The death of a spouse is one of the most devastating, distressing and psychologically traumatic experience. Possibly because of the quality of intimacy that the marital relationship entails such that the surviving spouses commonly experience changes in psychological well-being, evidenced by the increased prevalence of depression in this cohort. Grief is the involuntary, emotional and related behavioral response specific to the loss, whereas mourning is the voluntary social expression of that loss while bereavement captures the overall experience of the loss .Women are not only more at risk of bereavement than men, but they also appear to suffer from its psychiatric complications more often. Men, especially younger ones show less acceptance of their loss and turn to other romantic relationships sooner especially in a patriarchal society like ours hence we hear more of agitations to protect widows more often than widowers although elderly widowers may also be more at risk especially in a monogamous setting complicated by the empty nest syndrome. The grief process comes in phases which in practical terms may not be successive. The initial phase comes with shock and protest that encompasses numbness and disbelief with marked sadness accompanied by preoccupation with the thoughts of the loved one. This may be followed by a phase of disorganization as the loss is reluctantly accepted. The final phase of resolution sets in as inappropriate attitudes to the loss are rejected. This process of grief however can be complicated when the bereavement-related symptoms do not resolve within 6months .This could impair social and occupational functioning as the symptoms become persistent. Grief can also be inhibited when grief symptoms are repressed possibly due to social and religious prescriptions which may delay the grief process by consciously avoiding painful symptoms within the first 2weeks of a loss. An unusually intense bereavement reaction however may be associated with the development of mental illness invariably. Depressive disorders are commonly provoked by bereavement but we must know that depressive symptoms not as illness are part of the normal grieving process. However, we must watch out for the unusually prolonged persistent expression of these depressive symptoms in the surviving spouse like sustained guilt feelings, thoughts of death, worthlessness, slowness of thoughts, prolonged functional impairment, hearing voices of unseen individuals in clear consciousness which will definitely require mental health consultation. Certain factors are predictive of a poor outcome of bereavement in the surviving spouse such as low self-esteem that exaggerates the fear of survival, non-cordial relationship with the dead spouse, certain individual personality traits that are unstable, the female gender, when the death is sudden, unexpected, untimely and traumatic which could be a suicide, murder or other stigmatized deaths. The loss could be complicated when the surviving spouse lacks social support, socially isolated with poor socio-economic status associated with concomitant life events. Evidence however appears mixed with respect to the consequences of widowhood on physical well-being. Widowed persons are more likely to exhibit physical ailments and undefined physical complaints compared to their married counterparts. The depressive symptoms in the widower may be masked by an increased intake of alcohol that may invariably predispose to serious medical problems later. Culture could be a liability when it furnishes the factors of predisposition for complicating grief. In some culture; the disposal of the deceased may take place months after death and could involve several rituals and rites to be performed by the surviving spouse involving periods of seclusion ,fasting , shaving of the hair, dressed in black attires and not going to work. The social isolation, refusing to allow widows resume work prompt and at times insisting that widows marry the brother of the late husband so that the family investment is retained are some of the practices that could predispose them to developing mental illness. In some instances; the properties are confiscated by the husband’s family while she is abandoned to cater for the children without any economic support. This may even be terrible in inter-tribal manages where the family of the deceased may consider the widow as a stranger and usurper. In some cases; the widow could be accused of being responsible for her husband’s death especially after some religious consultations. In some religious circles; widows are avoided as they may be seen as channels of bad luck which reduces social support. Remarriage may also be discouraged as the widow is not expected to have male friends too soon which may portray lack of respect for the deceased. Widows also experience significant sexual harassment especially from close family friends who may give socioeconomic support as baits. There should be a strong legislation in place to guarantee the socioeconomic and psychological needs of widows especially in a strong patriarchal society like ours since most widowers apart from the older monogamous ones are fairly protected.
Dr Adeoye Oyewole
adeoyewole2000@yahoo.com
+2348034905808(Whatsapp only)
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