Children's Experience and Reaction with Grief

Introduction

Children, adolescents, and adults, experience, understand and react to the passing of a loved one or passing of any person differently. Grief is normal and an expected response in anyone that experiences a loss; however, the symptoms of grief are often misunderstood in children and youngsters going through bereavement. When a loved one dies, how a child and/or adolescent’s grief will depend on many factors and will differ among children in several ways. Theories and research indicate children’s individual characteristics, their developmental stages including cognitive level, their environmental and familial experiences must be considered to identify how they are coping with their grief and loss. (Norris-Shortle, 1993) While there is no way to forecast how a child will respond, or how death will affect them, some situations may increase the chances that a child will experience prolonged sadness and depression after a loved one dies. (DiMaria, 2018) Depression, if left undiagnosed and thus untreated can worsen and significantly affect a youngster’s childhood and diminish their quality of life. (William, Chung & Muening, 2017) Depression and grief share several common characteristics. They both may include sadness, tiredness, restlessness, lack of appetite, loss of pleasure, and difficulty focusing. (Ferszt,& Leveillee 2006) We must learn and teach children the similarities and differences between symptoms of normal grief and depression because when issues like fatigue, insomnia, and indecisiveness persist from two weeks to several months; depression may be the root of the problem. (Ferszt,& Leveillee ) To help kids manage the unexpected emotions of grief after a loved one’s death, grief counseling and grief therapy are imperative in easing the healing process of grief.

Grieving Reactions of Children by Age Group

Babies and toddlers are unable to comprehend the concept of death or lack the verbal communication to express their feelings; nevertheless, they can portrait sorrow and distress by looking for the deceased, crying more and wanting to be held more by the surviving members. (KidsHealth, 2017) Children ages three to four years of age, tend not to understand that death is permanent. Understanding the eternal concept of death is challenging for them, since they tend to believe the deceased would come alive again, as often viewed in cartoons and animations. They often express grief by looking for the person who has died. They tend to feel uncomfortable in new surroundings and seek familiar places. They feel insecure and scared when taken away from their environment and do not like what they accustomed to change around them. (KidsHealth, 2017) Kids ranging from five to nine years of age and enroll in elementary education are beginning to learn the concept of death. They have some muddled and disorderly thoughts about death. Some may continue to think as a preschooler and think death is temporary and others understand the permanent action of death and express concerns about the deceased welfare, like if the deceased is comfortable in the casket, or if they experience feelings of thirst and hunger. They also show curiosity about how the deceased has died and what happens to the body after death. Their grief behaviors may start to mimic adult behaviors like anxiety, panic attacks and feeling of extreme sadness. They may also have physical symptoms like headaches, upset stomach, and body aches. (KidsHealth, 2017) Children between 10 and 12 years of age fully understand that death is eternal and are conscious of how the death of a loved will change their lives. They are also aware that death can be associated with pain in tragic events and long-term diseases. They are mindful of the pain and suffering their surviving family members are experiencing and don’t want to be a burden to them by showing emotions of grief. They often stick to their daily routine of attending school, homework, chores, and extra-curriculum as a coping mechanism, as not to let themselves mourn. (KidsHealth, 2017) Adolescence, between 13 and 17 years of age, understand the concept of death. Even though some may not have experienced it personally, they are aware death is part of life and its inevitable. They experience grief in some aspect like the other age groups, such as wanting to be near families and friends, concerns about death, dying and mortality, physical complaints of body aches and anxiety, but they also differ greatly from the younger groups. Some teenagers tend to cope with grief by participating in risk-behaviors, to cope with the pain associated with grief, like experimenting with drugs, sex, drinking, reckless behaviors and acting like or saying, they don’t; care. According to Fitzgerald, (2000) everyone battles with the heartache and anguish of losing a loved one. Adults, adolescences, and children all feel the unbearable pain of loss upon the death of a parent, sibling, child or other significant other; however, it has been observed that adolescent face physically and mentally agonizing adjustments following the death of a loved one. As these feelings intensify, it can increase the chance that they might fall into a downward spiral or even depression from grieving.

Do Children and Teens Mourn like Adults?

Children respond differently from grown-ups when a loved one dies. How a child or adolescent mourns when they lose a loved one will depend on many factors like age, gender, their developmental stage, family circumstances, available support, personality, any prior experiences with death, how others are grieving and the bond they had with the deceased. (KidsHealth, 2017) Children and teenagers may seem undisturbed, by the loss of a loved one. In comparison to adults, children may continue their normal routines undisturbed. They can easily continue going to school, enjoy playing and even socialize in moments of expect grief. Due to this behavior, adults often assume they do not properly comprehend the severity of the situation. Kids grief differently, children may go from crying one minute to playing and laughing next. These behaviors do not mean they aren’t depressed by their loss or that they are no longer mourning. What it shows, is that children cope differently than adults, and playing and having fun can be a defense mechanism to prevent themselves from unpleasant thoughts and emotions like guilt, anger, shame, and anxiety towards the situation. (Ehmke, 2019) However, children do grief the death of a loved one, in their own way.

