Hearing my mom crying night after night, seeing my dad break down, added so much more sadness to losing Sophie. We were all just so sad for what seemed like so long.
—Emma
Sadness is the feeling we naturally connect with grief and loss. We expect people to feel sad when someone they love dies. Some of the other feelings, such as anger, come as a surprise, and sometimes the intensity and length of our sadness surprises us too. It’s not unusual to move between mad and sad feelings or to have both feelings combined. I call it “smad” when you are feeling both mad and sad at the same time, or when you get mad because you are so sad, and you don’t want to be sad anymore. Sometimes you show your mad feelings more easily than your sad ones, and vice versa.
It is also easy to confuse sadness and depression. We sometimes think they are the same thing, and certainly there are feelings and body reactions that suggest we are small d depressed when we are grieving. There are big differences between these reactions and a big D depression diagnosis that is a mental illness and needs professional help.
This chapter will help you understand how sadness affects our brains and our bodies. We’ll look at the difference between sadness in grief and big D depression, and how both affect our bodies. We’ll talk about suppressing your sadness and how that can lead to suicidal thoughts or self-harm behaviors. Throughout the chapter you will find ways to manage your sadness, and maybe, surprisingly, you’ll even find some joy in your sadness. When you look carefully, you may find that your days are not as full of sadness as you thought, as Emma describes:
Even though we felt sad every day, when I looked for the happy moments I could still see the glint in my dad’s tear-filled eyes, like whenever we talked about Sophie’s goofiness.
Feeling sad affects our body in easily identifiable ways. For starters, as we struggle to accept the loss and face life without the person we love, grief causes stress hormones to build up in our brain, throwing brain chemistry off balance. The muscles in our body ache from the stress hormones as well. Most grievers also notice a slump in their posture, the way they sit, or the way they walk. This slump is the result of a lack of energy. When we are sad, often we don’t eat or sleep well enough, so our energy stores become depleted. Our digestive system slows down, too, causing acid to build up in our stomach, which leads to more frequent stomach pains. We often eat more junk food with little nutritional value when we’re grieving, which can worsen the problems with energy level and stomachaches.
Headaches tend to be more frequent during grieving. One reason for this is the buildup of stress hormones in the brain, but dehydration is also a cause. Most people express sadness through crying, which is natural, but not paying attention to how much water you drink when you’re crying a lot can cause dehydration. Expressing feelings by crying, believe it or not, helps release the stress hormones from our body, keeping us healthier and making it less likely that the hormones will create more physical and emotional problems in the future. Expressing emotions is easier or more acceptable for some, but doing it does not require a witness or audience; it only requires a willingness to participate. Whether it is watery eyes, a single tear, full-blown sobbing, or snotty-nosed, red-eyed wailing, crying relieves grief.
Some people have the mistaken notion that if you just hold back the tears and don’t let your feelings out, you have control over them. To a certain degree, this is true; you can fight back tears when you need to, such as when you’re in school, in the grocery store, or with friends. However, the best way to treat your grieving body and deal with the feelings you have about a loved one is to find the space and time to have a good cry, releasing those tears.
People talk about needing to have a good cry or how much better they feel after having one, but you may feel like there’s nothing good about crying; you may be tired of crying or hearing everyone else crying. Here’s a different way to look at crying.
Crying is good for you because tears release stress hormones from your body, flushing tension in order to calm and soothe it. Tears of sadness have a different chemical makeup than tears of joy (Fogel 2009). Emotional tears, not the tears we get from dust or cutting onions, have meaning and feeling behind them, and they also contain pain-relieving hormones. Oxytocin is one of these hormones; it’s found in new mothers and babies as they bond to each other after birth, and your body produces it when you hug another person. You may think that crying makes you weak, but in reality, since the minute you were born, crying has been a sign that you are alive, that you need something or someone in order to stay alive. And yet repeated crying can lead to dehydration, headaches, and sore eyes, as Emma found out.
