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Chapter
3. Common Mental Health Issues
As the preceding chapters suggest the circumstances surrounding the disappearance of people are never identical. People go missing for lots of reasons. There are also many and varied effects of this disappearance on those left behind. Many family members and friends of missing persons experience mental health issues. The following chapter explores a number of these issues in detail. These issues may be a direct response to the case of the missing person, or existing conditions may be worsened by the stressful event. The chapter also looks at suitable ways of coping with mental health issues. The information provided is to be used for educational purposes only. It should not be used as a substitute for seeking the care of mental health service providers in the diagnosis and treatment of mental health issues. Many professionals in this field are in a position to understand the complexity of your situation and offer sound advice. However, different people find different strategies useful. Therefore, it is important to shop around to understand what you find most helpful. Chapters Six-Ten offer a list of organisations that you might like to contact. For further information you may also like to visit www.missingpersons.org.au 3.1. Mental Health Issues You May Experience Learning that your loved one has gone missing can give rise to many emotions, some of which were explored earlier. Some of the more common emotions you may experience include extreme sadness, grief, and depression . These feelings can be accompanied by tremendous uncertainty and doubt for the whereabouts and welfare of your loved one is unknown . Collectively, these intense feelings can bring about a number of mental health issues that may have adverse effects on your life. For instance, some family members and friends of missing persons may not recognise that their worries about the missing person have developed into an anxiety disorder. This in turn may prevent them from leaving the house, or cause episodes of panic. For others, the ongoing sadness and grief they experience may develop into a depressive episode – they may cry a lot, be unable to concentrate, and even find it difficult to get out of bed each day. If you or someone you care about might be able to relate to these experiences it is important to talk to your doctor or another health or mental health professional. The onset of a mental health issue is especially likely in people who are predisposed to a particular mental health issue. For instance, they may have experienced the issue in the past, or they have family members who have. Despite their experience with a mental health issue many of the family members and friends of missing persons do not seek the support of others, particularly mental health service providers. Since their negative feelings develop gradually they tend to become accustomed to the way they feel. Many believe that in light of the stressful circumstances they are facing their feelings are normal and they should just get used to them. However, it is important to recognise the onset of mental health issues. Various treatments and self-help strategies can make the symptoms more manageable and greatly improve the quality of life. The following section explores some of the common mental health issues experienced by the family members and friends of missing persons. These include grief and loss, anxiety, and depression. Also offered is information on positive coping strategies. More information about other mental health issues (schizophrenia, addictions, bipolar disorder, personality disorders, etc.) is on the website www.missingpersons.org.au. Grief may be painful and, at times, seem bottomless. This is especially the case when a loved one is missing. The following information is presented to help you, as a family member or friend of a missing person, identify some of the stages of grieving that you may experience due to the disappearance of your loved one. It may provide you with a better understanding of your emotions, and perhaps enable you to feel less isolated. These intense emotions and mood changes are a normal part of grieving. After all, grief is a typical reaction to loss. Grieving is a very personal experience and there is not a right way or wrong way. It is determined by culture, your relationship to the person who is missing, and the way the person went missing. Therefore, family members and friends of the same missing person will experience this process quite differently. There are also gender differences. Glassock advises that when a loved one is missing, men tend to react in ways that are different to women. For instance, men are more likely to remain silent about their experiences and express their thoughts to no one – not even their partner. They may engage in solitary mourning or secret grief. For instance, they may spend long periods on their own in the back shed. Alternatively, they may become immersed in a lot of activity. They may spend more time at work, do more than usual around the house, or take legal action to resolve any financial matters left by the missing person. They may also exhibit addictive behaviours – whether it is to their work, the consumption of alcohol and/or drugs, gambling, and so forth. This in turn can create new problems. Although the following information is presented as stages, it is important to remember that you will probably not identify with all of them. Grieving is a fluid process. It can involve moving forward through the stages, stagnating for long periods at a particular stage, as well as moving backwards. When a loved one is missing there is a lot of uncertainty. It is therefore common for those left behind to feel emotionally stuck. They may feel as though they are making little, if any, emotional progress. The grieving process that unfolds when a loved one is missing appears both fluid and frozen. This may be partly because