Kids and adolescents tend to mourn differently, then adults their loved ones. They are known to mourn in spurts and briefly without evoking too many emotions. Children are known to avoid grief due to the unpleasant thoughts, emotions and bodily sensations experience in the process. They tend to stay clear of the pain and sorrow by continuing their usual daily routines and activities which brings them comfort. What a grieving child is feeling today may diminish and be substituted with different attitudes and behaviors throughout the course of their bereavement process. Grief has no set pattern and timeline. Anyone acquainted with grief understands that emotional state, setbacks, breakthroughs, barriers, triggers, and resolutions can happen unanticipated, impulsively and in inexplicable times and durations. (Williams & Haley, 2018) In spite of the substantial changes in the understanding of grief in children, some medical journals continue to rely on the continuous recognition of Elisabeth Kübler-Ross five stage of grief approach. (DeSpelder, 2010) The five stages of grief are composed of the phases of denial, anger, bargaining, depression, and acceptance are part of the frame of grief. In recent years, a new approach in grief is considering how the biopsychosocial effect of the passing of a loved one has directed grief counselors and therapist on identifying and treating people at risk for mental and physical health risks due to their grief. (Kersting, 2004) Instead of using the five stages approach, to all mourners, recent peer-review journals, scholarly books, and professionals are suggesting that deep sorrow caused by a loved one’s death does not move smoothly and predictably through a series of predetermined stages, as previously assumed. Grieving kids and adolescents need to be closely monitored since grief can affect children in many ways than it does in adults. When a child and/or teen is told of a loved one’s death, they might not express any feelings of sorrow or sadness at the moment, as anticipated in an adult. For children, the overwhelming news might take time to process and understand. For an adolescent, they tend to minimize their feelings, thoughts, and emotions because teens may be uncomfortable with the attention of being center stage as everybody observe how they’re coping. Teens most often choose to grieve privately and may downplay their pain. Many teens battle emotional pains due to the guilt and anguish, they feel when they are having fun and living while their loved one is dead. It is not uncommon for the anguish and sorrow of grief to manifest itself later in an adolescent’s life, well after the loved one departure. (Kersting, 2004)

Helping Kids and Teens Cope with Loss

The loss of a loved one is always hard and tough for everyone but is an undisputable fact that children and adolescents will suffer deeply the death of a significant family member, like a parent, a sibling, or other significant family members. To aid kids and teens cope with grief, the healthcare community and caregivers must understand the similarities and difference between children, adolescents, and adult’s grief. They must provide a better understanding of how to offer support to grieving children and adolescents while recognizing the misunderstandings of providing similar support, guidance, and care that is offered to grown-ups experiencing grief and sorrow. We must keep in mind, to be patient and open-minded. We must allow children and teens to grieve in their own way. Kids and teens must be reassured that any range of different emotions, from happy and laughing for one minute to crying the next one is totally normal. We must train grief counselors and grief therapist to better understand the differences between children, adolescents, and adult’s grief, so grieving children some experiencing death for the first time can feel comfortable expressing their feelings. (WYG) For children and teens who have minimal experience with stress, pain, and death, this might be an overwhelming experience. The death of a loved one, as children can be a disturbing experience, a child must be prepared to understand and comprehend the changes the death will impose in their lives. Unfortunately, this can be terrifying to children, as well as adults. Children, as well as many adults, do not possess the knowledge to know what types of coping strategies can help them, manage the hurtful emotions of grief. Death can be a traumatic and confusing situation for our youth to experience. (Ehmke,2019) It may seem that children and teens are able to overcome their grief more quickly than adults. But his doesn’t mean they have managed their grief, since many grieve in cycles or in spurts. In fact, their grief can last longer, and be disguised by their coping mechanism. Caregivers and grief counselors must be attentive to their behaviors and grieving progress while allowing them to come to term with death in their own way; but attentive, since in fact, their grief can last longer. (MarieCurie, 2019) Attentiveness to children and teens understanding of grief can help caregivers and healthcare providers, like primary care doctor or grief counselor, be able to recognize the early signs of depression in the context of bereavement, the child might be experiencing. It will help them identify if any additional help is necessary to aid the child to overcome their sorrow and help the child avoid and evade feelings of hopelessness, that can lead to depression.

Experiencing a significant loss of a loved one like a parent, siblings or caregiver in some children and /or teenager can generate stronger emotional reactions, such as guilt, anger, hopelessness and a sense of rejection that are similar symptoms of both grief and depression. (Schirmelpfening, 2018) Caregivers and health professionals must be able to identify and make the distinctions between normal grief and depression, in their child or children and their patients to be able to help them cope with their loss and grief and avoid depression. Education is very important in providing information to make a distinction between grief and depression since they share similar symptoms. Learning to identify the difference in normal grief and depression is important to the mental stability of a grieving child. It can be life-saving for a child, to seek treatment for depression, rather than continuing their emotional pain and agony without an understanding and hope. (Schirmelpfening, 2018) A better understanding of the similarities and differences between grief and depression can help significantly. We must create awareness of the difference of depression to grief, so everyone can be attentive to the signs and seek help. Understanding that everyone grief at their own pace and should be allowed to grief and mourn without a timeline or a pattern, is understandable; however, we as parents, caregivers, and health professionals should be more conscious and aware of the length, grief symptoms are taken to lessen. The difference between grief and depression is the length of the symptoms and emotions are affecting us. Grief is extremely painful, more so in children who might be experiencing these feeling of anxiety, sadness and possibly fear for the first time but these emotions and feelings should dwindle over time and resurface when trigger by memories and thoughts. Unlike, depression tends to be an ongoing feeling of hopelessness and sadness. Children suffering from depression feel depressed all the time, exhibits signs that their life has no purpose, usually by isolation and losing the desire to engage in social activities. (Nall, 2017) Creating awareness in the difference of grief and depression is an excellent way to help relieve the unnecessary suffering depression can cause our children. (Ferszt,& Leveille, 2006)