Bereavement and Grief: When do you need medication?

Losing someone to the cruel hands of death is never easy and trying to be there for people who are undergoing the process of grief is almost as challenging.

ByDr Mona Nongmeikapam

Updated 8 Jan 2021, 7:13 am

Representational image (PHOTO: Pixabay)
Representational image (PHOTO: Pixabay)

Have you ever lost someone very dear? I recently did. The heavy numbness in the heart and the angry denial in the mind that comes with the passing away of a close one is, unfortunately, an emotion all of us are familiar with.

Bereavement and grief are terms that are often used synonymously. Bereavement refers to the state of loss and grief means the reaction to that loss. Losing someone to the cruel hands of death is never easy and trying to be there for people who are undergoing the process of grief is almost as challenging. Perhaps understanding a little more about the process of bereavement will facilitate with coping, if not lighten the grief in any way.

The stages of grieving:

Denial: There are five medically accepted stages of grieving. The first one is denial. One can never be ready for death. It is just too abrupt, just too final and oh so terribly cruel! It takes anyone a certain amount of time to absorb the shock and acknowledge the fact that someone so dear and so vibrant and alive is gone forever.

Anger: After Denial comes Anger. The inexplicable, uncontrollable wrath, and who bears the brunt? Anyone around, inanimate defenceless objects but above all, the person who is bereaved! Why me, why to my family... I could have done this, this shouldn’t have been done this way… Why? How?

Bargaining: Several unanswered questions and a huge void masked as anger. Then the bargaining begins. Don’t we all just love a good bargain? And what won’t we give up in exchange for a dear one? Anything. You name it, perhaps life itself. There lies the tragedy. All our pleas and bargaining fall on the deaf ears of cruel fate!

Depression: Needless to say, the next stage that follows is depression. The degree of pain and the depth of hurt vary, depending on the relationship with the deceased, the circumstances preceding the death and various other factors.

Resilience and Acceptance: Then steps in human resilience- the undeniable inner strength. Although unfathomable in the beginning, we somehow pick up the broken pieces and move forward unto the final stage of Acceptance.

Helping one attain acceptance are the other weaker family members whose responsibility now befall on one’s shoulder, a good support system and our own personal day-to-day responsibilities.

What is to be done – norms in Manipur

Kapchasanu! (Let them cry it out) All lot of our ritualistic ceremonies are actually straight out of a textbook of Psychology!


Asiba Hangba chatpa (relatives and friends offering condolences)

Lairik Taaba (spending some time each day remembering the deceased and the Lord), spending time with the close kin fondly remembering the last few days and sharing one’s anguish more or less comprises the steps under Grief Therapy.

When do you need Medication and Professional Help?

Grief reaction is entirely a natural process and you never treat something natural. One can only stand by and let the stages of grief get over on its own, offering support when sought and letting the bereaved get on with the process of grieving.

Medication should be refrained from unless the bereaved individuals are severely sleep-deprived and may need an occasional prescription of non-benzodiazepine sedatives or a rare anxiolytic to offer them temporary respite. But because of the high abuse and dependence potential of these drugs, they should be used only when recommended by a trained psychiatrist who has interviewed the individual at length.

When does the grief process become complicated?

Bereavement, though considered to be a natural process of life, can turn complicated in about 10-15 per cent of affected individuals.

Chronic grief reaction: The normal grief reaction is taken to be that starting within two months of the death of a close one and not persisting beyond two-three months thereafter. When the symptoms persist beyond six months and is classically characterised by bitterness or the idealisation of the deceased, it is said to be complicated. This usually is seen when the relationship with the deceased was extremely close or dependent or in case of lack of reliable support system.

Hypertrophic grief reaction: This is usually encountered after a sudden or unexpected death. The grief process is exaggerated and the affected individuals may adopt several maladaptive coping methods including withdrawal.

Delayed grief reaction: The grief process is filled with denial, anger and guilt.

Post-traumatic stress reaction: This usually follows unnatural or violent deaths. Despair, flashbacks and preoccupation with the circumstances leading to death are few of the symptoms that may be seen in this case.


These are complicated grief reactions and need immediate attention from mental health professionals.

Finding Solace

Losing somebody close is never easy but like every challenge given the right and timely support, this trying times can also be tided over. There are support groups, help-lines; we can seek professional help in the form of Grief Counselling.

Many find solace in the time-tested ritualistic practice of mourning specific every culture and religion but all meant for the same purpose: bidding our farewells and some form of closure.

As for me, I console myself of my grief remembering a quote from the Bhagwat Gita: "For death is certain to one who is born...thou shalt not grieve for what is unavoidable."

Brief Author’s NoteOur family lost the Captain of our family ship, our patriarch, my dearest Pupu after a see-saw battle of wills and destiny since the first of 2021. Fate did take him but he went shining like a hero he always was, not a wince of pain, no distortion on his calm demeanour and in complete peace. We miss you or not, for you continue to live us, every day in our actions, prayers and in our convictions. We love you Pupu, see you on the other side.

(The views expressed in the piece from Pukning Pothasang is the author's own. The author can be reached at pukningpothasang@gmail.com)


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First published:


deathGrief CounsellinggriefBereavement

Dr Mona Nongmeikapam

Dr Mona Nongmeikapam

The author is Assistant Professor, Department of Psychiatry, Regional Institute of Medical Sciences, Imphal, Manipur


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