My eyes hurt so much from crying, and my nose was sore from running; crying gave me a fierce headache.
Each time you find yourself crying, whether it’s a good, long cry in your bedroom, the angry cry of frustration, or tearing up as you remember something about the person who died, drink a big glass of water. If you rehydrate with at least this small amount, you will find your headache quickly becomes less severe. Letting yourself fall asleep also helps make a crying headache go away, or taking yourself outside for a short walk—after you drink that glass of water!
Placing a cool washcloth across your eyes will soothe them and reduce their redness. Or you can alternate hot and cold. Fill a washcloth with ice cubes and fill a bowl with warm water and a washcloth. Place the cool cloth on your eyes for three minutes, and then switch to the warm one. Continue this until the redness and soreness go away. If you’ve been crying all day and your eyes hurt, cut slices from a cucumber or cooled potato (you’ll need to place these in the refrigerator in advance) and place them on your eyes for fifteen minutes. Tea bags that have been steeped in hot water also help draw out the redness and relieve the ache (make sure the bag has cooled off before you put it on your eyes). While you’re waiting for these to take away the redness and soreness of a good cry, take the time to do activity 3.1 (whole body muscle relaxation) to calm everything else down.
Crying doesn’t take away our sadness, but it allows us to express and release it from our body. Sadness can feel like a thick, weighted blanket. It makes us want to curl up on the couch or under our covers and just lie still. We may find ourselves without enough energy to do anything but stare out the window, wipe away our tears, and get another tissue. All these activities are normal parts of feeling and expressing sadness.
One easy way to bring some energy back into your body is to get a little sunshine. Human beings need the light rays of the sun to grow food and to stay alive, but sunshine provides a lot of other benefits, especially when you are grieving, sad, or depressed. Getting out on a sunny day can significantly change your body’s health, your mood, and your energy level because the sun is a source of the necessary vitamin D.
Vitamin D is essential to our body for a number of reasons. It helps with mood, bone growth, and a healthy immune system. Studies have shown that it prevents sickness, heart disease, and bone disease. However, people living north of the equator are more likely to be low in vitamin D, which can contribute to depression (Kerr et al. 2015). If you’re one of these people, it’s important to make sure you get enough of it.
Feeling the warmth of the sun on our skin is comforting. Our body automatically relaxes, and our skin absorbs vitamin D from the sun’s UV rays. For just fifteen minutes a day, three to four times a week, go outside and soak up the sun. That short amount of time will not contribute to skin cancer, so don’t worry about slathering on sunscreen; you want your skin to be able to absorb the natural vitamin D in the sun’s rays. This small but regular exposure to the sun is a great source of vitamin D, but vitamin D supplements can also help if getting out in the sun regularly is not an option. Check with your doctor about how much vitamin D you can take.
Sunshine is great, but at some point your body needs more than vitamin D. It also needs fresh air and movement in order to release sadness—that slumpy, dumpy feeling. When you’ve had a lot of sadness in your day, balance it out with movement. Without exercise, sadness can turn into depression, which we’ll discuss later in the chapter. Your body is designed to move, even when it is experiencing emotional or physical pain. Moving can be especially hard when you’re grieving, when your energy stores are depleted and your emotions have left you tired and weak. When all you want to do is sleep, the only way to feel better is to move!
You can start slowly, perhaps with a five-minute-long walk or a short walk to the corner and back. Don’t look at this movement as merely walking to the school bus stop every day or walking to classes. Moving your body purposely, to feel better, is the intention. It’s never easy to start anything new, especially something that requires physical energy when you don’t feel you have any to spare. Just ease into the activity below slowly and see if you notice a difference in how you feel, physically and emotionally. Pace yourself and keep at it, and, most importantly, find what works for you.
4.1 Move!
You can do this activity alone, or better yet, ask a friend or family member to do it with you. The other person will keep you company, encourage you to keep doing the activity, and support you as you improve.
