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  • What Trauma Feels Like;
  • I Feel Scared, Nervous, Panicked;
  • Anxiety Reduction Techniques; Crisis Self-Care Strategies; Intrusive Thoughts & Nightmares;
  • To Reduce General Anxiety (Fear, Insomnia, Depression);
  • Food and Stress;
  • Helping Children After a Disaster;
  • What Should I Do for Someone Experiencing a Loss?

Click to left to jump immediately to that section. Camp Fire resources here. Database of found Camp Fire cats here. Below, you’ll find tips on anxiety reduction, how to stop flashbacks and nightmares, insomnia, how to help children cope, loss, and more. As a licensed clinical psychologist, I’ve treated many survivors of trauma, and taught Community Mental Health (among other courses) at the University of California for decades. I’m also a dream/nightmare researcher/author, and wrote this to offer effective ways, following a traumatic event, to help survivors/responders avoid developing PTSD, feel better and recover emotionally. On 10/17/89, I was in downtown Santa Cruz when the Loma Prieta earthquake destroyed the town. So while these words may feel like they’re coming from a distance, I remember the shock, dry feelings of devastation, and grief. Please feel free to share widely! CA PSY 15379. If in distress, also consider calling the National Suicide Prevention Lifeline at (800) 273-8255 or the National Disaster Distress Helpline, with trained mental health counselors available 24/7, 1-800-985-5990, or text to 66746. Text one word with no spaces, talkwithus; or in Spanish, text one word, hablanos. Please reach out! You don’t need to be actively suicidal to call. Many, many people care and can help!  

WHAT TRAUMA FEELS LIKE

         It is normal to feel numb, confused, lost, sad, angry, and many other feelings after a disaster! Your sense of safety and security have been attacked. It is very important for you to recognize your own symptoms and take steps to take good care of yourself at this time. If you’ve experienced trauma before this, the fire may reactivate prior feelings, as well. Usually, shock begins to ebb 1-2 weeks after the disaster and you may have strong feelings. (For some, it takes months or even years.)

        Cognitive difficulties: You may have trouble concentrating, find you experience a briefer attention span, have difficulty solving problems and trouble remembering what you've read or heard. Lack of sleep can compound these difficulties. Cognitive symptoms pass in time.  Give yourself plenty of space and time to complete what used to be ‘normal’ activities of the day. Schedule fewer responsibilities. Consider making no major decisions until things feel a bit more normal again.

        Physical difficulties: Headaches, gastrointestinal discomfort, restlessness, muscle tremors and trembling (from adrenaline), muscle aches, fatigue, shortness of breath or feeling like you're suffocating (from hyperventilation) are all common reactions to trauma. A quick way to eliminate the last two is to breathe in to a count of 4, hold for 4, and breathe out to a count of 4 while consciously focusing on relaxing major muscle groups.  Work up to a count of 7-2-7. Stretching, warm baths, and massage are also helpful. (Other effective techniques to cope with anxiety follow.)

        Thoughts: One of the most effective methods to help reduce the likelihood of developing PTSD from disaster is to pay close attention to the story you tell yourself about what’s happened to you.  We naturally stop telling the story at the point of most fear and danger. This actually makes it harder to recover.  Instead, tell the story all the way to the end, when you knew you were safe, and help others to do so, as well:  “I had to flee in the middle of the night, and could see the flames and smell the smoke and I was very afraid. I was able to drive through the danger, and was terrified seeing the burning.  I got to a shelter, got out of the car, went inside, AND I WAS SAFE AND AM SAFE NOW.”  End every re-telling with “and I was safe and am safe now.”

        Feelings: You may feel overwhelmed by sadness and sudden crying, grief, guilt at not treating others better or for surviving (“survivor’s guilt”), nervousness, fear, anger, feeling alone, and/or feeling confused. This is a time to be gentle with yourself and others, while allowing time to pass and allowing the feelings to flow through you as much as possible when they arise. When we try not to feel things, we tend to feel worse. Tell yourself, “This is a normal, temporary reaction to trauma. My feelings cannot harm me. They will pass.”

