day-to-day. You may be surprised by the strength of your reactions, but it might help to remember that we grieve intensely because we loved intensely.

Physical reactions

Physical reactions to grief, trauma, and loss may include:

  • Aches and pain, especially in back or chest

  • Changes in sleep patterns—inability to sleep or over-sleeping

  • Fatigue

  • Feeling paralyzed, unable to function

  • Changes in eating patterns—lack of appetite, nausea, binge-eating

  • Increased use of alcohol or other drugs

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Emotional reactions

Emotional reactions to grief, trauma, and loss may include:

  • Shock

  • Disbelief

  • Anxiety

  • Irritability or restlessness

  • Anger and/or rage

  • Emotional numbing (feeling nothing)

  • Urges to hurt yourself

  • Depression

  • Trouble concentrating or remembering

  • Sadness

  • Feeling overwhelmed

  • Panic attacks

  • Feeling disconnected from your body

  • Shame

  • Dreams that your loved one is still with you

  • Guilt

  • Suicidal thoughts

  • Desire for revenge or punishment

  • Worry about burdening other people

  • Loneliness

  • Needing to avoid places, people, or memories associated with the death

  • Relief

Although these feelings can be very unpleasant and may even feel scary, these are all very normal ways that we respond to traumatic events, grief, and loss. Many of these reactions are ways that your mind and body try to make sense of what happened and try to take care of you.

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Responding to difficult emotions

The feelings you have in the days and weeks after your loss may feel overwhelming. They may feel so intense that you think you can't survive them. You can. But you might need some help navigating these intense and painful emotions. Below are some strategies for experiencing difficult emotions in general, and some strategies for specific emotions as well.

Let your body feel what it needs to feel

Some people try to fight big, painful emotions. They might try to fight this by keeping really busy, by using alcohol or other drugs to numb their emotions, or by pushing the feelings down and ignoring it. Although these all make sense, fighting the big emotions can cause more pain than actually feeling the painful emotion in the first place.

Some people find themselves afraid of feeling whatever emotions are coming up, afraid that they will be overwhelmed or that the pain will never stop. The truth is, there's no getting around feeling the feelings. If you keep pushing it down you might find it leaks out in unexpected ways, being angry at your loved ones for no reason or yelling at the grocery checkout person. If you find yourself continually pushing your emotions down, one way to let yourself feel big emotions is to set a timer for five minutes, with a plan for after. Find a safe, quiet place where you can be alone, and let yourself feel whatever you need to feel for five minutes and then do something to distract or comfort yourself—make some tea or go for a walk.

Although emotions like grief, sadness, and anger can be very large and painful, they tend to come in waves, lessening in intensity if you let yourself sit with it and experience what comes.

If the emotions you're experiencing feel like too much, it's okay to take a break. Using grounding skills might help calm you down (see page 10). Once you’ve calmed down a bit, you can do something comforting or distracting.

Set a regular "date" with yourself

Some people might find it helpful to set a regular date to check in with their feelings—maybe once a week. Find some time and space where you can be alone and let yourself feel whatever you need to feel. Especially for people who tend to make themselves busy and focus on "getting stuff done" in the face of grief, letting yourself have space to uncover the feelings below can be very helpful.

When you set a date with yourself, it's important to also have a plan for after and to have a plan in case the emotions that come up are bigger and more painful than you expected. Having a friend you can call or even a crisis line number can be helpful. A list of crisis and support lines can be found here or you can call the BC Bereavement Helpline at 604-738-9950 (Lower Mainland) or 1-877-779-2223 (toll-free, outside of the Lower Mainland).

Anger

Anger is a very common response to losing a loved one to an overdose. You might feel angry at the world, angry at the substance, or angry at the person who sold the substance to your loved one. You might also feel angry at the system that you feel let your loved one down. You might even feel angry at your loved one.