Once you start moving, however slow the pace or short the time, you will notice that you feel slightly better when you get back from the walk than before you started. Soon you will recognize how much better you feel when you do move your body versus when you skip it. You may even look forward to it. That was Emma’s experience:
Hard as it is to admit, the therapist got this one right. I hated doing this; the first five-minute walk felt like five years. I thought my sore, tired legs and body were going to give out on me. At first I was a drama queen during this activity. What got me doing it regularly was having the time to myself. Getting outside my room, away from the family, and just going away felt like a break from things.
As big and overwhelming as our sadness feels, and as long as it seems to last, the thing that is most important to notice and understand about sadness is that it is a feeling and not a way of being. Feelings come and go; they don’t last forever. With the death of a loved one, you may be sad off and on throughout the day, perhaps more than you have felt before in your life. But you still have feelings of happiness, silliness, worry, frustration, or disappointment, too, off and on throughout the day. Now if you truly do not believe you have any other feelings but sadness, then you may be dealing more with big D depression than grief. It can be confusing to know the difference between grief and big D depression, so take a look at appendix B for a comparison.
If you are seeing more checks on the “depression” side of this list, you need to talk with someone whom you trust, preferably an adult. You don’t have to talk with a parent right away. If your parents are also grieving, you might feel like you don’t want to “bother” them or “make things worse than they already are,” thinking you’re somehow protecting them from more grief by not telling them what’s going on with you. Or maybe their grief is so intense that you think they wouldn’t notice or care about what’s happening with you, and by not telling them you are protecting yourself from more grief and loneliness. Most parents want to know what’s going on with their kids, no matter what; so if you can talk to them, do it now. Otherwise a school counselor or a nurse, a pastor or spiritual leader, an aunt or uncle, or a neighbor or family friend make good confidantes. Let one of them know that you are struggling and need to talk to a doctor. Doctors or mental health therapists can determine if you are experiencing little d depression with sadness, which is normal with grief, or big D depression, a mental and physical illness that needs professional attention.
It can be scary to see and feel some of the symptoms of big D depression in yourself. Try to remember that it only becomes big D depression when you experience the symptoms all day, every day, for at least a couple of weeks without relief. Don’t expect that you will suffer from big D depression just because a loved one dies, but be aware that it could become an issue for you. If you are diagnosed with big D depression or major depressive disorder and are given medication, keep in mind that there is no magical instant cure; however, there is support, and it comes from a three-legged stool approach.
Most people who are grieving the death of someone they love are not suffering from diagnosed depression, but if you have any questions about it, get a doctor or a mental health professional to screen you. If you are diagnosed with depression, keep in mind that you will recover. You will recover sooner if you follow the three-legged stool approach.
These three “legs” are going to be what support you as you resolve the diagnosed depression. One or two on their own will not be as effective and may increase the length of time it takes to reduce your symptoms. You don’t have to keep feeling bad; there is help, even if seeking help feels hopeless.
A few weeks after JR’s suicide, Matt’s feelings of blame and anger shifted to feelings of hopelessness and helplessness. His perspective on life became What’s the use? Soon Matt’s grief and sadness intensified to the point he stayed in bed all day, every day he could. He wasn’t eating and had no energy. Matt’s mom waited a couple of weeks for things to get better, and when they didn’t, she made him a doctor’s appointment. Seeing the doctor really turned things around for Matt.
So I ended up on antidepressants for a while. I just couldn’t get out of bed and didn’t want to do anything—at all. Therapy was not easy, but it did change things. I started to feel alive again, started to feel some hope, a light at the end of a tunnel.
Matt’s doctor assessed his risk for suicide, which can be a symptom of depression and is part of its diagnosis. Matt’s anger and sadness had turned inward, and his symptoms of depression had escalated to the point that he wanted to take his own life to relieve his pain.
Before I got help, the depression made me so weak and tired, I thought I may as well just join JR rather than keep feeling this bad. There were a few times when I thought I couldn’t live with the sadness anymore.
