Anticipatory grief: what it is, causes, symptoms and how to manage it.

These are the characteristics of anticipatory grief and how it affects mental health.

Death is mysterious. We do not know what is on the other side, although we do know that it happens in an instant, in the blink of an eye a person may have ceased to live.

There are deaths that catch us by surprise, that we did not expect at all and that provoke all kinds of unknowns, feelings and thoughts, all of them experiences that will shape the mourning before that loss, more intense if it is due to the death of a loved one.

However, there are cases in which deaths are practically announced, especially if the person who is thought to be dying soon is very ill or suffers from a terminal condition.

In these cases, family members and even the patient himself are getting used to the idea that the end is near, and are preparing themselves for such an experience. They are experiencing an anticipated mourning, a mourning for a person who is still alive.. Let us see more in depth what are the particularities of this type of mourning.

What is anticipatory grief?

Anticipatory grief is the process that some people go through before the death of a loved one occurs or is confirmed.. It occurs when several circumstances point to the fact that sooner or later a loved one, such as a family member, a partner or a friend, is going to die.

Thus, we can say that it is like conventional mourning, only that instead of occurring after the death of a loved one, it is done knowing that this event is about to occur.

The emotions that occur throughout anticipatory grief can be just as intense as those that would be experienced in a bereavement for recent and sudden loss. The difference here is that people who experience it can better prepare for the death of their loved one, manage the emotions it provokes and also manage the emotions it causes.The difference here is that the bereaved can better prepare for the death of their loved one, manage the emotions it provokes and also settle unfinished business by taking advantage of the time they have left with their loved one, such as apologizing for past mistakes or spending time together and reminiscing about happy moments.

As a general rule, this type of bereavement occurs in the following two situations.

Terminally ill loved one

The most common scenario for anticipatory grief is when a loved one has a chronic, terminal illness, such as certain types of cancer, multiple sclerosis or Alzheimer's disease. Doctors and others responsible for the patient have already informed the family that the patient will die in a matter of time..

It is thanks to this that relatives begin to elaborate the loss, or at least some aspects of the loss, before the death occurs.

Disappearances and major accidents.

The second assumption, and this one is not so common, is when a loved one disappears in strange or violent circumstances, and it is not certain whether or not they are still alive..

The family, even if they have not given up hope, anticipates that somehow the person has already passed away, and they try to get used to the idea of that possibility. This is the case with disappearances and major accidents (e.g., air disasters, ship sinkings...) where it takes time to know the total number of victims.

Emotions experienced in anticipatory grief.

Grief is not experienced in the same way by everyone, but is an experience with particularities and unique experiences related to aspects such as the relationship with the deceased, the individual characteristics of the mourner, and also the traumatic nature of the death.

In the case of anticipatory grief, this is even more diverse, something that is evidenced by the fact that we cannot speak of unique and universal phases in this case, as is suggested in cases of conventional bereavement..

Among the main emotions and thoughts that occur throughout anticipatory grief we find:

• Sadness.
• Anger.
• Anxiety and stress.
• Depression.
• Guilt.
• Fear of uncertainty.
• Fatigue.
• Emotional numbness.
• Lack of concentration.

Advantages and disadvantages of anticipatory grief.

Anticipatory grief arises in preparation for what is inevitably going to happen..... Although one prepares psychologically for the death of a loved one, it is difficult that when the time comes it does not end up affecting, but fortunately if there has been a previous preparation it helps to make the grief after the death more bearable, the emotions it arouses are better managed and there is less risk of long-term emotional sequelae.

We can highlight a series of advantages of living an anticipated bereavement:

• Recognizing the reality of the loss gradually.
• Resolving pending issues and unfinished business now that time is running out.
• Changing aspects of oneself, valuing the present and enjoying the time that remains.
• Prepare for the loss with progressive emotional detachment and opportunity to express emotions.
• Plan for the future that still remains for that person.

However, some authors also consider that anticipatory grief can bring with it certain disadvantages if not properly managed if not properly managed:

• It causes exaggerated worry.
• The loss is anticipated before it occurs, which can provoke greater anxiety and prevent the enjoyment of the present.
• Depressive symptoms may appear.
• One of the reactions of being aware of the approaching death is to give up and not enjoy the life that remains, both one's own and that of the person who is going to die.
• It hinders care, feeling that there is nothing more to do and deprives the patient of care and emotional support, wishing for the end to come as soon as possible.
• There is a risk of abandonment of the patient.

How to cope with anticipatory grief?

It is essential to understand that bereavement, whether anticipated or not, is a healthy and normal process when someone or something is lost. Although in this particular case we are talking about grief caused by the death of a loved one, what should be clear to us is that the negative emotions experienced are not pathological, but are the totally healthy reaction of feeling that one has lost something. Grief is felt when you feel that you have lost something, that your life has changed so much that you need to adapt to your new reality.

In the case of anticipatory grief, this is a normal reaction, even though it may interfere with our daily well-being. As we have mentioned before, getting used to the idea of the death of a loved one can help us to take advantage of the time that remains and solve any conflict, argument or bad memory we had with him or her, so that before he or she leaves this world everything that was pending to be solved is solved at once.

The Pain of anticipatory grief is unavoidable, and it is preferable to grieve now rather than after the death of the loved one. The mind needs to prepare for the loss and and grief is a process of adaptation, an opportunity to manage what happens.. If this is done before the final event occurs, which is the death of that loved one, the grief following the death will be more bearable, shorter and less likely to leave emotional sequelae.

However, it should be said that while one should not try to avoid the pain associated with anticipatory grief, this does not mean that one should just sit back and let things happen. There are a number of strategies that can be undertaken to make this period less intense and traumaticThere are a number of strategies that can be implemented to make this period less intense and traumatic, so that emotions are managed more appropriately and do not degenerate into depression.

Find a way not to keep all the pain to yourself. Sharing it with other family members and other loved ones of the ill person can help to get through this difficult time. Revealing our emotions, concerns, feelings and thoughts can help us to see that other loved ones also have them and will serve to receive and give support.

Although these are hard times, we should not give up or give in. Our physical and psychological health are aspects that must be taken care of, especially during this period.. We must get enough sleep, exercise frequently, eat properly and socialize with friends. We should not feel guilty for enjoying and taking advantage of our lives while our loved one is dying. It is the disease that is taking him/her away, not us.

In case the anticipated grief is caused by the disappearance of a loved one, it is essential to consult a psychologist. Cases of disappearances and serious accidents in which the body of the loved one has not yet been found are very delicate and traumatic situations. In these cases it is essential to receive specialized psychological help in this type of situation.

The most important thing is to spend time with a sick person who will soon no longer be with us. If there is something to forgive or ask forgiveness for, now is the best time to do so. It is also the ideal time to say how much we love her, how much we value her and to remember happy times together.