Bereavement and Mental Well Being



The central theme in bereavement is LOSS; but not loss in a general sense.   It is the specific, personal loss of a loved one through death.  It is a final exit of a loved person from the physical space where all forms of previous interpersonal contacts become impossible again.  This picture attempts to capture in graphic terms the impact of this loss on the human mind and the consequent activation of the coping mechanisms.  The involuntary emotional and behavioral reactions to this loss are often described as grief while the traditional, voluntary ,social expressions  to this loss is mourning which may overshadow  all the other aspects of bereavement  especially in Africa.
It is normal for human beings to express this involuntary grief reaction by an initial phase of shock, protest and disbelief followed by preoccupation with the thoughts of the deceased, which is often characterized by searching for other intrusive thoughts about the dead.  As a process of resolution, there is a stage of reluctantly accepting the reality of the loss, which is followed by outright rejection of attitudes of guilt or self-pity with respect to the deceased.
Where adverse bereavement- related symptoms persist for more than 6 months or when there is the absence of expected grief symptoms or the avoidance of painful symptoms within the first 2 weeks; a situation of abnormal grief reaction ensues that require psychiatric consultation. The human cognitive template has valuable recordings of memorable interactions with the loved one that cannot be switched off as can be done to a television. To view the human mind at that mechanical level is to have a poor understanding of how the human mind functions. The grief reaction state may come out in close resemblance to depressive illness except that guilt and suicidal ideations are not free floating if they ever exist as they will always be in the context of the deceased. There are usually no associated feelings of worthlessness, hallucinatory experiences or prolonged functional impairment.  The grief reaction may initially appear mild until the one year anniversary when manifestations may become more intense.  To mask this; some may take to alcohol and substance abuse.
 Frank stress reactions to the loss especially when the death is sudden, unexpected or violent may present with re-experiencing and flashbacks of the circumstances of the death of the deceased. Folks with previous history of psychiatric illnesses may be more prone to committing suicide following bereavement.  There is a demonstrable higher rate of hospital admission and increased medical consultation among those bereaved especially if they are parents, children or spouses in relation to the deceased.  The women may present more with frank psychiatric disorders while the men would develop more medical complications because of bereavement if they do not remarry.  Some of the subtle but potent factors that can facilitate complications of bereavement are social and emotional isolation, absolute loss of social role, unemployment, financial hardship and loss of supportive social networks. Some bereaved individuals may have low self-esteem, ambivalent or dependent relationship with the deceased or previously unstable personality profiles.  The women especially become more vulnerable and destabilized following bereavement just as men show less acceptance of their loss and turn to other romantic relationships sooner.
  Mourning as a conscious, voluntary socio-cultural facility could have a creative and profound positive impact on the grief reaction by ameliorating factors that can get it complicated.

In Africa where a widow is viewed more as   property of the deceased husband and by extension of the extended family; prospect of remarriage is usually marred by family gossips and persecution as obsolete cultural practices whereby a sibling of the late husband may be  expected to take over the widow of his late brother without her consent. Properties acquired jointly are oftentimes seized by the extended family if she does not comply with the family directives. Some mourning practices can take several months, which may foster social isolation, loss of self-esteem and disconnection from supportive social networks and means of livelihood. Both religious and cultural practices should ensure that those who harbor guilt feelings following the death of their loved ones are reassured so that they can have enhanced mental capacity to bear the loss rather than wallow in self-pity. Memories of our loved ones can be devoid of pain when we immortalize them with projects that can serve the good of the community especially the vulnerable ones. As a consequence of suicide bomb attacks, air disasters, increasing road traffic accidents and reduced life expectancy generally; there is definitely an increasing population of widows, widowers, orphans that would require a robust social welfare program from our government at all levels because their bereavement would have taken a negative toll on their socioeconomic standing.

Dr. Adeoye Oyewole
adeoyewole2000@yahoo.com
+234 803 490 5808 (WhatsApp only)

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