Entries in Grief (5)


Mary Kennedy's Children Likely Dealing with Complicated Grief

Charles Eshelman/FilmMagic(NEW YORK) -- The four children of Robert Kennedy Jr. and Mary Kennedy face a complicated grieving process in the aftermath of her suicide, mental health experts say.

"Initially, the biggest challenge for kids that deal with the suicide of a parent is taking in that news and all the information and circumstances surrounding the death," said Jon Ebert, assistant professor of psychiatry at Vanderbilt University Medical Center.

The couple's four children range in age from 10 to 17, and around that age range, children dealing with the suicide of a parent can experience a number of emotions.

Starting at about age 12 or 13, children have a better understanding of suicide.

"Children can differentiate between death and suicide well, and they usually interpret the suicide by saying that the parent was sick or ill," said Dr. T. Byram Karasu, professor and chair of psychiatry and behavioral sciences at Albert Einstein College of Medicine.  "They will usually blame the spouse.  They will deny the loss and hate the spouse."

Karasu added that children who lose a parent at such an age end up growing up very quickly.

"Their growth is interrupted," he said.  "Adolescents usually end up becoming adults very fast."

In some cases, children end up identifying with the deceased parent and assuming that parent's role, which can be a healthy defense mechanism, Karasu said.

But in other cases, children may respond by acting out and rejecting authority.

Younger children usually see death and suicide as interchangeable, Karasu explained.  They may feel depressed and anxious but not know why, and may also feel very vulnerable after the loss.

Children also struggle with the unanswered question of why their parent left them, Ebert said.

"It's important to clearly communicate to kids that their mom or dad was sick," he said.  "Suicide is a symptom of depression, and it's a level of depression that is significant to the point that the person felt so helpless or hopeless that they took their own life."

The children's grief is also compounded by the publicity surrounding Mary Kennedy's death and the notoriety of the Kennedy family.

Copyright 2012 ABC News Radio


Online Grieving: Support a Keyboard Away

Zach Whiteman via Reddit(KOKOMO, Ind.) -- On March 8, a young man marking a painful anniversary went to and posted three short sentences and a photograph depicting a heartbreaking story of young love nipped in the bud by cancer.

"A year ago today, I proposed to the love of my life. She passed away 5 days later due to ovarian cancer. She was only 17," he wrote in words that moved more than 1,800 members of Reddit's online community to respond.

When strangers asked why he proposed to a dying woman, the young man, identified only as koolaidman2011, explained: "We found out she wasn't responding to her treatment two days after I proposed, and she only got worse after that. The doctor hadn't told us the severity of her situation at that point in time. So yes, I proposed to her just as any person would. I never could have imagined she wouldn't be here today."

By choosing to share such raw emotion in an open forum, koolaidman2011 might have been seeking an outlet for his grief, empathy for a searing loss and perhaps a chance to connect with others who'd endured similar pain. New to the site, he said he'd only been registered a couple of days when he posted his story of lost love.

The vast majority of responders to his online grieving offered kindness and compassion. Several shared losses of parents, siblings, and lovers, and how they'd gotten through them.

And yet, for what might only be explained as the darker side of human nature, some people, shielded by their online names, posted nasty comments.

Their anonymity is "part of the danger," of posting to a general audience, said Gary M. Laderman, an Emory University religion professor who specializes in death and dying. "More often than not you have aliases, different avatars, different ways to identify yourself where you can shield your true identity."

That emboldens some people to "be really rude, whether it's some kind of story on the politics of the day, or really personal issues," Laderman said. Even though most people would assume that common rules of decency would prevail, "online and on the web, those things are out the window."

Despite the veil of anonymity, little is truly private in the digital age. When one user apparently recognized the woman in the photograph as Morgan Brantley, some quick online searches turned up several stories about Morgan Alizabeth Brantley, a Kokomo, Ind., high school senior and varsity swimmer whose illness and death united her community. The Kokomo Tribune also covered how Zach Whiteman, a fellow senior and varsity basketball player, put a ring on her hand during a bedside marriage proposal.

From Brantley's diagnosis on Dec. 17, 2010, through her death on March 13, 2011, friends and loved ones posted thoughts and prayers on three Facebook pages, raised money for medical expenses and sported "Team Morgan" T-shirts designed by Whiteman. The "Pray for Morgan Brantley," page featured the same photograph Whiteman posted on Reddit.