of the western society in which we live. In the event of loss, western cultures tend to encourage resolution and closure viewing it as an achievement. This is in line with the value western societies place on accomplishment. However, this can be a problem for the family members and friends of missing persons for their loved one may never be found: “When people used to being in charge cannot stay on top of a situation, find the answer, fix the problem quickly, society itself grows impatient and withdraws from them” . Particular social practices may worsen the situation still. For example, when a loved one dies it is typical to expect a funeral service of some kind. This ritual can be helpful to those who are mourning – it enables them to say goodbye to their loved one, attain a sense of closure, and attempt to re-engage themselves with daily life. However, the family members and friends of missing persons do not have similar rituals. Few social practices bring meaning to their experience of grief and loss. It is therefore important not to expect yourself to progress easily through the gamut of intense emotions you may be experiencing. This type of undue pressure only worsens your well-being. A better approach might be to develop a clearer understanding of these experiences, and to be patient with yourself. It is also important to realise that these emotions are not a sign of personal weakness. Whether your emotions change constantly, or stagnate for long periods, these are both common responses when a loved one is missing. Stages of Grief As a family member or friend of a missing person you may experience the following stages of grief. However, we are reminded that this process is seldom linear but might be more akin to a roller coaster ride of emotional experiences that journeys both forwards, backwards, and even stands still. 3. Numbness / Denial Feeling emotionally numb can be your first reaction when a loved one goes missing. In the denial stage you may refuse to believe what has happened. This could mean laying clothes out for a child or expecting the person to walk through the door. 2. Anger Anger with ourselves, or blaming others for the disappearance, is not uncommon. Other strong emotions and a longing for the person who has gone missing can accompany anger. You may also feel agitated or angry, find it difficult to concentrate, relax or sleep. 3. Bargaining Many imagine the what if’s? – “What if I had done this, or I had not done that?” Some people may blame themselves and feel guilty. They may dwell on arguments they had with the missing person or things that they should have done differently. 4. Sadness Extreme sadness is a likely outcome for all those who are missing a loved one. During this time you may withdraw from family members and friends, feel listless and tired, become withdrawn, or become prone to sudden bouts of tears. You may feel like your world has been shattered and life has lost its purpose. It can be difficult to make sense of a world without the person who is missing. Most of the family members and friends of missing persons can never be certain that their loved one will be found. Consequently, the sadness they experience can seem infinite and never ending. It is therefore not uncommon to feel stagnant at this stage with little emotional change. It can be difficult for those around us to understand the pain we feel. Although they may be familiar with the pain associated with the death of a loved one few will know how this differs to the disappearance of a loved one. Those around us may not know what to say or do. Consequently, they may not discuss the missing person with us, or they may even reduce the contact they have with us. 5. The Fluctuation of Feelings Another stage you may experience is tremendous emotional change, and your feelings may fluctuate from one extreme to the next. At times, you may feel as though you are coping; you may feel content and able to take on personal responsibilities; you may even begin to accept the disappearance of your loved one. However, you may find these feelings change and again you experience the depths of sadness and despair. 6. Acceptance The emotional roller coaster associated with the disappearance of a loved one may seem never ending. However, some people do find that, in time, life becomes a little easier. Although the pain may never go away life becomes more manageable. In the words of one family member of a missing person: “There are still bumps in my life, but the bumps get smaller”. The pain, sadness, and depression might start to lessen, and life is seen in a more positive light. You may experience slight improvements in your energy levels, and find it easier to eat and sleep. Overall, there is a greater acceptance that life goes on. However, some people find that their experiences of grief and loss resurface as they get older and enter their senior years. This may be particularly the case for aging parents whose child has gone missing. Although, over the years, they have come to accept the disappearance some fear that they may die not ever knowing the whereabouts or welfare of their child. This again demonstrates the way in which feelings can change from one extreme to the next. How Do I Cope During The Grieving Process? Understandably, many of the family members and friends of missing persons want to know how to make their emotional pain disappear, or at least, make it bearable. There are no easy responses to this ask, and some people may never experience this. However, you may find some of the following strategies useful. Be Accepting of Yourself The disappearance of a loved one can give rise to a mixture of intense emotions, including guilt and blame. During this time it is important to be aware that this is a common experience among the family members and friends of missing persons, and has been aptly termed, ambiguous loss . This term tries to explain that the loss felt by those left behind can be confusing and unclear. Knowing that