It can feel scary and confusing to have such a strong emotion, especially if anger is a new emotion for you. Anger is a normal, healthy response to losing someone you love. Here are some ways people express their anger:

  • Talk to a therapist, other mental health professional, or spiritual counsellor

  • Talk to a trusted friend or family member

  • Make art—paint, draw, or write about your anger

  • Exercise—walk, run, lift weights, swim

  • Punch a pillow

  • Listen to loud, angry music

  • Yell or scream

Panic attacks

A panic attack is the sudden onset of intense fear or discomfort. Panic attacks can be really scary—so scary that you might think you're having a heart attack or other health emergency. Even though it might feel like you're dying, it’s important to know that a panic attack won't literally kill you.

Panic attacks can include:

  • Rapid heartbeat or pounding heart

  • Trembling or shaking

  • Shortness of breath

  • Feeling like you're choking

  • Chest pain

  • Dizziness or light-headedness

  • Nausea or diarrhea

  • Sweating

  • Feeling out of control

Even though it might feel like it will last forever, most panic attacks reach their maximum intensity within 10 minutes or less and then start to subside.

Using grounding skills can help calm you down enough to prevent a panic attack or to help you come out of one once it's started.

Suicidal thoughts

Thoughts of suicide are not uncommon when faced with a devastating loss. Sometimes the hurt can feel so big and overwhelming that you want any way to stop feeling it. Other times it can feel like the one thing you have control over.

Suicidal thoughts should be taken seriously. If you are worried that you might hurt yourself, call a crisis line or a trusted friend or family member. The British Columbia Crisis Centre hotline is available 24 hours a day, 7 days a week and can be reached at 1-800-784-2433 from anywhere in BC.

Negative coping mechanisms

You might find yourself engaging in coping mechanisms that concern you (for example, drinking more than usual, taking medications other than as prescribed, or binge eating). You should know that these are common responses when something awful happens.

These coping mechanisms are ways that we try to sooth ourselves and reassert control over our lives. They may not be the coping strategies we'd wish for, but they might be the best ones we have in the moment. If that is the case, you can try working through the self-care strategies on page 9. Getting help through a counsellor and/or support groups might also help you come up with new coping strategies that feel better.

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How long will I feel like this?

There is no timetable or schedule for grief. For some, the pain will soften over time. For others, they'll find they have longer periods of less pain in between bouts of great pain. No matter how your experience of pain shifts over time, you will never forget your loved one (nor would you want to). It's important to know and remember that grief recovery is not linear. You will move up and down the scale of intensity, experiencing disbelief, anger, acceptance, and other emotional and physical reactions.

This is a new normal. That doesn't mean that it is okay or that it doesn't hurt. But it is your new reality. Life will never be the same again. Gradually the intense pain will subside in frequency and you will have longer period of less intense pain. You will survive what you thought would be unsurvivable. The path will be challenging at times, but you will find a way to deal with the pain and grief.

Give yourself time and space to do this. There is no map, there are no stages that you must attain. Grief is unique to each individual. Life will be different. It may seem impossible to believe this after such a heartbreaking loss but gradually you will find a way to honour your loved one and a way to be more at peace with yourself.

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Grieving together

There are as many different ways of grieving as there are people—each person will grieve a little differently. Where one person may get very inward-focused and spend a lot of time alone and crying, another may find they want to be constantly surrounded by people, focusing on remembering the good times with the person they've lost. Sometimes this can cause confusion and even resentment if someone's way of grieving is significantly different from yours—you might even wonder if they’re grieving "properly." The grieving process and grief rituals will also vary by cultural background and family traditions.

As much as possible, try to remember that each person will grieve in the way that is best for them, even if it looks very different from how you are grieving. Although you might find yourself feeling resentful of someone who is grieving very differently, try to remember that they are hurting too and stay in touch with them.

You may also find yourself feeling anger or resentment for things that another person did or did not do when your loved one was alive. Although this is a very natural response, most people already have regrets and guilt over things they did or did not do and will not be helped by hearing about the things you wish they’d done differently. Similarly, if someone is putting blame, anger, or resentment on you, remember that they are grieving and trying to make sense of their loss. You don’t have to accept or agree with the blame or anger they place on you.

When grieving, one of the best things you can do is ask for help. Tell your family, friends, or other loved ones what you need them to do and be specific.

 

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