Matt was brave enough to talk to his doctor about his feelings and how he was thinking about suicide. Together, they got help for Matt. Thoughts of suicide are not a normal part of grief or sadness, but a lot of grieving and depressed people have them. Reach out for help if you feel like life is not worth living; if you think others would be better off without you; if you think, as Matt did, that the difficult, sucky feelings you’re having are just too much or are lasting too long. Let a professional determine if you are big D depressed or just sad, and accept the help and advice he or she offers. Those who love you will be grateful.
Research indicates that 90 percent of people who die by suicide have a mental illness or a substance-abuse diagnosis (Substance Abuse and Mental Health Services Administration 2010). Besides depression symptoms, suicide risk behaviors can be tricky to spot. Appendix C has a list of risks for suicide and includes the national hotline for preventing suicide. If you or someone you care about exhibits any of these signs, please get help—immediately. You will not give the person the “idea” of suicide if you talk about it. You may actually give that person the chance he or she was looking for to talk to someone and get help. This is a serious, life-threatening situation, and no one can get through it alone.
Here is an activity I encourage all people to do if they have had even fleeting thoughts of suicide. If you feel like the world would be better off without you, if you feel isolated and hopeless or like you can’t take what the world is dishing out right now (remember, feelings are not forever), keep in mind that you have a helping hand to get you through.
4.2 My Helping Hand
Keep an open mind and heart for five minutes or less.
Knowing there is always someone you can count on, someone who will help you when you need support, is crucial to surviving suicidal thoughts, deep depression, and sometimes everyday life. Having a physical representation with you at all times lets you see firsthand, so to speak, that there is help out there; all you need to do is reach out and express to your helpers what you need or how you feel. For many grieving teens, that may be easier said than done when they are suppressing emotions, holding feelings in, not letting others help, or questioning whether their helpers will or can help; and it’s these behaviors that lead to unhelpful, unhealthy, and even deadly actions.
Some grieving teens decide to avoid the sadness, deny the hurt feelings, ignore the memories, and stuff all of it deep down in the darkness of their brain or their heart because it is just too hard to feel the feelings, to cry, to yearn for the person, and to be reminded of that person’s absence. The pain of grief and loss can feel worse than any other pain, and when teens find a way to control it, it seems like a way out of the grief. It’s not. Katie didn’t realize how much she was harming herself by pushing the hurt of her grief away.
Finding a way to relieve my pain, to control my feelings, to control anything, was the reason I stopped eating. No one could make me eat; no one could make me grieve. I had to have some control over these uncontrollable feelings. I stopped eating because I was too sad to be hungry—for anything.
Suppressing sadness can have several negative effects on your body. As we’ve learned, stress can build up in your body, and if you don’t find release, it can cause headaches, stomachaches, sore muscles, and even heart disease. Suppressing feelings can also turn into an eating disorder (Fogel 2009).
When Katie said she was too sad to be hungry, it meant that she had lost touch with what her body was telling her. Holding her deep feelings of sadness inside suppressed her body’s natural hunger. Forcing your body to not feel and express emotions will not help you. Suppressing your body’s natural processes only hurts it. If you find yourself in this situation, you need to reach out for professional help—a doctor or a grief counselor—right away.
So often, especially if you are the oldest sibling in your family, or the oldest male, you can feel as though you have to be the family’s rock, or the glue that holds the family together, so you hide your sadness. Besides not eating, other self-harming behaviors, such as cutting, burning, punching, head banging, drinking, eating harmful substances, or rubbing and scratching to the point of injury, are ways that teens sometimes release the energy of intense feelings. By feeling physical pain or some sort of control over both their emotions and physical body, they may feel like they can cope with the suppressed emotional pain. These self-harming behaviors may not be suicidal, but they can be extremely dangerous. As with suicidal thoughts, you need to get help and support if you are harming yourself, especially if the following ideas for distracting yourself from these behaviors do not help.