        Behavior: You may find yourself withdrawing from others, spending more time alone, not talking very much. You may have trouble sleeping or awaken in the night, have nightmares, and your appetite may change. You may become irritable with others, startle easily, and avoid places that re-stimulate the original fear. Alternatively, you may feel unable to stop seeking information about what you went through.  If possible, shelter yourself from such new information, and particularly avoid visuals, like video. This is necessary to allow your psyche to absorb what has happened and to rest and refuel without re-traumatizing yourself. The unconscious doesn’t know the difference between fantasy and reality: when you watch a video, your limbic system is activated, and part of you believes the trauma is happening again.

        All of these responses are normal. It is okay, and even appropriate, to feel badly during a crisis, and talking to a trusted person or mental health worker is very helpful. 

I FEEL SCARED, NERVOUS, PANICKED

Hyperventilation Syndrome: Panic

        For people in the throes of hyperventilation, death feels as though it will arrive at any moment. People suffering from hyperventilation syndrome (I'll abbreviate it as HVS) feel a variety of things. First: mild disorientation, dizziness, feelings of unreality, and/or lightheadedness. Next: heart pounding, racing heart, sweating palms, breaking out in a sweat all over, 'hot flashes,' nausea, feelings of dread, fear of death or fainting or going crazy, claustrophobia (for example, 'if only I can get out of here and get home I'll be okay'), feelings of suffocation/not being able to get enough air. One can have all, or only a few of these.

        In normal breathing, one breathes in about the same amount of oxygen as one exhales carbon dioxide. (Carbon dioxide is a byproduct of metabolizing oxygen). Hyperventilation means that you are breathing in more oxygen than you need. You are actually taking in more oxygen than you are exhaling carbon dioxide. Paradoxically, carbon dioxide builds up in your blood. This happens when you take quick, shallow breaths without the accompanying physical exertion that would require more oxygen. And you have no idea you are doing it.

        Our ancestors needed the ability to quickly escape from predators and other threats, and to quickly respond to a fleeing animal when hunting. The 'fight-or-flight' response enabled early humans to perform these tasks. In modern day life, we rarely need such a dramatic physical response. Chasing the dog at the beach doesn't require quite the same level of physiological readiness as did running from a charging animal! Nevertheless, our bodies haven't evolved out of the fight-or-flight response, and can’t differentiate between a vivid thought or memory of danger and actual danger. Anxiety triggers the hyperventilation/fight-or-flight response in our bodies, and unless we restore the oxygen/carbon dioxide balance quickly, the symptoms will increase until we pass out and automatically begin breathing normally again.   If you regularly suffer from anxiety attacks, excellent self-help books are Claire Weekes' classics, Self-Help for Your Nerves, and Peace From Nervous Suffering.

        Note: As with any physical symptom, please check with your doctor to rule out any medical cause for your anxiety. There are very few physical disorders resulting in panic-like symptoms, and you’ll want to rule those out, particularly if you experienced anxiety or panic before the fires.

        Once your doctor has determined your anxiety is not due to a medical disorder, s/he might prescribe anti-anxiety drugs. They block the fight-or-flight response, and are to be used only when absolutely necessary and for a limited time, as they are potentially addictive. Alternatively, you can try the exercises below. They’ve been shown by research to be as effective as medication. Let those close to you know you are suffering from anxiety, and that you may need help staying with these techniques when anxiety arises.

