Transcription:

Scott Webb: We've all suffered grief and loss in our lifetime, and perhaps that's especially true over the past few years. I'm joined today by Dr. James Lew. He's a family medicine doctor and obstetrician and he's here today to help us understand grief and assure us that it's okay to grieve the loss of loved ones. This is Ask the Experts, a podcast from Salinas Valley Memorial Healthcare System. I'm Scott Webb. Dr. Lew, thanks so much for your time. Let's start here. What are the different types of grief, and generally speaking, why do we grieve?

Dr. James Lew: There's many different types of grief. We grieve, I would say on a daily basis on something, you know, But what I'm talking about is bereavement today. That is the grief. One experience as losing a loved one and that as we know with the pandemic has been , magnified tenfold. There are estimates by sociologists that for every person that has died of covid during the pandemic, nine grieving persons are left behind in its wake of that death.

And so, you know, we have this crisis that we're in the midst of that I think we're just beginning to understand. And that's something that I think we need to begin to acknowledge as a society. And I see it manifest itself in my clinical practice on a daily basis. And I think, from the highest levels of leadership in our government, it's time for us to maybe invest some time and money into maybe addressing these where there's really a huge public health issue.

Scott Webb: Yeah. It really is. And is it that there's a stigma attached to mental struggles and mental health? Like, why don't we do a better job? What can we do to encourage folks to put time and money and effort into understanding and accepting that people need to grieve?

Dr. James Lew: You know, I think it's a fundamental part of our human experience to grieve. If we live long enough, we will lose loved ones. And I think all the great religious traditions have addressed this issue. For example, I know here in Salinas where I live, a huge Catholic community, peopl e will say the rosary for nine days in a row, for example. And one can look at that superficially as a religious tradition. But actually it's a very profound process of processing ones grief and processing one's bereavement, unfortunately those opportunities were cut short with the pandemic because of obviously issues with contagion.

We weren't able to get togethe r in congregations to share, our communal Grief and process, the bereavement. And I think that has been detrimental to our society, to the fabric of our society. But that said, now things are opening up thank God, and we're able to get together and churches and synagogues and grieve together. And that's a very important process for once Communal mental health, so to speak and one's own personal health. And I think imperative that we as clinicians, as nurses, as social workers, become aware of the prevalence of bereavement around us and the psychosomatic manifestations.

Scott Webb: Yeah, I think you're right. And I wanted to talk to you a little bit about sort of the healthy ways that we can try to overcome grief. And you mentioned, you know, now that we're out of Covid a little bit and folks are being able to get together and grieve maybe that's one of the healthy ways, but what are some of the other healthy ways that folks can grieve?

Dr. James Lew: There is good grief. You know, I think of Charlie Brown when I was growing up.

Scott Webb: I was thinking that when you said, good grief. Exactly.

Dr. James Lew: Yeah. And I think, as I've matured and grieved the loss of my own loved one. and I realized the first thing is acknowledge your loss. I think that's very important. That is to say, take the time to grieve. I think it's important to remember your loved ones. One format that I have found very helpful is a grief support group. There's one here in Salinas that does meet on Thursday's. Shout out to Mick Erickson who's a wonderful man who's dedicated his life to helping people grieve. That's held at the VNA Hospice Center on Thursdays here in Salinas. It allows the time and space to share what are very profound feelings that people are enduring sometimes quietly.

And I think can be a very cathartic and healing process. And I have found that for many people it is very helpful, and in terms of good grief, I would have to say that there are certain things you will learn in support groups. There are common things, for example. You know that everyone's journey through, bereavement, through grief is unique. Everyone grieves a bit differently. Sometimes, again, acknowledging one's loss. Is one thing. But I also, I think it's important for the family friends to also remember acknowledge the loss of others.

I think that in itself can be very healing. And to recognize that, yeah. If someone doesn't want to come to the Christmas party, it may not be that they're slighting you personally, etcetera. It may be, they're just not filling up to the spirit, and that's okay. And to realize that I think the holidays are difficult during the time of bereavement because sometimes it was that wife or that husband that made that season special.

It was the husband who was a Santa Claus, or was the mother who hung, the stockings and filled them up with toys and who's no longer there. And I think these moments can conjure up memories that can be, let's say, sorrowful. And that's okay. I think as a society, it's interesting. We, want to smile and be happy during the holiday season. And that's understandable. Yeah, I think it . Was the late queen Elizabeth who was quoted as saying that, grief is a price we pay for love. And I think it's important to realize that, that you're crying, you're very real sense, honoring those who have left us. Yeah.

Scott Webb: Yeah. Sometimes having a good cry is okay. You have to be okay with that. You have to acknowledge the loss, acknowledge the grief. you know, sometimes though, doctor the periodic sadness can turn into real depression, clinical depression. So I wanted to talk to you a little bit about that for folks who do become depressed, where can they go? What should they do? How can their loved ones help them? And so on.

Dr. James Lew: That's something that I think my fellow clinicians can help address with their patients there is a difference between depression and grief. And it's interesting because I think it's taken time for the mental health community to realize that. It's interesting when you look at grief the symptoms of grief tend to actually peak at about six months after the loss of a loved one. So that's, you can say on normal and it can even last longer.

I think what obviously can complicate the situation is depression. And as we know, a major depression could be very debilitating. A very serious illness and needs to be treated medically, as well as psychologically. And I think that if someone is incapacitated, can't function, can't focus on their job or their activities of daily living, that's a serious issue. And they should go see their doctor and have he or she address that issue with them many times medication may help if there's an coexistent severe depression.

We were talking about a good grief. There is also bad grief, and that is to say sometimes people start to self-medicate. And that can be very dangerous with alcohol especially. And we do know that, for example, many children and teenagers have lost loved ones at a very vulnerable age. And that's when experimentation with sex and drugs can spike. And so I think as a parent, as grandparents, that's something to be aware of and maybe to hopefully lovingly counsel our youngsters as well. And again this is a huge crisis right now. And I think we need to acknowledge and start to address it. On these levels.

And by the way, for maybe the healthcare workers listening to this, recently there was a debate among the psychiatric community, the psychiatrist and psychologists got together and actually they did recognize that there is something called prolonged grief disorder. And there was a lot of debate and decided, okay, if someone can't function at one year after the loss of a loved one we'll call it prolonged grief disorder. And I hasten to add, there was a lot of pushback because, people did not wanna pathologize, which is really a normal human experience. But they thought that they put it into this book called the DSM five which is the Bible of psychiatrists. And it's about maybe 4% of the population.

Scott Webb: Doctor, this has been great I really appreciate your compassion, your expertise. Thank you so much. You stay well.

Dr. James Lew: Thank you.

Scott Webb: And if you found this podcast to be helpful, please be sure to tell a friend, neighbor or family member and subscribe, rate, and review this podcast and check out the entire podcast library for additional topics of interest. This is Ask the Experts from Salinas Valley Memorial Healthcare System. I'm Scott Webb. Stay well, and we'll talk again next time.