there is a term for this loss can offer reassurance in itself. This may decrease your tendency to feel confused and helpless, or to blame yourself. It is also important to remember that some things in life are beyond our control, no matter how intense our efforts. It can be very difficult to accept that a loved one has disappeared: “Learning to live with this special type of loss is one of the greatest challenges to families… Loss by itself is difficult enough, but add ambiguity to it, and the results are agonising and immobilising” . Often, we so desperately want to resolve the loss and seek closure. However, this is seldom possible. Boss advises that those who cope best with this difficult situation demonstrate three qualities: 1. They can tolerate doubt and the fact that they do not know all the answers 2. They are deeply spiritual and do not feel helpless when they cannot understand a situation 3. They are able to hold two opposing ideas in their mind at the same time. This is demonstrated by comments like “My son is gone, but he is also still here and always will be in some ways”. Or, “I’m moving forward with my life but I won’t stop looking for him” : “When there is no clear answer, the only way out of despair is to hold on to both possibilities of absence and presence”. Glassock agrees with this last point and speaks about a Dual Process Model of Coping to demonstrate the importance of holding onto two ideas at the same time (see Diagram One). The model shows how it is possible to swing between feelings that seem very different. Diagram One
Do Not Lose Hope When a loved one is missing, particularly for a long period, there is often a difficult bind. Family members and friends are left wondering whether they should give up on the hope of seeing their loved one again. If they do give up there is fear that this in someway betrays the missing person. Glassock however, recommends that the family members and friends of missing persons should not give up their sense of hope: “After all, you don’t survive without it”. Rather than lose your sense of hope Glassock again emphasises the importance of maintaining two opposing ideas at the same time. Those that seem to cope through this difficult time are able to acknowledge the disappearance of their loved one yet maintain a hope in seeing them again. Be Patient With Yourself It is important to recognise that it is only natural to experience grief and loss when a loved one disappears. Try not to pressure yourself into getting over it or getting on with life. Such undue pressure will only worsen your well-being. In fact, it may be better to give yourself permission to experience the grief and loss – so long as you do not become stuck in depression. Seek Support of Others Surround yourself with shock absorbers like a healthy support network of family members and friends. Communicate your needs to them, advising them of what you find helpful as well as what is not helpful. At the times you feel like talking about your missing loved one, encourage family members and friends to discuss the topic with you rather than avoid the subject. Alternatively, when you no longer want to discuss the subject let them know. Some people may cause you added anxiety because they cannot pick up the signals about how you might be feeling. If this is the case, and you want to spend less time with them, try not to feel guilty about it. It is important that you feel supported by those around you and that you feel comfortable with them. This might mean that you spend little time with people – you might leave social gatherings early, or try to avoid people that you find emotionally draining. It is important to spend time with people that are positive and encouraging as they can serve as emotional shock absorbers. Consider the experiences of one young woman who is missing a close family member: “Some friends were wonderful to be with. I felt comfortable with them and was able to get close to something like enjoying myself. Other friends I just didn’t feel comfortable with. It made the missing worse; it made it harder to bear. So finally I decided to be selfish and do a social edit. I decided to only do things that I wanted to do with people I wanted to see. For others I told myself it was ok to let them down and say sorry, can’t make it, I just didn’t have the energy. And later on, when I found things more manageable, those other friendships were still there and recovered fine. I just needed some space”. Avoid Major Decisions When we feel emotionally vulnerable our ability to make sound decisions may be impaired. It might therefore be preferable to avoid making important, life-changing decisions. Try to delay the decision or, if it cannot be delayed, seek the assistance of someone you trust. Consider the advice of a family member who is missing a loved one: “I sought a promotion at work. I thought I needed it. I needed to keep my brain busy and challenged with something other than him being missing. I needed the distraction. And I did fine with the added responsibility, but later I knew I’d paid the price. I was exhausted. I was avoiding the pain by hurtling myself into something else, and I ended up being absolutely exhausted and having to work through the pain anyway. I should have taken better care of myself and let the promotion pass”. Express Your Emotions Try to avoid bottling up your emotions for this might make it difficult to deal with your experiences. Expressing your emotions is also a helpful way to communicate to those around you what you are experiencing allowing them to respond appropriately. Yet, it is important to understand that there is no right or wrong way to respond to the stressful situation you are going through. The disappearance of a loved one can give rise to many and varied responses. These responses are influenced by a range of factors including your culture, your relationship to the person who is missing, the way the person went missing, and your gender. Expressing your