ANXIETY REDUCTION TECHNIQUES

For fear, panic, nightmares worry, agitation, anger: Anxiety following trauma arises due to hyperventilation following the thought, “I am in danger.” Most of us don’t realize we are hyperventilating, and the symptoms can happen quickly. Symptoms resolve when hyperventilation (triggered by the amygdala and limbic system) stops. These techniques offer several effective ways to do that on your own, without medication, and will help with sleep:

Breathing (1 minute).  You can do this anytime, anywhere. If you’re starting to notice physical tension, or any of the signs of hyperventilation, count your breath. Breathe in to 3, hold for 3, out for 3. Repeat for 1 minute. Then, 4-4-4. Then, 5-4-5. Strive for 7-4-7. You may feel yourself fight this at first; you will not pass out, however!  Remember,  you actually have too much oxygen, so regulating your breathing can only help you. (Sleep is 8-2-8.)

Breathing into a paper bag also works. Although you might be embarrassed to try this, once you begin to notice panic rising, pull out a paper bag and breathe into it, slowly, in and out, for a minute or two (you are filling the bag with carbon dioxide and thereby reducing the amount of oxygen you're breathing).  

5-4-3-2-1 (5 minutes).  A cognitive technique, 5-4-3-2-1 requires you to concentrate intently across multiple physical modalities, which, in turn, forces the neurotransmitter norepinephrine (which triggers the amygdala and your overwrought stress response system) to stop surging. It is immediately effective.

Pick a spot you want to look at, and keep your eyes focused on it without moving them at all (blinking is okay) throughout this exercise.  Name 5 things you see in your peripheral vision, without moving your eyes; look as far “out” from center without moving your eyes as you can. Next, name 5 things you hear. Listen intently. If you can’t hear 5 things, repeat something, but keep listening intently. Remember, your voice is one!  Next, name 5 things you feel -- not emotionally, but physically (your foot on the ground, your hand on your lap, etc.).  Make sure you are feeling them, not just listing them.  Now, name 4 things you see in your peripheral vision -- don’t move your eyes! 4 things you hear. 4 things you feel.  Then, 3… and so on until you’ve finished 1-1-1.  Then, sit quietly for a few moments and let your eyes move normally.  Most of us notice deep calm between 3-3-3 and 2-2-2.  Repeat as necessary.  (If you’re around people, feel free to “name” things silently to yourself.)

Relaxation Response (10 minutes). Dr. Herbert Benson developed the well-researched Relaxation Response, which has been shown to help people avoid the almost universally negative physical health consequences of extreme stress by allowing the limbic system to rest. (We now know that stress is also one of a few major risk factors for most mental illnesses.) It is actually not possible to feel anxious when your body is fully relaxed!

Here is the relaxation response method (“tense and relax”). This entire sequence should take about 10 minutes. Practice it once, and preferably twice daily for one week.  At various times during your day, recall to mind the feeling of your body at the end of the sequence, and say the word ‘relax’ to yourself. Your goal is to be able to induce the end state into any moment of your day without going through the steps. That tends to take about a week, and it will benefit you throughout your life.

First, if you are alone, audiorecord yourself giving yourself the following instructions, starting with ‘close.’ If someone is with you, have them read the below. Each time you get to the word, “hold,” stop talking for 10-20 seconds.  Once you’ve recorded the below, reclining comfortably, play back the recording, tightening each muscle for 10-20 seconds before slowly releasing it. Each time, relax all-of-a-sudden, in one, quick movement. As each muscle relaxes, concentrate on the sensation of relaxation:

Close your eyes tightly. Hold; then relax.

Wrinkle your nose and flare your nostrils. Hold; then relax.

Push your tongue firmly against the roof of your mouth. Hold; then relax.

Make a facial grimace. Hold; then relax.

Clench your jaws tightly. Hold; then relax.

Tense your neck by lifting your head up a few inches until it almost shakes with tension. Hold; then relax completely all of a sudden.

Arch your back. Hold; then relax.

Tense your arms and clench your fists. Hold; then relax. Tense your biceps. Hold; then relax

Tense your stomach muscles. Hold; then relax.

Tense your buttocks and thigh muscles. Hold; then relax.

Point your toes to tighten your calves. Hold; then relax.

Pull your toes up as far as you can. Hold; then relax.

Scrunch your toes. Hold; then relax.