Whiteman, now a college freshman, didn't respond to attempts to reach him through Reddit and Facebook to learn whether the online posting provided any solace.

"If it's only been a year since his fiancée died, his grief is still very fresh," said bereavement counselor Pamela Gabbay, program director of the Mourning Star Center for Grieving Children in Palm Desert, Calif. "I think that he was focusing on the positive, his memories and his love for her, and never thought that people would be negative, mean and cruel."

Many younger people reared in the online age "are more comfortable expressing their most intimate feelings in a virtual fashion," Gabbay said. However, she said that dedicated sites for the bereaved tend to protect them from the stinging comments of critical outsiders in more open forums like Reddit. "Typically, grieving people tend to be kind to each other because they know what it feels like to be hurting."

Whiteman's posting illustrates how the Internet has made grieving a much more public ritual, Laderman said. "There's a whole plethora of online grieving support networks and memorialization pages that are very much focused on people struggling with grief. The online virtual world has really become important."

Cyberposts can provide comfort to the grief-stricken, which is "why we're seeing more of the kinds of sites or posts where people are putting their little testimonial or memorial," Laderman said. "This is part and parcel of larger trends around death and dying in our culture that are breaking it out from purely religious institutions and authority and from the controlling hand of the funeral industry."

Ultimately, Gabbay said, online forums and discussion boards can provide healing and comfort, but virtual interactions "cannot replace face-to-face support. The Internet can't give you a hug."

Some online sites and interactive forums dedicated to grieving and loss:

Copyright 2012 ABC News Radio


Grief: Normal, Not A Mental Illness

Hemera/Thinkstock(NEW YORK) -- Grief following the death of a loved one isn't a mental illness that requires psychiatrists and antidepressants, according to editors of The Lancet, who oppose "medicalizing" an often-healing response to overwhelming loss.

Routinely legitimizing the treatment of grief with antidepressants "is not only dangerously simplistic, but also flawed," says the unsigned lead editorial appearing in Friday's edition of the influential international medical journal. "Grief is not an illness; it is more usefully thought of as part of being human and a normal response to the death of a loved one."

In rare cases, a bereaved person will develop prolonged grief or major depression that may merit medical treatment "or sometimes more effective psychological interventions such as guided mourning may be needed," they wrote. However, they suggested that for the majority of the bereaved, "doctors would do better to offer time, compassion, remembrance and empathy, than pills."

The editorial opposes the American Psychiatric Association's controversial proposal to re-categorize grief reactions as a mental illness in the upcoming edition of the Diagnostic and Statistical Manual of Mental Disorders, (DSM-5), due out in 2013. That book, often referred to as the Bible of psychiatry, defines mental health disorders and assigns them diagnostic codes which, among other things, drive health insurance reimbursements for treatment. Among other pending changes in the DSM-5 are the addition of premenstrual dysphoric disorder, and a revised definition of autism that some critics and parents fear could limit the number of youngsters receiving medical, social and school-based services for autism spectrum disorders.

The proposal opposed by The Lancet's editorial writers would eliminate the so-called "grief exclusion." For years this "exclusion" has said that someone who has experienced recent bereavement is ineligible for a diagnosis of major depression for a set period of time, according to a defense of the change written by Dr. Kenneth S. Kendler, a member of the DSM-5 Mood Disorder Working Group and posted on the DSM-5 website.

An earlier manual, the DSM-III, said a person could go through the grieving process for a year before a psychiatrist determined that persistent feelings such as sadness, disturbed sleep, loss of appetite, low energy and poor concentration constituted depression to be addressed with medications and psychotherapy.

More recently, the DSM-IV shrank that period to two months. The pending revision to the DSM-5 would shrink that period even further, allowing the psychiatrist to diagnose depression following two weeks of such symptoms.

In defending that shorter period, Kendler said it "provides the possibility but by no means the requirement that treatment be initiated," and suggested doctors have the option of so-called "watchful waiting." Good care involves "intervening only when both our clinical experience and good scientific evidence suggests that treatment is needed."

The two sides of the debate were laid out in an accompanying "Perspectives" piece by Dr. Arthur Kleinman, a Harvard psychiatrist, social anthropologist and global health expert. Critics of the change contend that with a looser standard, the APA would be creating more patients, and more demand for medications, thus making bereavement "a potential profit center for the business of psychiatry." Supporters of the change contend that bereaved people with disabling symptoms would benefit from the recognition and treatment, he said.