emotions may occur through a range of ways. For instance, keeping a journal can be particularly therapeutic. You may become better able to express and understand your experiences. Furthermore, by revisiting your entries, a journal also allows you to reflect on how you felt in the past. Sometimes it helps to write a letter to the missing person, or to talk to them using a photo you have of them. These strategies enable you to direct and channel your emotions to your loved one. Do Not Be Afraid to Think About the Missing Person Some people believe that their emotional pain will be minimised if they do not think about the missing person. However, any relief this strategy offers is usually temporary. Try not to be afraid to think about the missing person. Although this experience may be painful it may help you to identify your emotions. To help with this process you may find it helpful to plant a tree or some flowers in living memory of the missing person. Alternatively, you may do something your loved one previously enjoyed. For instance, they may have been fond of visiting a special place, or they may have enjoyed a particular hobby. Use Symbols and Rituals Those who have worked with family members and friends of missing persons suggest the important role of symbols and rituals . These can offer a number of benefits. For instance, symbols, like a tree or some flowers, can serve as a positive way to remember the missing person. Rituals, like a memorial service, can help people accept the change in their life, and the absence of the missing person. Symbols and rituals can give you permission to begin the grieving process. Just as a funeral typically marks the death of a loved one, symbols and rituals can play an important role when a loved one is missing. A memorial service can be held to celebrate the life of the missing person and mourn the loss you experience. Prayers can be adapted to suit the service, and the service can be held on a day that has special significance – for instance, a birthday or anniversary. Yet, it is important to remember that not everyone may welcome the use of symbols and rituals. Some family members and friends of the missing person might object to this practice believing that it signals a loss of hope, or that the missing person is being betrayed in someway: “Family members rarely reach the same conclusion at the same time, and in families of the missing there is often conflict” . For this reason, you may wish to discuss the use of symbols and rituals with your family members and friends. You may collectively agree on a suitable way to remember the missing person. Alternatively, you may all decide to adopt your own symbols and rituals so that each person may select something that has personal value to them. Manage Your Emotions When a loved one is missing our emotions can be intense and unpredictable. Sometimes, through the course of our daily life, particular situations or objects remind us of our loved one and invoke emotional outbursts. To be able to manage these situations you might find it useful to maintain a diary. In the diary you can keep a record of the situations or objects that seemed to provoke particular emotions – whether these are negative or positive responses. You might also record how you felt at this time, and how long the feelings lasted (see Diagram Two for a suggested layout). With this information you might develop a clearer understanding of the situations and objects that both help and hinder your sense of well-being. It may also help to share this information with someone you trust and who can offer you some support, like a mental health service provider, a family member, or a friend. Diagram Two
*Use a scale of 1 to 10, where 1 means a low intensity and 10 means a high intensity. Help Others Sometimes helping others can make us feel good. You might find that by offering support and assistance to someone else actually enhances your sense of well-being and self-esteem. Eat Well When we experience stress, like the disappearance of a loved one, our bodies use up enormous amounts of vitamins and minerals. The depletion of our body’s nutrients can leave us tired, run down, irritable, and less able to deal with daily life. This is worsened when we lose our appetite and reduce the amount we eat and/or how often we eat. During times of stress, vitamins C and B complex, as well as calcium, magnesium, phosphorus, and zinc are the hardest hit nutrients. These can be restored through a diet rich in fresh fruit and vegetables, dairy products, nuts, yeast, brown rice, fish, liver, eggs and kelp. It is important to try to incorporate these in regular, healthy meals. Sometimes the foods that we reach for when stressed are the foods that interfere with our body’s ability to absorb vitamins and minerals. Consequently, these foods worsen the amount of stress we experience. Foods to avoid when stressed include tea, coffee, cakes, biscuits, soft drinks, chocolate and white bread. Use Gentle Exercise Gentle exercise is invaluable in releasing tension and assists in the processing of vitamins and minerals. Any physical exercise is helpful like walking, swimming, jogging, or gardening. Exercise need not be a chore especially if it is done with a family member or friend. The most important point to remember is to do it regularly. Use Relaxation Techniques Relaxation techniques can greatly aid the reduction of stress. The most common strategy involves progressive muscle relaxation. This exercise involves consciously focusing on one area of the body at a time, clenching the muscles then relaxing them. When relaxing your muscles, imagine all the tension flowing from your body. This exercise can be performed lying down or sitting. Another technique is the use of imagery. We are all aware of how particular environments can be very relaxing while others can be intensely stressful. The principle behind the use of imagery in stress reduction is that you can use your imagination to recreate a place