Rest for a few minutes, taking an imaginary journey through your body. Where you find any remaining tension, tense and relax that muscle group until you are completely relaxed.  Imagine yourself in a place you love and that soothes you. Imagine every detail of the place, including how relaxed you are when you are there. Then, say the word, ‘relaxed’ to yourself, and rest a few minutes longer (or fall asleep!). In future, you’ll be able to say “relaxed” to yourself, or imagine the place you visualized, and immediately feel the sense of relaxation you feel now.

        Meditation. If you have a regular meditation practice, it will help you manage anxiety. If you don’t, consider learning meditation when your situation stabilizes. There are many online resources for meditation education. Practicing the techniques above will give you a head start!

        Nightmares.  If you and/or your kids are having nightmares, the most effective remedy is to take a few moments to practice the techniques above, until you feel calm. Then, vividly imagine yourself back in the dream, just before the scary part happened.  You’re walking down steps, and are perfectly safe, and when you get to the bottom, you’ll be back in the dream before the dream became frightening. Now, vividly imagine a different, positive, safe ending, as if you are making up a new story.  Keep that story in your mind throughout the day, imagining it as clearly in your mind as you can.  Repeat if new nightmares arise.

Making the new story external by writing it down, telling it to others, or drawing it will also help stop nightmares.

Having children draw the fire with someone—parents, firefighters—putting it out does NOT work as well, because children have already experienced the fire and know its reality.  (This technique does work in non-survivor situations, however.)  Here is a post from my blog, Creative Dreamers, on nightmares.

Intrusive Thoughts.  Because you were in a dangerous or actual life-or-death situation, your mind is replaying what happened in an effort to help you ensure you can find safety if it ever happens again.  However, it’s extremely unlikely you’ll ever need to escape another fire, and if you do, you could probably tell everyone, right now, exactly what you would do. You are also more likely, going forward, to have safety and evacuation plans ready for the rest of your life, making you safer.  So what can be done about these painful thoughts?

Practice the anxiety reduction techniques above, regularly.  When unwanted and upsetting replays of the traumatic situation arise, slam your palms on the nearest table or floor and shout STOP! and then distract yourself with activities that require as many sensory modalities as possible (hearing, moving, using your hands, scents, and so on). You may need to do this a few times in succession in the beginning.  If you are not alone, shout STOP! in your head, and immediately practice a relaxation technique, calming yourself with pleasant images of places you’ve been at happy times, and telling yourself “I am safe,” over and over. (You can add to the power of this technique by snapping a rubber band around your wrist or lightly pinching yourself at the same time as you say “STOP!”)

Listen to soothing sounds. Our world is filled with mechanical noises, and stimulating sound.  Take a break from that and listen to the sounds of the Rocky Mountain National Park here.

CRISIS SELF-CARE STRATEGIES

We can regress to an earlier developmental stage/age when experiencing trauma, which is why physical soothing is so helpful at these times, and why it’s important to especially avoid visuals of violence, disaster, or upset, including internet, TV and video. Suggestions for each sense:

Vision:  

Find one flower; make a space in your room for your spirit; light a candle and watch the flame; set yourself a nice place at the table using your best things; go to a museum; sit in the lobby of a beautiful hotel; take walks in nature and notice tiny things growing; go out late at night and watch the stars; look at a photography book in a bookstore; go to a dance performance or watch one on TV; be mindful of each sight that passes before you, not lingering on any.

Hearing:  

Turn the volume down on devices around you. Pay attention to the sounds of nature nearby; sing your favorite songs; hum a soothing tune; play an instrument; call 800 or other information numbers or listen to non-upsetting talk radio to hear a human voice; go near a playground or park and listen to the children, listen to music that creates a feeling that is the opposite of the one you are struggling with (if feeling sad, play something upbeat; if anxious, play relaxing music); contact someone by phone or in person (texts don’t count); call Suicide Prevention (1-800-273-TALK nationally) for support, even if you’re not feeling suicidal at the moment.

