Many mental health professionals still look to the five stages of grief to explain how the grieving process can evolve over time. These include denial, anger, bargaining, depression, and acceptance. In practice, this can involve everything from only being able to think of your loved one’s death, to numbness, to feeling like your life has lost all meaning, according to the Mayo Clinic. It’s crucial to understand that these stages aren’t neat, tidy, and sequential, the American Psychological Association explains. Instead, they’re more of a cycle, where you may experience one stage for a much longer period of time than the others or barely at all, and these feelings can also overlap. “It’s very messy, with emotions you can’t compartmentalize,” says O’Neill. “Oftentimes, people are moving through these stages or oscillating between them.”
When does the grieving process become “unhealthy”?
This can be a tricky question to answer under normal circumstances, let alone during an ongoing pandemic. But, in general, there are a few things that can complicate the typical grieving process.
One involves a condition known as complicated grief, which you can read more about here. Complicated grief stems from the school of thought that you can categorize the process of learning to live with loss into acute, integrated, and complicated forms of grief, the Center for Complicated Grief explains.
Acute grief is what happens right after a loss, when the grief feels inescapable and uncontrollable. Integrated grief happens when you adjust to the loss. It doesn’t mean you somehow get over the loss and it no longer affects you, but that you’ve learned to live with it in a more manageable way. “We tend to move through and recover from grief over a period of time,” says Gould. Complicated grief (also known as persistent complex bereavement disorder or prolonged grief disorder) means that after six months to a year, you’re not able to move from acute grief to integrated grief. (The exact timeline depends on which mental health resource you turn to.) It involves a lot of the same symptoms as the normal grieving process, but they persist for longer than is typical and are severe enough to get in the way of living your life, accepting the loss and, ultimately, healing.
Beyond the existence of complicated grief, pinpointing when grief becomes unhealthy can also get difficult because even healthy grieving can mimic, cause, and exacerbate mental health conditions like major depressive disorder and generalized anxiety disorder. And, of course, there’s the fact that the coronavirus is changing basically every aspect of life, including grief, which we’ll explore more in a bit.
With all of that in mind, the main signs that grief has become unhealthy revolve around the persistence and/or severity of symptoms, many of which are involved in the healthy grieving process but can become destructive when you’re stewing in them for too long. Typically, experts would suggest looking for the following signs at six to 12 months after the loss: You can’t function, you feel stuck in sadness or other grief symptoms, you feel hopeless, and you avoid regular contact with loved ones. Other signs that are notable regardless of how long it’s been since the loss would be consistently turning to substances to numb your emotions, and having thoughts of hurting yourself or suicide.
While it’s good to keep these parameters in mind, the truth is that given the drastic ways the coronavirus pandemic has affected our lives, mental health, and coping mechanisms, the lines between “healthy” and “unhealthy” grief can feel so blurred as to be practically non-existent.
COVID-19 is turning the typical grieving process on its head.
The pandemic itself is forcing us to change how we grieve, O’Neill explains. Isolation, safety fears, and a lack of control make the grieving process even more complex than usual. “We’re still in a pandemic with no answers as to when [normal life] can resume. This is impairing the ability to go through the grieving process,” says O’Neill.