or scene that is very relaxing. The more intensely you use your imagination to recreate the place or situation the stronger and more realistic the experience will be. Deep breathing is another very effective method for relaxation. You might find it useful to slowly take several deep breaths, and focus your energies on the gradual act of inhaling and exhaling. Relaxation can also mean listening to music, patting your pet, having a nap or reading a good book. A meditation program will prepare you to manage both physical and mental stresses. It will help to recharge your system making it easier to cope with difficult circumstances. The most important thing is to set aside time for it to happen. If you can make time to relax each day as this will enhance the relaxation effect. Be Good to Yourself It is also important to be good to yourself. At times of emotional turmoil we can have extreme thoughts and be quite critical of ourselves. For instance, we might convince ourselves that we cannot cope with life. Consequently, our sense of self-worth and personal confidence can wane, and we overlook the positive qualities we have. To begin thinking realistically it might be useful to remind yourself of your positive qualities by making a list of them. This list may include your sense of humour, your sense of compassion, or your laid back attitude to life. Although it can be difficult to recognise positive qualities in ourselves this process might be eased by asking a family member or friend to help. To never lose sight of these positive qualities some people find it useful to write each one down as a statement and place them around the home, perhaps on the walls. These can serve as useful reminders. With this fresh reminder of your positive qualities it might be worthwhile to consider what is making you have the extreme negative thoughts you experience, and how likely is it that these negative thoughts will happen. By overestimating the consequences of any event we become increasingly stressed. Being good to yourself might also include performing activities you find enjoyable. You might enjoy listening to music, getting a massage, going to the cinema, or participating in a creative hobby, like carving or knitting. These activities might provide you with some time out from the hardships you face. To ensure that you are treating yourself kindly you might find it useful to end each day with a reality check. Take some time to reflect upon the day, and think about what you did. For instance: · What did I eat today – was it nutritious? · Did I rest during the day? · When did I last spend time relaxing? · When did I last treat myself to something special? These questions may serve to remind you of your own personal needs. Organise Your Time During times of extreme stress life can appear overwhelming and even the smallest tasks seem unmanageable. We can reduce the amount of stress we perceive by using our time and energy efficiently. A realistic list of things to do for the day is a good start. Allow ample time to get things on your list done. It is important to acknowledge that you can only do so much in a given period. Setting priorities and learning to slow down are essential ingredients in reducing your level of stress. Become Active During times of loss we tend to feel helpless and that we have little, if any, control in our lives. To bring back a sense of control recognise the other commitments you have in your life and try to attend to them. These, for the most part, are controllable and can provide a sense of order in your life. Being active might also mean having greater involvement in the search for the missing person. This may include the distribution of posters and pamphlets. Although you need to be careful that you do not overtax yourself, you may find that your searching efforts offer some relief. Another way to become active is to be more involved in issues related to missing persons. Consider, for instance, Fr. Brian Jones an Australian Catholic priest. Following the disappearance of his own brother, Tony, Fr. Brian used the knowledge and wisdom he had gained through his journey of grief and loss to support others in a similar situation. He and his family offered a religious service – a Mass for Missing Persons. Although difficult Fr. Brian suggests that it was a very rewarding experience: “Preparing for this event was emotionally traumatic, but it enabled us to turn our tragedy into something constructive” . Seek Additional Support When we first learn about the disappearance of a loved one our lives tend to become chaotic and intense. We try frantically to locate the missing person, and can be heavily involved in search activity. During this time, “psychological first aid” and practical assistance are usually most helpful, and we may not need to seek traditional forms of counselling . However, this type of support may be needed when our loved one has been missing for an extended period. Mental Health Professionals The support of mental health service providers like a counsellor, a psychologist or a psychiatrist might be needed if: · Your sleep and/or eating patterns are badly affected · You feel that your health is failing or you experience physical symptoms like: o Unusual breathing patterns o Unusual heart beat rhythms o A tingling sensation or numbness in your limbs, fingers or toes o You perspire more than usual · You feel distressed, irritable, on edge or agitated most of the time · You feel hopeless, despairing, miserable, and like you cannot go on · You have trouble concentrating, are distracted, and cannot do your usual tasks · Memories of trauma and loss resurface and become troublesome · Relationships with family members, your partner, or friends, have been adversely affected. However, you do not have to experience these symptoms to consult a mental health service provider. Even if you have a few concerns about your emotional well-being, a mental health service provider can offer useful information and