Smell:  

Use your favorite lotion or cologne; spray fragrance in the air; light a scented candle; burn scented essential oils; put lemon oil on your furniture; boil cinnamon; bake cookies, cake, or bread; smell roses; find or travel to a natural area and breathe in the fresh smells. The natural world is still there, and will support you!

Taste:  

Have a good meal; have a favorite soothing drink such as herbal tea or hot cocoa; treat yourself to dessert; put whipped cream on your coffee; sample flavors in an ice cream or yogurt store; suck on peppermint candy; chew gum; get a little bit of something special you don't usually splurge on, like fresh-squeezed orange juice; taste the food you eat. Do watch your consumption of refined sugar and carbohydrates, which spike blood sugar and can cause palpitations and other anxiety symptoms. Try eating some protein (nuts, peanut butter, cheese) every time you eat a carbohydrate. Calcium and magnesium naturally calm the nervous system. Most people don’t get enough of either. For many people, taking a calcium-magnesium-zinc supplement when anxious or just before bed is very helpful and can help with insomnia, as can Yogi brand Bedtime tea (check with your doctor first if you have a medical condition, and don’t use with sleeping pills or anxiety medication).

Touch:  

Take a bubble bath; put clean sheets on the bed; pet an animal; have a massage or give one to yourself; soak your feet; put lotions on; put a cold towel on your forehead; sink into a comfortable chair; put on a silky piece of clothing; try on fur-lined gloves in a department store; brush your hair for a long time; hug someone; hug yourself tightly; rub the area over your heart in slow, circular motions.

Other ideas: 

Do something engaging that takes a little energy:  dance,  take a walk, straighten up wherever you are, stretch. Avoid heavy exercise, caffeine, and substances, as they can stress your hardworking adrenal and endocrine system.

Practice mindfulness meditation: When you are in intense emotional pain, remember that the peak intensity of emotions (and urges to be self-destructive) last about 10 minutes.  Breathe into your belly, in through your nose and out through your mouth. Focus your attention on your breath, paying attention to the sound and rhythm of your breathing. Notice how you feel without trying to block, stuff, ignore, or judge your feelings. Keep breathing and let the distressing thoughts flow right through your mind, without clinging to any of them, until you are calm.

TIPS TO REDUCE GENERAL ANXIETY OR DEPRESSION

Supplements.  Research on anxiety has found that 5HTP, green tea, and St. John’s Wort help with the “worry” component of anxiety, whereas SamE helps with low energy depression and pain.  Check with your doctor or pharmacist regarding drug interactions first. Other supplements found to relieve anxiety include lavender, kava, and daily fish oil. (Synthetic antidepressants relieve anxiety by depressing brain activity, much like alcohol.)  For ADD and generalized anxiety, daily fish oil, avoiding food dyes, zinc supplement (FDA guidelines), daily exercise, and a Mediterranean diet reduce symptoms as well as do amphetamines (Ritalin)—and are also associated with good health outcomes, in general.

Diet. The Mediterranean diet emphasizes:

  • Getting plenty of exercise
  • Eating primarily plant-based foods, such as fruits and vegetables, whole                      grains, legumes and nuts
  • Replacing butter with healthy fats such as olive oil and canola oil
  • Using herbs and spices instead of salt to flavor foods
  • Limiting red meat to no more than a few times a month
  • Eating fish and poultry at least twice a week

The diet also recognizes the importance of enjoying meals with family and friends.

Exercise. Daily exercise has been demonstrated to relieve both anxiety and depression as well or better than antidepressant medication.  That doesn’t necessarily mean a trip to the gym: walking at a reasonable brisk pace around the block when you feel anxious reduces anxiety.

Thought monitoring.  Anxiety is a physiological reaction arising from either a physical condition (rare) or anxiety-provoking thoughts about the future (anxiety is fear about the future). Anxiety and depression often occur together. When you find yourself feeling anxiety, use the following questions from cognitive psychotherapy to ask yourself the following questions about the thought(s) you are having:

Is it true?