4.3 Distract the Hurting
Mark this page or rewrite these distraction options on a sheet of paper to keep near you for when you feel the need to self-harm. Try each one to see what works. Different distractions may work on different days, but keep trying. If none of these ideas keep you from hurting yourself, get professional help as soon as possible.
There are several activities in this chapter and book that will help you express your feelings and get the hurt out without hurting more or differently. Suppressing your feelings, trying to keep them in, or diverting them with a different kind of pain will not ease the hurt. Grief is something you have to go through in order to get through it; holding on to your grief and pain adds more grief and pain.
You can express your sadness and release its intensity through art. Creating a memory scrapbook, photo album, or collage using photos of your loved one is a great way to release sadness. You may cry while working on these projects, but you will also remember sweet moments with the person who died. Over time, you will find that your sadness subsides a bit as you look at these memory projects, and your memories will bring smiles. So often there are no words to capture our sadness or our memories or all that happens when a loved one dies; however, these projects can speak the words that we can’t speak right now.
4.4 There Are No Words
You may want to gather magazine photos, images from the Internet, your own photos, crayons, markers, glue, scraps of colored paper, scraps of material or old clothes your loved one wore, coloring books, or sketchbooks to have on hand for these projects.
You may be surprised at how using your sense of sight, creativity, imagination, and curiosity in these ways shifts your mind and body toward a new way of being. All these memory-making activities are bittersweet, because they remind us of sweet, happier times with the person we love and the bitter sadness we feel knowing that this person is now gone from our everyday life. These activities can teach us that joy and sadness are both part of life.
Sadness is not the opposite of joy or happiness. These emotions are all part of life. However, living in a home filled with sadness can be too much at times. It’s okay to escape the sadness and have fun or be happy even when you feel grief. Doing so does not disrespect the person who died, take away your grief, change what happened, or mean you are heartless or horrible. You are human, and humans can only take so much sadness before they need to find relief, even when someone they love has died.
When it seems as though every day is a sad day, find a way to also see joy and happiness. Doing so will take your concentrated effort. Give the search just a few minutes each day, if that’s all you can spare or think you can bear.
There has been a ton of research on the subject of smiling and the impact it has on our lives. You may have heard the saying that it takes more muscles to frown than it does to smile, and it’s true. You may have also heard the saying “Fake it ’til you make it.” What do these things mean, and how might they affect our sadness?
Just pretending to be happy can make you happy. Smiling even when you don’t feel it, when you are faking it, can change your sad feelings. Smile studies by Robert Zajonc (1989) found that if you place a pencil in your mouth to trick your facial muscles into smiling, your brain sends more blood to those muscles, which signals our brain to a change in mood. Try it. With or without the pencil, let yourself smile. Here are some other ideas of ways to induce smiling and experience some joy when you feel sad.
4.5 Joy’s Turn
Let go of sadness for just a few minutes once a day in one of these ways.
It really is okay to smile again, even to laugh through your tears. It’s okay to set aside sadness, because it will be there again. Sadness is part of what your mind, your heart, and your body need while you’re grieving, but setting aside your sadness while taking care of your body and finding joy are also part of healing grief. It’s important to allow yourself to express all of your feelings and give your body what it needs.
This has been a full and intense chapter. We looked at sadness and the effect it has on our body and behavior. The more we know about sadness, little d and big D depression, suicide, self-harm, and suppression of intense feelings, the better we can help ourselves and others we care about. Sadness is something that everyone experiences in life. It can be scary to have such intense feelings, and perhaps this is the first time you have felt this deeply sad. The one thing to always keep in mind is that the sadness will pass; its intensity will lessen. Even though profound sadness will enter your life, you can and will find joy and happiness again.
Losing someone we love, wanting this person back again, and wondering if we’ll lose more people can bring on a loneliness that feels like it will never go away. In the next chapter we’ll look at feelings of loneliness and being alone, exploring how to find a community and friends and make connections with others who are grieving and feeling the same loneliness.