respond to your queries accurately. The grief and loss associated with the disappearance of a loved one is quite different to those experiences often associated with others types of loss. For this reason, it is important to carefully consider which mental health service provider you would like to consult. The Families & Friends of Missing Persons Unit suggests that particular models of therapy can be helpful. These include those that help the individual cope with their changed life circumstances and find greater acceptance. Examples of this are found in Cognitive Behaviour Therapy, Narrative Therapy, and Personal Construct Theory (for information about these models, please see Appendix Four). However, what is appropriate for one individual is not necessarily appropriate for another. This is why it is important to trial several approaches to ensure that your personal needs are being met. Chapters Six-Ten offer some useful contact information to enable you to locate a mental health service provider that best suits your needs. To begin this process you might find it useful to ask yourself, “What do I expect from a mental health service provider? What sort of changes would I like to see?” The answers to these questions will help you determine which service provider is most helpful for you. Once you have located a service provider you might find it useful to ask them some questions about their work practices. This will give you a better idea about whether they are the most appropriate person to help you. For instance, if you feel comfortable you might like to ask them: · How long have you been a counsellor? · Have you assisted many family members or friends of missing persons? · How do you assist people who are in this situation? (If their answer is not very clear to you ask them to explain what they mean). · How long do you expect treatment to take? · What changes can I expect to see? · Is there a long waiting period before treatment can start? · How much is the treatment going to cost? · Are you available for the long-term? · Are you aware of local self-help or support groups that might be relevant to my needs? · If the treatment does not meet my personal needs are you aware of other services that might be helpful? (You might first look at the list of organisations in Chapter 6.1 which provide specialised counselling services for families and friends of missing persons. A broader range of organisations providing, tracing, counselling and support services are listed in 6.2 to 6.5.) The Support of Your Peers The assistance of mental health service providers is not the only form of support available. Other family members and friends who have experienced the loss of a missing person can be an invaluable source of support. The insight these people have as a result of their personal experience is incomparable to more traditional forms of support. They are, after all, in the same boat. Talking with other family members and friends of missing persons can offer a sense of affirmation. It can be comforting to know that they too experience similar emotions and reactions to the sudden loss of a loved one. They can also offer invaluable suggestions and advice about how they were able to cope on a daily basis with the loss of their loved one. This is not to question the important role of mental health service providers for they can offer information based on academic study and theory. Yet, some family members and friends of missing persons have found value in complementing the support of service providers with the support offered by fellow peers. Each offers something quite unique. Self-help or support groups that have been established for the family members and friends of missing persons can be a useful way to meet people with similar experiences. Admittedly, there are very few of these groups in New South Wales. However, Chapters Six-Ten offer a comprehensive listing of organisations that may have contact with relevant groups. Religious People If you are religious you may find it helpful to talk to an appointed person in your religion. This may include an imam, pastor, priest, minister, nun or brother. These individuals may provide support within a spiritual framework. How Do I Help Other Family Members and Friends Who Are Grieving? This is not to suggest that you should neglect your own well-being. It is important to attend to your own needs - both physical and emotional - for only then will you be able to support those you care for. At times of loss it is helpful to have people around that offer comfort and support. However it is often difficult to know what to say to someone who is grieving the disappearance of a loved one. You might find yourself asking, “What does the person need from those around them? What are the best things I can do to support them? And what are the worst?” The following section outlines some ideas that may assist you in feeling confident in the comfort and support you offer other family members and friends who are also missing your loved one. How Does Grief Affect a Person? People deal with the disappearance of a loved one in extremely diverse ways, and this can often make the person offering support feel uncomfortable. Despite individual uniqueness a grieving process does tend to occur. This was discussed in an earlier section titled, Stages Of Grief. Understanding this, and the way emotions tend to change from one extreme to another, may help you to show compassion during the different stages of grieving. Useful Strategies Allow the Grief It can be very difficult to watch those we care for go through the grieving process. Witnessing this can be made more difficult when their grieving process differs to ours, as this makes it difficult to understand their experiences. The disappearance of a loved one gives rise to varied reactions. It is important to recognise this and validate the different views of other family members and friends. Research suggests that unexpressed grief can lead to outbursts of anger