Can I absolutely know it is true?

If it were not true, then what?

If it were more true, then what?

How do I feel when I believe it?

Who would I be without it?

FOOD AND STRESS

The body does not distinguish between 'good' and 'bad' stress. It views all stressors as demands--usually only temporary--for more energy output. The body's long-term response to chronic stress is serious.

        Here's what happens within a split second when your body responds to a stressor (be it a sharp word or a life-threatening emergency): blood pressure rises and pulse rate increases in order to speed nutrients where they are needed; blood sugar increases to provide instant energy; vitamin C is mobilized to fight infection; B vitamins, calcium, and other minerals ªare drawn from the bones to stimulate muscles; irrelevant body functions slow down (i.e., digestion); sodium content (and water retention) increase to prevent dehydration. Afterwards, protein which was broken down to form blood sugar in the stressful moment cannot be reused as protein. Vitamin C and B vitamins are excreted and no longer available. Minerals cannot be reinstated into the bones. Therefore, people under chronic stress can become deficient in B vitamins, vitamin C, protein and minerals. This is why it is so important to attend to your diet when under, or following, prolonged periods of stress. Make sure to eat in a calm, relaxed environment, since if you are under stress when you eat, you will not completely digest your food.

        When the body is forced to draw on reserves of protein for blood sugar for instant energy, protein is taken first from the adrenal glands, then from the thymus and lymph glands, and then from the muscles. People under chronic stress who are not eating enough protein are actually digesting their own muscles in order to physically cope with the effects of stress! Because of the demands stress makes on the body, repeated or prolonged stress can cause a host of physical difficulties, including adrenal exhaustion, heart problems, central nervous system difficulties, and digestive problems. It is also a leading cause of depression.

Coping with stress

        Reframing the stressor really does work! Research shows that finding something positive in the stress you are experiencing ("I am learning to cope with difficulties in a new way," “I am going to be able to withstand almost anything after this,” “This disaster is deepening my sense of empathy for others in trauma,” and so on) actually reduces the physical response to stress and the length of time it takes to heal from its effects! A large body of research also shows that seeking social support (for females) and making a plan to solve the problem (for males) decreases stress. Because there are so many physical effects, it is crucial to do some type of exercise when under stress, but do take it easy in the initial week or so following a trauma. As little as a 10-minute, brisk walk three times a day, four days a week (or 50 minutes of exercise at your own fitness level three times a week--be it running, jogging, or simply walking) can help ease the stress response. Exercise which also teaches you to calm the mind and control the breath, such as a martial art or yoga, can be particularly helpful for anxiety. Meditation training and spiritual or religious study have also been shown by research to reduce the duration, severity, and negative physical effects of stress in adults.

HELPING CHILDREN DURING AND AFTER DISASTER

(For children’s nightmares and intrusive thoughts, see Anxiety Reduction Techniques, above.) Children’s nervous systems, like adults’, respond well to physical soothing by family members and other safe adults (gentle, rhythmic stroking of the back, feet rubbing, hugging, hair-brushing, and so on), which has been shown to reduce blood pressure and general anxiety. Here are some recommendations originally from the wonderful nonprofit, Kidpower, with some edits to make it appropriate for this disaster:

1. Protect children from adult feelings.

        Remember that talking about worries and fears creates anxiety without making kids safer. Practicing skills helps to reduce anxiety and increase competence. Protect your children from hearing details, speculation, and media coverage of the fire as much as possible. For example, regarding those who have died, ONLY if a child is likely to hear about what happened, you might say calmly, "We are sad because a little girl got killed in the fire. People are working hard to make sure this never happens again, but this is still very upsetting and scary. Let's practice our safety plan together."

