Covid has drastically changed every routine and aspect of daily life. We have been knocked off centre and now find ourselves unsteady and wobbling. For the majority of the population, coping strategies have shifted as we continue to deal with social distancing, isolation, anxiety, and the now cliched – ‘the new normal’. We have lost so much, but we may not always recognise all the big emotions that are associated with our experiences or may not acknowledge them as a normal, natural process.  Grieving is one of those natural emotions associated with loss.  

Loss brings on great emotional distress that manifests emotionally, physically, and spiritually.  It often translates to a feeling of isolation from the rest of the world while we process and translate the experience of being without the loved ones we lost.  

The loss of loved ones during the public health crisis is especially hard. In the past, we could connect with community, hug, and process the life event together.  This aids us in moving out of our emotional isolation and into processing. In recent times, we lack options of gatherings due to safety concerns. For some we have experienced not having opportunities to hold the hands of loved ones passing, or hug those in pain from broken hearts, or stand in groups reminiscing about our loved ones.  The human connection has been lost within our losses.  

Grief should be noted to be a normal stress response to a loss.  It is in no way considered pathological in nature. The symptoms may resemble that of depression or anxiety, but the biggest differentiating factor is that people emerge from uncomplicated grief or the normal grieving process and move forward, returning to daily life.  Elisabeth Kübler-Ross described five stages of grief, popularly referred to as DABDA. They include: denial, anger, bargaining, depression, and acceptance. We can see all stages at work in our society in correlation to the pandemic.

Two years on, we still have constant changes and updates related to masking and unmasking, vaccines and boosters, health mandates, health policy and list goes on.  The truth of the matter is that in at least one area of our lives we have all experienced grief in the last two years.  This mass effect of a society in grief changes a culture on all levels, world, national, state, community, family, and individual.  We’ve denied that Covid was happening or that it is continuing to ravage our population.  We have seen anger in different view and perspectives, we’ve bargained for a new hope, and we have sunk into a darkness of depression that will require floods of light to change, and finally we are in a place of acceptance that this is a new normal, at least for now.

What happens if we simply can’t move on and we get stuck in this grief.  The grief turns into something known as persistent or prolonged grief. M. Katherine Shear, at Columbia University, has noted that persistent or prolonged grief is noted as a sadness and longing with disbelief and an inability to move to acceptance of the loss. Prolonged grief can increase the risks for substance use disorders, insomnia, decreased immune responses, and suicidal thoughts.

There are times that, someone will struggle to fully process the loss and move forward with daily activities. If the grief becomes disabling in nature and spans a timeframe longer than six months is may meet criteria for prolonged grief disorder.  According to the American Psychological Association in the DSM-5 criteria, prolonged grief is ‘persistent and pervasive’.  This means that the grief takes over the thoughts and becomes the person becomes preoccupied with the deceased for the majority of the day, every single day, for a minimum of one month.  In addition to the preoccupation thoughts of the deceased, at least three of the following symptoms must co-exists:

• Disbelief
• Longing for deceased
• Acute emotional pain
• Identify confusion feelings as if part of the person has died with deceased loved one
• Avoidance of memories or reminders of the deceased
• Numbness, significant impairment in functioning of daily activities
• Intense loneliness
• Difficulty engaging in life as before loss or re-engaging in normal daily activities.

Grief is very much a part of our human experience.  At some point in our human existence, we will all experience a loss.  Grief is hard, processing grief is difficult. For some, moving through the process occurs more easily than for others.  When we dig deep however, what we know, is that grief brings us pain and that we have to find hope for the next steps.  How do we accept our losses and move through the stages of grief to make it to the other side? Past cultural experience shows us that the best way to process grief is to be with others who are also mourning.  In this age of ‘no large gatherings’ what can we do to effectively move forward? We have to find creative ways to connect with others who are also grieving similar losses.  A few tips as we continue to process our grief and manage it in our daily lives:

• Acknowledge the grief. Note that grief comes in many forms and is not only associated with the loss of a loved one but can be associated with loss of routine, time, and many others.
• Set routines. Change daily behaviours by substituting new routines.  This will help give you a sense of control and certainty of what is happening next.  It allows you to have greater focus and more space for processing the grief while also allowing more energy to be available to devote to processing loss.
• Connect often. Humans are community creatures, connection helps decrease anxiety and depression, helps us regulate emotions better, and increases our hope. Start a virtual book club, initiate a friend walk at the park with social distancing.
• Make memories in new ways. Memories help us regulate emotions and connect them to time. Initiate a dinner or game night for your family once a week, Schedule a virtual friends and family game night once a month – pictionary is super fun on Zoom.
• Find hope together. Have the hard conversations and discuss emotions with friends and family.  
• Seek help if needed. Additional treatment options for those who feel they may be experiencing prolonged grief include identifying coping strategies that the individual utilises for other stressful life situations, engaging with others in conversation about the loss and the emotions accompanying the loss.  Conversations may be with others who have also lost the same person or with a psychotherapist.  Health care providers can aid in educating the person on the normal stages of grieving as well as aid in identifying new coping strategies to shift focus back to the current day and also provide emotional support.

If you experience grief during this pandemic, it can be overwhelming and cause strong emotions.

Get immediate help in a crisis

• Call 911
• Disaster Distress Helplineexternal icon: call or text 1-800-985-5990 (press 2 for Spanish).
• National Suicide Prevention Lifelineexternal icon: 1-800-273-TALK (8255) for English, 1-888-628-9454 for Spanish, or Lifeline Chatexternal icon
• Get Help in a Crisis

Find a healthcare provider or treatment for substance use disorder and mental health

• SAMHSA’s National Helplineexternal icon: 1-800-662-HELP (4357) and TTY 1-800-487-4889
• Treatment Services Locator Websiteexternal icon

Nicole Walters, DNP is a psychopharmacology and psychotherapy course coordinator at Regis College.