Co-Occurring Grief & Loss Treatment Center in Pittsburgh

Learn about grief & loss

Grief is a normal reaction to loss and is the emotional suffering that one feels with someone or something you love has been taken away. And, while losing a loved one is never easy, it can be especially difficult for a child or adolescent, potentially causing complications that can last the rest of his or her life. Many times adults will try to protect children from their grief by trying to distract them or not telling them the entire truth about the loss. However, the reality is, that just like adults, children need the ability to express their feelings surrounding a loss. While grief can occur as the result of various circumstances, grief tends to be most commonly associate with the death of a loved one. Additional circumstances that can elicit feelings of grief in young people can include experiencing a traumatic event, divorce, death of a pet, or being diagnosed with a serious illness. Generally speaking the more significant the loss, the more intense the grief will be. However, it is not uncommon for even subtle losses to lead to the development of grief.

Stages of grief

The grieving process is broken up into five different universal stages. However, this does not mean that each individual goes through these five stages in the exact same way. Each individual, including children and adolescents, will spend different amounts of time in each stage and will express each stage with varying levels of intensity. Additionally, these stages do not occur in any particular order, it is perfectly normal to jump around from one stage to another or skip one stage entirely. They are simply a list of responses that an individual may have, but there is no one typical response to a loss. These five stages of grief are described in more detail below.

• Denial: This stage is thought to be the first reaction that someone has when they learn of a loss that has occurred. During this stage an individual will deny the reality of the situation and refuse to believe that the loss has actually happened. Individuals in this stage may be in a state of shock and try to hide from the facts. This is a temporary state that is meant to get through the initial pain and overwhelming feelings felt.
• Anger: As the reality of the situation sets in an individual in this stage will become overwhelmed with anger that this has happened to them. This anger could be directed at others, inanimate objects, or even at the person who has just passed away in an attempt to find someone or something to blame. During this stage, children and adolescents may act out in defiant, oppositional, or aggressive behaviors.
• Bargaining: Bargaining is a normal reaction to feelings of helplessness and guilt. During this stage an individual may begin to question why this happened and wonder what they did to deserve such a thing. Individuals may begin to make deals with a higher power in an attempt to make the pain they are feeling go away.
• Depression / Sadness: Children and adolescents have reached this stage have come to recognize that this loss did indeed occur and they now become overwhelmed with sadness and depression about their loss.
• Acceptance: The fifth stage in the grieving process is when children and adolescents have accepted the loss and is no longer making attempts to change the situation. Acceptance however, should not be confused with healing or recovery from the loss because individuals in this stage still feel a number of different emotions brought on by their grief. These individuals are ready to move on with their lives again.

Signs and symptoms of grief

While every child and adolescent grieves in their own way, there are some common signs and symptoms that young people may experience when they are grieving. Additionally, while they may have some symptoms that are similar to those observed in adults who are grieving, children tend to react differently than adults do because of their developmental stages. It is important to pay attention to specific signs or symptoms that your child may be displaying as it may mean that they are having a particularly hard time dealing with grief. Some of these signs and symptoms may include:

Behavioral symptoms:

• Withdrawing from friends and family
• Losses interest in daily activities
• Noticeable changes in behavior and temperament
• Constantly talking about the loss or refusing to speak of it at all
• Significant drop in academic performance
• Refusing to go to school
• Refusing to be separated from certain attachment figures
• Changes in peer groups
• Angry outbursts or temper tantrums
• Crying spells
• Demands more attention
• Acts younger than their age
• Instigating fights
• Acting out in impulsive and high-risk behaviors
• Engaging in problematic behaviors

Physical symptoms:

• Fatigue
• Chronic headaches
• Chronic stomachaches
• Digestive disturbances
• Nausea and vomiting
• Bedwetting
• Unable to sleep
• Loss of appetite
• Onset of panic attacks

Cognitive symptoms:

• Preoccupation with the person whom one lost or with the loss itself
• Preoccupation with death and dying
• Paranoia
• Forgetfulness
• Lack of concentration

Psychosocial symptoms:

• Mood swings
• Feelings of insecurity
• Overly vulnerable
• Feeling as though one has been abandoned
• Feelings of loneliness
• Inability to regulate emotions
• Feelings of hopelessness
• Feelings of helplessness
• Despair
• Excessive anger
• Feelings of guilt
• Anxiety
• Extreme worry
• Irritability
• Easily agitated
• Depression
• Episodes of emotional detachment or emotional numbness

Effects of loss

If children and adolescents, who have experienced a loss, do not get support and treatment for their grief there is an increased chance that these young individuals will develop some long-term complications. Some of the possible complications that can occur as the result of prolonged grief may include the following:

• Higher risk of engaging in substance abuse
• Development of conduct disorder
• Higher risk for developing a mental illness in adulthood (especially depression and anxiety)
• Compromised immune system / increased likelihood of becoming sick
• Feelings of loneliness
• Feelings of having been abandoned
• Onset of symptoms synonymous with posttraumatic stress disorder
• Beginning to engage in self-harming behaviors
• No longer participating in activities that were once enjoyed
• Onset of suicidal thoughts and behaviors

Treatment for loss and grief

Overcoming grief is never an easy task, but there are a number of different treatment options available that have been known to help individuals deal with their loss and learn to move on with their lives. More specifically, inpatient and residential treatment programs are two common treatment options that have been known to greatly benefit children and adolescents who are struggling during this difficult time. Both of these treatment settings will provide children with access to mental health professionals 24 hours a day, 7 days week, who can provide them with the additional support they need while they work through the grieving process. Furthermore, through the grief counseling process these young people can learn to accept the loss, learn to identify feelings related to their loss, be able to live without the person who has died, and come to understand their methods of coping. In either of these settings, children can process through their experiences with a qualified mental health professional, engage in a variety of treatment methodologies, and be able to come to terms with their loss, allowing them to move on and experience a happy future.