       2. Beware of the Illusion of Safety

        - which happens when a situation is so familiar that you lower your guard about potential hazards such as traffic, water, animals, and people. Too often, children are injured or killed [during disasters] when lots of adults are around because no one is specifically watching out to protect kids. Before you let your child go anywhere without adult protection, practice how to stay aware, make safe choices, and get help everywhere they go. Take the time to make safety plans and to discuss, review, and practice safety skills with your children and teens.

3. Instead of talking about the bad things that can happen, help kids practice how to stay safe. For example, just telling kids to be careful is not enough for them to be safe crossing the street or riding their bike unless they have actually rehearsed many times how to do this safely... Teach children to check first with their adults before they change their plan about who is with them, where they are going, and what they are doing - even with people they know.

4. Support children with their own feelings. Children who know a child who has been harmed or who hear about a disappearance or tragedy can be deeply upset by what happened. Help children regain their emotional safety by listening with compassion, giving them ways to share their feelings such as writing a card or drawing, and empowering them with skills. The recommendations in our article, Helping Children Regain Their Emotional Safety After a Tragedy, are from many mental health professionals.

5.  Join with other concerned community members to find solutions, and let your children know you are do this to make things better.

 

Here are some Kidpower resources that many parents, educators, and other caring adults have found to be useful in preparing kids to explore their world with safety and confidence without teaching fear:

        •        Preparing Children for More Independence - A Five-Step Plan From Kidpower

        •        Helicopters or Protectors: How to Keep Kids Safe Without Unhelpful Hovering

        •        Resisting the Illusion of Safety

WHAT SHOULD I DO FOR SOMEONE WHO'S EXPERIENCING A LOSS? (INCLUDING YOURSELF...)

        (Note: Some of this last section came from a book I read decades ago, the title of which I sadly can’t remember. I’ve added to it throughout the years.)  You may have just experienced many losses: house, home, neighborhood, friends, pets, livelihood, normality, routine, job, sense of safety, hope. At the least, you’ve experienced what it feels like when the earth doesn’t know we’re here. Feel free to share this with friends and family who are outside of the fire zone, too, so they know how to help you best.

WHAT LOSS FEELS LIKE:  Along with the obvious feelings of pain and sadness, there are other reactions to loss, such as feeling helpless, fearful, empty, despairing, pessimistic, irritable, angry, guilty, restless; experiencing a loss of concentration, hope, motivation, energy; changes in appetite, sleep patterns, or sexual drive; a tendency to be more fatigued, error-prone, and slower in speech and movement.  Any or all of these are to be expected during and after loss.  It is part of the body's natural healing process.  Encourage your friend to accept them, not fight them.    

* Recognize that a grieving person's judgment and concentration will be off  for at least the first year.  Don't take over for her or him, but encourage your friend to make no major decisions during that time.  

* Allow the grieving person to cry.  Don't be afraid to offer comfort for fear you will make your friend cry.  Tears are healing. (They also release potentially unhealthy levels of cortisol.)

* Remember that the grieving process is not the smooth progression many people assume.  It's more like a lightning bolt, full of ups and downs, progressions and regressions, dramatic leaps and discouraging backslides.

* Grieving people often want to 'flee the scene' of the loss.  A healing, restorative vacation with friends or family members can be very helpful.

* Realize there are several stages of grieving:  shock/denial/numbness; fear/anger/sadness; guilt/questioning; understanding/acceptance/moving on.  They do not necessarily occur in any order, and they can come and go.

* Understand that your friend will be absent-minded, forgetful, and clumsy.  If your friend was a great organizer and arranged everything, he may not be up to that now.  Take over for awhile.

* Encourage your friend to talk about the one who died.  You can do this by saying something like "I remember when  (you told me) (name) did or said..." Not talking about the absent one does not keep your friend from thinking about them.  If the relationship was conflictual, now is not the time to be pointing out those conflicts to your friend.  Let your friend work this through with a professional.

* Be there for your friend: a week later, 6 months later, a year later.  Be the friend you profess to be—all the time.

