Ask Dr. Giles: I'm determined to get help with my grief, but I'm just so tired and confused.

Michael asks:

My name is Michael and on September 28 of this year I lost my grandmother and best friend to bile duct cancer after a 6 week battle. I’ve been posting on the discussion board and they recommended you as a good person to contact with addtional questions.

I am currently seeing a one on one grief counselor wit hospice and a primary care physician or these issues and this coming week and going to try to get back with a counseling/psychiatric center I uses to belong to.

Before I go any further I have to tell you that I have had some pre-existing mental and emotional issues long before my grandmother got sick. I am officially diagnosed as having Obsessive Complusive Disorder, Dysthemic Depression, and Tourette’s-like symptoms. Because of some unsual other features of my mental and emotional makeup my psychiatrist thought I might have something resembling Asperger’s (which would explain alot of disparate phenomena) and am prone to panic attacks and general anxiety as well.

I have to say all this out loud because I’m trying (and failing) to understand the increasing bizarre character of my grief. This last month has been both the best and worst since her death which is very disorienting.

In the last month (well, really two months) I have had more panic attacks than I can remember having in the last 2 years. I find myself becoming depressed/distraught/anxious at the drop of a hat — especially when something reminds me of her–which is often. Almost two years ago my family was kind and generous enough to support me as I have been fighting for social security disability to get help for my mental disorders and as a result of that I spent almost every day with my grandmother during that time and now find myself with a large amount of alone time and its grinding me down. I seize any opportunity to visit someone or go out for fresh air or work on some activity but I am still left with some much time alone (and when I’m alone the sad memories of her feel always close by). And every now and then I just explode with tears, raw emotion, and panic and its a horrible experience. I’m not generally someone who fights back tears in general and I don’t believe in emotional repression–I don’t object to the tears and emotions as they come and yet sometimes they still explode like a sleeping volcano I didn’t know was there.

And yet, in spite of all that, some very good things have happened to. Beyond the start of a new relationship with someone I really like, I can’t explain it but it like I can see the dawn coming over the horizon–I am beginning to be able to see that my life is just beginning and one day I will reach a new kind of happiness–but its just the contours, I can’t see what that happiness and new life will be like. Above all what I began feeling several times this month was a sense of real hope. And I know, know without doubt, that that is what my grandmother wanted for me and that somehow she’s watching and is happy for me. But still it makes the tremendous grief I’ve felt (which seems to grow with each month) all the worse.

Her sudden death came after years of her dealing with what seemed like a fair number of minor health issues and then suddenly one of them was the one that killed her. Her death has not only taught me again how precious life is but its all over much too fast. It’s created a renewed fear of illness and death in me that I have no precedent for. I don’t want it to become an obsession that cripples the slow progress I’m making. I wake up with the fear of a panic attack or deep despair before its even happened this last week and its scarying the hell out of me. This sadness is like waking up with a buzzard on my shoulder which I’m trying my damnedest to not always pay attention to but its very hard.

Having said so much and unburdened myself I do want to say I am still going to grief counseling (who has agreed I am on a genuine and healthy path of grief and am making real progress) and my personal physician and this week and trying to restart my treatment at the psychiatric and counseling center I used to attend. So I am determined to get help but I’m just so mentally tired and confused. I just wanted to ask if you think I;m doing the correct things or if there’s something more that I can do. Thank you and sorry for the long question.

Dear Michael,

I really like the way you have described the intense power and emotional magnitude of grief. I’m sure others have experienced the explosion from a “sleeping volcano” similarly to what you so effectively reported. I also appreciate that you took time to identify some of the good things which are happening in your life. There are always good things happening in our lives–even if we have a tendency to overlook them during times of trial.

I am glad that you are comfortable expressing emotion. I think that will be your most important asset as you deal with this intense grief.

I don’t blame you for being concerned about the frequency of panic attacks since your grandmother’s death. I would submit that it is likely a product of what is unknown to you at this point in time. From what you have written, here is a list of some of the “unknown’s” which have been highlighted by your grandmother’s death:

• The point in time when a life (yours or any other’s) will end
• The manner in which a life will end
• When it is that you will be beset by powerful emotion in response to your grandmother’s death
• What will be your mood when you wake up in the morning
• What will you do with your time now that your grandmother is gone

And here is a list of some of the “known’s:”

• You’re beginning a relationship with someone you really like
• You can see the “dawn coming over the horizon”
• Your grandmother is somehow watching over you and is happy for those beginnings of newfound hope
• Your grief counselor agrees that you are on a genuine and healthy path
• Your personal physician is going to help you
• The psychiatric and counseling center is there for you

I do think you are on the right path–and will continue to be–as long as you focus on what is known rather than what is unknown. Even if the “known’s” are not always good news, at least they represent those things which actually exist–rather than those things which may or may not exist later on. Because the “known’s” are things which actually exist, they are things which you can actually address and thereby make a difference in your quality of life. Continue to work with what is known, and you will find yourself less anxious and more happy.