Grieving process: What's normal?

After battling cancer for three years, our 34-year-old son died last year. He moved in with us for the last two years of his life so we could help him. I took him to all his appointments and treatments. Fortunately, he was relatively pain-free, and we were able to enjoy our time together. I miss him so much, but I have never cried about his death. Is this normal? Am I bottling it all up? I am currently taking an antidepressant.

- No name / No state given

Answer

My condolences to you and your family for the loss of your son. Grief in bereavement is a universal human experience that is handled in different ways by different people. The nature of the relationship that you have with the person you have lost, the quality of the relationship, the time you have to prepare for the loss and your own personality all play major roles in the grieving process.

From your description, you had appropriately prepared yourself in advance of your son's passing, and indeed anticipatory grief in such situations is healthy and often protective. There are no set rules or standards for what is healthy in grief. Some people may be frequently tearful, and others may deal with loss in other ways of remembrance.

There seems to be a greater consensus, however, on what can go awry during the grieving process and develop into more protracted forms of grieving, more serious forms of depression, and other mental health problems. Coping by avoidance or isolation or finding yourself unable to function within reason are warning signs that shouldn't be ignored.

Most people need no formal treatment for bereavement. But there are therapies that can help with resolving loss if you find that you need additional help. Although it's important to keep in mind that you need time and space to grieve in your own way, it's also important to be able to take advantage of behavioral therapies that can help you cope and re-establish a sense of control and direction in your life — if grieving becomes complicated and protracted.

Medications are not routinely used to treat grief. However, some can be helpful when specific symptoms arise that aren't easily addressed by behavioral therapies and that may stand in the way of a more healthy resolution of your loss.

Recently, I read a series of online postings on how to best cope with bereavement from individuals who had recently lost loved ones. I was particularly struck by an entry written by a man who had lost his mother and described three very different ways in which he and his two brothers dealt with her death. He concluded by stating: "How a person deals with the death of a loved one is intensely personal. It brings home one's mortality, and so brings to bear many, if not all, of one's moral and spiritual beliefs. That is why reactions can be so different. If I have learned anything, it is not to judge a person's reaction to death, or to any other kind of serious stress. Most often, I simply don't know enough about them to make an informed judgment."

The grieving process is very personal, commands respect, and requires time and sometimes professional assistance to achieve its own resolution.

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