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Monday, October 1, 2012

Emotional impacts of any major diagnosis or life change

Being diagnosed with anything life changing can have large emotional impact.  It doesn't have to be death or a terminal illness to have a response just because there is not a deathly outcome doesn't mean that if does not affect ones emotions.  Going through the five stages of grief can just be the start of handling the situation.  Even situations that have been resolved can have this sort of impact. 

When I was diagnosed with Celiac and with infertility and told of the loss and/or imminent loss of my pregnancies I went through these stages. I also went through this when I was told that I had cancer but it was removed and now I am cured.  During these periods I was lucky enough to have people around me that understood and tried to help, that still didn't make the news any less devastating. 

The five stages of grief are
Note: There is no right way to grieve and it may take some longer than others.   These steps may not be in order or may be repeated.  This is only an overview of what can happen not what does happen. 

1. Denial and Isolation:
This has been called a defense mechanism that buffers the immediate shock.  That thought that the doctor cannot do their job right and has made a large mistake.  Simply a person cannot handle the situation and hides from what is going on.  Some of these thoughts for me included "I just need to find someone who knows what they are doing." "There was a mistake in the blood work" or my favorite "who gave this idiot a medical degree?" This is a temporary response that carries us through the first wave of pain.

2. Anger
Once denial starts to wear and reality re-emerges a person can go through anger. This anger can come out at unreasonable times and be aimed at friends, loved ones, animals, inanimate objects, doctors or complete strangers.  This emotion is created to help deflect the pain.  Inside we know that the anger is misplaced, this can cause guilt at being angry which then turns to more anger.  In my case the anger came out at close friends, family and inanimate objects. Not that I didn't blow up at complete strangers it was just less.  I remember throwing a book I was reading since the characters were doing what I could not.  It took me a few weeks before I could read the book again without wanting to destroy it.  I accused those close to me of not understanding or not caring. 

3. Bargaining
This is a way to try to regain control of the situation.  It can come with thoughts of why didn't I make a bigger deal of those symptoms, why did I trust only one doctor.  These “what if” thoughts can often lead back to anger, as they consistently did for me.  I tried making deals with a higher power in order to be able to keep the baby, have a child, or just be healthy and able to eat normally.  This is almost a second form of denial in the way it is trying to protect ourselves from reality.  Once I found that I couldn't do anything different I would then get angry.  I personally was stuck in these two stages for a while on a couple of different issues. 

4. Depression
This can happen in a few different ways, it can be sadness and regret that lead us to separate ourselves from our loved ones and from normal activities.  This is the type I generally go through.  I would lock myself away in my room and fall into fantasy worlds where I didn't have to deal with anything.  I would put myself in front of the computer and hide in Facebook games, stupid things with no real bearing on anything real.
There is a second type of depression that is quieter, those people that look and act fine but haven't cried openly.  Those that keep going to work and seem to handle everything fine, this can sometimes be the more dangerous of the depression since it can last a lot longer and perpetuate it's self.  Thoughts like "why doesn't anyone notice how I real feel?" can occur, if this is the case please try to talk to someone.   In both cases sometimes a hug can really help.  It is not a permanent fix but it can be useful to help a little of the depression not feel so lonely, even if you made the loneliness yourself.   

5. Acceptance
This is the hardest stage to reach, and often you can be stuck in one of the other stages for a very long time.  This stage is shown by calm and withdrawal as you deal.  This is not happiness and often can be mistaken as still being in the depression state.  It is only after this stage that you can start to real deal with everything that has happened.  I am only now just starting to get to this stage after my ectopic pregnancy.  I was stuck in anger and depression for a long time.  I would start into acceptance and then fight against it. Coping with any large change like a diagnosis can be hard, and no one can really understand what you are going through since each person deals differently.  The only advice I can give is hypocritical since I don't follow it, that advice is to allow grief to take its course, try not to fight it.  However, I personally know how hard if not impossible that advice can be.  

With my celiac and immunoglobulin A deficiency it took me a few weeks to come to grips with everything.  The depression stage was short but I real held on to the anger.  Why me and why not others, what did I do wrong? Those thoughts kept me angry since I didn't want to deal, I just wanted it to go away.  I went through many tests and kept hoping that each test would say that the others had made a mistake and I was fine.  However, when I was found to be IGA-D (immunoglobulin A deficient) that was all diagnosis the doctors really needed.  Further testing was to see how far along I had progressed not to prove that I had Celiac. 

Knowing what the stages of Grief are doesn't make it any easier to deal with.  Never let anyone tell you that you cannot be going through those stages simply because they don't think you should.

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