and rage, restlessness, depression, addiction, compulsion, as well as anxiety and panic disorders. Physical symptoms can include the worsening or development of diabetes, heart disease, hypertension, cancer, asthma, allergies, constipation, diarrhoea and ulcers. Although it is important to allow others to express their grief, an exception to this is when their reaction or perception causes potential harm to either themselves or those around them. If you believe that a grieving family member or friend is likely to harm themselves or someone else it is important to contact a health or mental health service provider. This might include your General Practitioner, your local Community Health or Mental Health Centre, the mental health crisis team, the Emergency Department at the nearest hospital, or emergency services by calling 000. Communicate When a loved one is missing it is often difficult for those left behind to support each other. In the face of intense stress, communication channels that were once effective tend to wane and diminish . Yet, strengthening the communication channels with other family members and friends is important for several reasons. By talking about and sharing your perceptions and emotions you and those around you can better understand each other’s experiences. Although difficult it can be useful to learn how others have been affected by the disappearance. Although perceptions and emotions will invariably differ from person to person this can encourage tolerance and appreciation for diverse perspectives. And by creating a supportive atmosphere people feel more comfortable with sharing their emotions. Open communication between yourself and those around you also helps to create an understanding of life without the missing person. Although difficult this process helps individuals come to terms with their changed situation and helps them continue living their lives effectively. Be Supportive Many people restrain from supporting those they care for because they are afraid of saying or doing the wrong thing. Rest assured that the person grieving probably does not expect you to know exactly what to say. The most important step is usually to acknowledge the person’s loss. This does not necessarily involve in-depth discussions but can involve communication in less verbal ways. This includes simply recognising that individuals need space to be on their own and reflect on the situation at hand. The disappearance of a loved one can give rise to a multitude of emotions, some of which may be difficult to understand. Despite this, it is important that individuals grieve in a way that is suitable for them. If you do not have the words to express your support for someone you care about, a hug can speak volumes. Accept the person’s grief and offer your supportive presence even if this makes you uncomfortable. Another way to support other family members and friends is to provide them with reassurance. Reminding them of the strengths and qualities they possess may reduce their insecurities . They may be encouraged to explore their experiences and make the best possible use of their skills. Make Allowances Some people who are grieving the loss of a missing person can exhibit some (temporarily) unusual behaviour that affects relationships and everyday activities. They may appear: · Withdrawn, isolating themselves, and wanting to be alone · Jealous that others are not grieving · Critical in ways that are out of character · Odd, saying and doing things that are unusual but seem real to them. For instance, they may sense the presence of the missing person. If the person concerned is worried about these or similar behaviours it may help them to know that these are a lot more common than they may think. Things You Should Not Do When trying to support other family members and friends of a missing person some behaviours are best avoided. For instance: · Do not avoid the person – maintain regular contact with them · Do not say things like, “Keep your chin up”, “It’s God’s will”, or “It’s all for the best”; or, if someone’s child has disappeared, avoid saying things like, “You have other children”, or “You can always have another baby” · Do not expect them to get over it – there are some losses that we must learn to live with, not get over. How Do I Help Children and Young People Who Are Grieving? When a loved one is missing, adults are not the only ones who experience the loss. Children and young people are also affected. It is important to recognise and attend to their signs of grief because, without proper attention, mental health issues and physical ailments may ensue. As in adults, the grief experienced by children and young people can show itself in many ways. They may: · Appear withdrawn · Become angry with others and attack things · Have difficulties with their studies · Have difficulties separating from family members, carers or friends · Experience changed eating patterns · Experience changed sleeping patterns. Children and young people may also blame particular people for the disappearance of the missing person . Having a limited understanding of the situation they may blame the missing person and express resentment. They may even blame other family members or friends for the disappearance. These, and other changes in behaviour, can indicate that the help of a mental health service provider is needed – particularly someone who specialises in the care of children and young people who have experienced grief and loss. It is important that you try to understand the loss experienced by children and young people and not place added pressure on them. When a child is missing sometimes parents become overprotective of their other children – whether they are young in age or adults. Although the parents may act in good faith, their over-protectiveness may place added pressure on children who are grieving the disappearance of a brother or sister. Sometimes the brothers and sisters of a missing person place added pressure