The central problem, as Kleinman sees it, is the lack of "conclusive scientific evidence to show what a normal length of bereavement is." Drawing from his anthropological studies, he said that "across the world, societies differ greatly in what they regard as normal grief: some do regard a year as a marker, and yet others sanction longer periods -- even a lifetime."

Kleinman recounted his own experience of losing his wife of 46 years to Alzheimer's disease in March 2011, describing the agitation, fatigue, weight loss and other symptoms that set in. It took six months before his grief lessened. Nearly a year since he became a widower, he continues to experience "sadness at times and harbor the sense that part of me is gone forever."

"My grief, like that of millions of others, signaled the loss of something truly vital in my life," Kleinman wrote. "The pain was part of the remembering and maybe also the remaking. It punctuated the end of a time and a form of living, and marked the transition to a new time and a different way of living."

According to the editorial writers, "it is often not until 6 months, or the first anniversary of the death, that grieving can move into a less intense phase." Grieving also is individual, shaped by age, gender, religious beliefs and the strength of the relationship with the lost loved one, they said.

Copyright 2012 ABC News Radio


Heart Attack Risks Soar for Grieving Loved Ones

BananaStock/Thinkstock(WASHINGTON) -- Scientists have found new evidence that grief might actually break your heart. A new study shows that people grieving the death of a close loved one could have a heart attack risk that is 20 times higher than normal.

When researchers interviewed nearly 2,000 people in the early 1990s who were hospitalized after a heart attack, 270 reported that they had experienced the death of a parent, sibling, spouse, friend or other loved one in the six months before their heart attack; almost 20 people had experienced a loss within the past day.

The authors calculated the risk of a heart attack as 21 times higher in the first day after the loss of a loved one, and six times higher during the week after such a loss.

The study was published Monday in the American Heart Association's Journal Circulation.

While previous studies have shown that the death of a loved one is linked to worsening health over time, the latest study is the first to show that the effects can begin so immediately and strongly after a loss, findings that surprised lead author Elizabeth Mostofsky and her colleagues.

Studies have shown that people can and do suffer from "broken heart syndrome," called takotsubo, a condition in which heart attacks occur in the face of abrupt, stressful news or events. Scientists aren't entirely sure how shock or grief lead to a heart attack but, most likely, emotional stress boosts levels of stress hormones and other factors that can increase heart rate, blood pressure, blood clotting and other factors that put the heart at risk.

Broken heart syndrome is more common among older women, but in the latest study, the grieving heart attack survivors were mostly younger men.

Heart attack symptoms include chest discomfort, stomach pain, shortness of breath, nausea and lightheadedness, according to the American Heart Association. Patients with such symptoms should report them immediately.

Copyright 2012 ABC News Radio


Rep. Weiner May Feel Symptoms of Grief After Resignation

Andrew Burton/Getty Images(NEW YORK) -- While the jury is still out on whether just-resigned Rep. Anthony Weiner is addicted to sexting and other lewd Internet behavior, experts say his fall from grace may take a toll on his mental health, addiction or not.

Weiner, 46, announced his resignation on Thursday, 10 days after the news conference where he admitted to lying about sexual behavior with strangers, including a former porn actress, through social media sites such as Twitter and Facebook.

Weiner's crotch shot seen 'round the world was the first of dozens of photos he shared with online strangers to surface.  After he admitted to sending the initial photo at a news conference, political leaders across party lines pressured the congressman to resign.

"The extent to which this might impact an individual depends a great deal on their personal coping resources, personal support system and overall resilience in the context of their pre-event psychological make-up," said Dr. Martin Binks, clinical director and CEO of Binks Behavioral Health.

Binks said the theme of loss may play a part in Weiner's decline and possible recovery, especially if there is a loss of respect and reputation that may play a large role in his sense of self-worth.

"The fall from grace can be far more devastating if one's sense of self relies too heavily on these external factors," said Binks.  "In other cases, where something that is seen as out of one's personal control causes personal and emotional devastation, we fall back on the love and support of those closest to us to be our staunchest allies.  These close personal supports are the rock in our emotional foundation."

Binks noted that when that devastation alienates a person's support system, as could possibly have happened in Weiner's case with his wife Huma Abedin, he may lose that support, and the feelings of loss and grief can become amplified.

Copyright 2011 ABC News Radio

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