* Offer to help. Don't ask how  you can help, just DO something.  If you bake, take some cookies over whenever you happen to feel like it.   Encourage your friend to get out of the house.   Call and ask her to go out for lunch or dessert and coffee.   If she is having trouble concentrating on work or on studying, offer your help.

* Say "I'm so sorry for your loss. Please let me know what I can do. I’m thinking of you."  Do not say: "He was old, he had a long life,” "She is no longer suffering,” (your friend sure is) “I know just how you feel,"  (no one knows how anyone else feels)  "God wanted her to be with him," (so does your friend) "God only takes the good ones," (where does that leave your friend?) "You're strong—you'll make it," (your friend has no choice) "You're young; you'll meet many people in life" (Your friend can't replace the person lost—yes, he can love again but he doesn't feel like that in the beginning and doesn't want to hear it).  Listen. Listen. Listen.  This will put you in touch with the parts of yourself that block out and try to change the subject when you get uncomfortable.  Your friend experiences this disconnect as intense isolation.

* Do understand that this is not something your friend should get over in a certain period of time.  Don't put a timetable on grief—everyone heals at their own pace.  Full healing following the loss of a close loved one or family member generally doesn't come for at least 2.5 to 6 years.  It can take much longer if the lost one died in a disaster, violently or suddenly, or in the case of suicide.

* Ask how your friend is feeling, and if the response is "fine," say, "Are you REALLY fine?"  Your friend will say "fine" because she knows that's what you want to hear, but please make the effort to really find out how she's doing (ask how she is sleeping, eating, and how she is dealing with each day— she needs to tell you).

* Expect to see irritability.  It's normal to feel anger towards the one who left us, God, fate, doctors, the stopped up sink, and so on.  This is part of healing.  Please don't tell your friend she's being unreasonable.  Just allow her her anger and listen with love to her ranting and raving.

* Drop a card in the mail if you know your friend is dealing with an anniversary of a birthday, death, or commitment.  She is feeling alone and vulnerable; she needs to know you are out there and thinking of her.  Anniversaries of 1 month, and years 1, 5, 10, 15  are particularly difficult.

* Give your friend many hugs, if your friend is comfortable with touch.  

* Be sensitive to the fact that people grieve differently.  Some cry openly, whereas others cry behind closed doors.  Some may not speak of the lost one, but you'll notice him wearing the deceased's shirt, watch, looking at pictures, and so on.   This allows your friend to feel close to the beloved.

* Suggest going for a walk, or playing some sport.  Depression can be lightened a little by the biochemical changes brought on by exercise, which can also encourage better sleep. Do understand your friend's whole life was changed by this death.  Your friend is not only grieving the loss of a loved one, but also the loss of the role that one filled in his or her life (mother, friend, child, father, wife, etc.).

* Allow your friend to talk about his guilt.  Even though you may feel he has nothing to feel guilty about, most of us feel guilt about some aspect of our loved one's death.  We need to talk about it with someone who will listen, care, and not judge.  Talking about our guilt will help us to let it go.

* Understand that not everyone feels comforted by religion.  We all have our own spiritual beliefs and now is not the time to push your religion's beliefs.  Particularly, in the situation of a lost pet, avoid saying, “Animals don’t go to heaven.” This is just cruel. Instead, listen to your friend's thoughts about where the lost one might be, or the meaning of the loss.

* Be prepared to be rejected.  Be prepared for illogical behavior.  Be forgiving.  Do not feel the person who is grieving is treating you badly despite your best efforts.  Your friend will remember you were there when things settle down.  Don't hold a grudge.  Try to always keep in mind that what your friend wants the most, you nor anyone else can give:  to have the loved one back.  Everything else, from sleep, to food, to manners, is superfluous.

* Most importantly:  DO follow through if you say you're going to do something for your friend or invite your friend over.  At this point in your friend's life, she or he feels there is very little, if anything, he or she can count on.  Let your friend at least be able to count on you.

This, too, shall pass… 💚