on themselves. Concerned about mum and/or dad they try to appear happy and at ease so that they are not an extra burden on the family. They may even feel guilty about asking mum and/or dad for support. They may also seem content to go without the usual pleasures of life – they may not celebrate their birthday or other special occasions because of the guilt associated with being happy at such a difficult time. Additionally, they might try to avoid events that bring family members and friends together. The absence of their brother or sister means that these once-joyful situations are no longer the same for there is an empty space where the missing loved one should be. The brothers and sisters of a missing person may also experience regret and dwell on what might have been. Someone they thought would be with them for life is now absent. There is no opportunity to grow up together, start families of their own around the same time, and watch their children play together. The brothers and sisters of a missing person may experience a sense of increased responsibility to take care of their parents. They feel the need to support mum and/or dad through the trauma of the disappearance, and pick up the pieces. Then, as mum and/or dad get older, they may feel it is their sole duty to take care of their parents. They may have once thought that looking after mum and/or dad in their old age was something they would tackle with their brothers and sisters – but this situation has now changed and they feel that the responsibility must be faced alone. When a loved one is missing it is important to recognise the effects on children and young people who were close to the person. There are strategies that you may find useful when supporting them. For instance: · Discuss the disappearance of the missing person with them for secrets and silence are especially confusing and can cause anxiety and depression · Help them understand what has happened as this can reduce their sense of doubt · Allow them to grieve or ventilate feelings. Emotions can be expressed in a number of ways, including open discussion, play and recreational activities, art, the writing of a journal, or the writing of poetry and stories. It is important that children and young people feel comfortable to discuss their concerns – whether it be with a family member, a responsible adult, or a mental health service provider. Not only does this prevent emotions from being suppressed, it also helps others to identify any incorrect or fictitious thoughts they might have. For instance, some children and young people might believe that they caused the disappearance of the missing person. Without proper attention these feelings can lead to extended periods of inappropriate feelings of guilt . Recognising Unhealthy Signs Those who are grieving the disappearance of a loved one and experience long-term stress often show symptoms of anxiety and/or depression. They may become preoccupied with endless questions that do not seem to have answers, and never take a conscious break from the constant flow of mind traffic. Others may listen to depressing music for days and days, falling deeper into misery. Some family members and friends of missing persons may even develop diagnosable mental health issues, and become unable to function on a daily basis. The following section summarises some of the common mental health issues experienced by the family members and friends of missing persons. However, many other conditions can also be experienced. More information about other mental health issues (schizophrenia, addictions, bipolar disorder, personality disorders etc) is on the website www.missingpersons.org.au. The information provided is to be used for educational purposes only. If you think you, or someone you care about, may experience a mental health condition it is important to seek help from your doctor, or a mental health service provider. Chapters Six-Ten offer a comprehensive listing of organisations that might offer some assistance. As a family member or friend of a missing person you may experience anxiety. News that a loved one has disappeared can give rise to nervousness and worry, especially when the safety and welfare of the missing person is of concern. This is therefore a natural response. However, the uncertainty that surrounds the missing persons phenomenon means that the anxiety you may experience is usually intense and long-term. This has detrimental effects on the body – both physically and mentally. Anxiety becomes a problem when it is so constant, so pervasive, that it interferes with our lives. We become unable to carry out ordinary activities. This may be a sign that the anxiety has worsened and developed into an anxiety disorder. Anxiety disorders take on many different forms but all anxiety disorders are associated with symptoms that are emotional, physical, and behavioural. If you feel that you may be experiencing an anxiety disorder it is important to see your doctor or a mental health service provider. Health and mental health professionals can help you manage your situation more effectively and improve your quality of life. Depression is another mental health issue commonly experienced by the family members and friends of missing persons. The disappearance of your loved one may have caused overwhelming emotional pain. The intensity and enduring nature of this pain may give rise to feelings of hopelessness and helplessness – these are signs of depression. Depression is different to feeling unhappy or sad. It is long lasting and can be quite debilitating, limiting our ability to function on a daily basis. Depression can therefore be a major problem for those who experience it. If you feel that you may be experiencing depression it is important to see your doctor or a mental health service provider. These professionals will provide you with the support you need to manage your experiences and live a healthier lifestyle.
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