What they don’t tell you about grief.

This photo was an accident (it's not cropped), but I really like it.

This photo of us was an accident (it’s not cropped), but I really like it.

Actually, there’s a lot that no one tells you about grief. It’s been three months since my mom died and there were definitely times in the first two months when I found myself Googling answers to questions like, “Is it normal to be exhausted all the time?” or “How long will this last?” or “What if I don’t stop feeling like this?” I don’t feel like I was prepared at all for the reality of grief. I expected to be sad and to cry a lot, and that these episodes would become less frequent (but no less random). I didn’t know that I would turn into a hermit for awhile and that that was okay. I didn’t know that making big decisions would make me want to crawl into a shell. I didn’t know that faking upbeat for the duration of a necessary meeting or event would put me back in bed for days afterward at first. But I think what’s surprised me the most is what I’m calling “the Hulk Effect.”

I have a temper, I’ll admit, but very few people see it. I’m much more the shove-the-feelings-down-and-then-rant-to-some-poor-soul-for-hours-later type. I’m loyal and protective, and I strongly expect people to do what is right or best, for whatever reason. These days, when someone pushes those buttons in a way that should register as annoyance, it sometimes manifests as rage instead. We’re talking full-blown, fight-or-flight adrenergic response: heart pounding, shaking, GI upset, insomnia. Take bad drivers: Before, you had to almost kill me or call me a c**t after you did something wrong to elicit that kind of response. Now, you just have to not understand multi-way stop signs. Or interpersonal relations: You had to either do one really bad thing or a less bad thing many times to get me to the point where I’m shivering uncontrollably and my eyes are bulging. These days, there’s a limited-time shortcut to the front of the line available for being a passive-aggressive ass. Some might find the idea of the Hulk Effect amusing. It’s not. It’s hard to explain to people who’ve never experienced it, but when your emotions are beyond the control of your rational thought, whether it’s because of grief or hormone swings or some kind of mood disorder, it is VERY disconcerting. In addition to having lost someone you love or experienced some other tragedy, you also find that you’ve lost yourself. Not just in an existential “Who am I without my mom?” way, but in a “Who is this stranger controlling my body and why won’t it take orders from me anymore?” way.

Interactions between psychological processes that could lead to higher threat perception. (Nature Reviews Neuroscience via The Atlantic.)

With grief, because of the amount of pain you’re in, your id is trying to drive the boat for the first time since childhood so that it can protect you while you heal. An internal tug of war ensues because that’s just not a practical way to move through modern society for months at a time. You battle, and you win one. You manage to put on real pants and go mingle among the living, and then someone says something insensitive or you get upset for whatever reason and your id comes out swinging like that overprotective guy in a movie who “knew this wasn’t a good idea.” You get all amped up as it battens down the hatches for increased protection. It gets you home without a public meltdown, for which you’re grateful. After the “danger” has passed comes the crash and the sadness and the exhaustion. Your id says, “I told you so. Now go rest.” It’s temporarily strengthened by its moral victory, so the next time you try to put on real pants, the fight is harder. You probably lose that round. Maybe the next one, too. Maybe a hundred more. Eventually, as the pain that causes hysterical sobbing is replaced with the pain that sits on your chest like an elephant, you win the tug of war more often. As more time passes, the elephant is replaced with something more like the aura before a migraine or a seizure. It’s always there and you know it could take you out, but you start to make your peace with it instead. When you start to make peace with your pain, you start to feel like yourself again. You start to feel hope and happiness and to have energy. You may get overconfident and think that your back to back to back appointments at the hospital are going well and everyone has been so nice. But your id knows better. It doesn’t ask permission nor even make you aware as it secretly rallies its chemical army and prepares them for attack. Then, back home safe and reading an email, your id finds its target and opens the floodgates. Sure, it was an immature way to deal with an error in communication, but why are you shaking? Why is your heart racing so fast you’re sure it will explode? Maybe, unsophisticated component that it is, your id doesn’t understand that an annoying email exchange from home doesn’t mean that our hideout has been breached. You do some deep breathing, you pet cats, you snuggle with the only person it views as an ally. But it’s not enough to make the anxiety go away completely, so you get frustrated and you cry. It’s the only way to stop the flood of adrenaline and to regain control. The next day, your id slows you down on your way to a meeting, asking whether you’re sure you want to go back out there so soon, but now you’re too strong for it to change your mind completely. Maybe one day soon, you’ll be too strong for it altogether. You’ll be able to thank it for being there when you needed it, and to agree that its job for now is done. Hopefully it will take your advice and spend its downtime educating itself about the 21st century, just in case you need it again.

Yesterday was the first time that my blood pressure has been normal in a clinical setting (though my pulse was still 90) since I took over my mom’s care. And I could feel the adrenaline starting, so I think it was only hearing the guy in the triage room next to me talking loudly about his poop that thwarted a full-on surge. The thing with hospitals is, they all look like hospitals. That triage room yesterday looked like the one my mom was in when she was scheduled to have her PleurX taken out. The doctor’s bedside manner that day left a lot to be desired, so she got my mom all stressed out about the fact that general sedation/”twilighting” (which she didn’t need to have a tube removed locally) might kill her. I’m trying to mediate between the two of them and my mom grabs my arm, looks up at me, and goes, “I’m not ready to die!” She’d been running me ragged at home and she had ambulance transport to and from the hospital where they were pulling the tube out, which was an hour each way from her house, so I’d been complaining that I didn’t understand why she needed me to go with her when hospice had taken care of everything. After she got back to the triage/recovery room, she said, “I needed you here because I was scared.” How do you not think about stuff like that for months afterward, especially in a similar setting? And if you do, what are you supposed to do about the quiet riot that starts in the pit of your stomach?

Of course, grief is not the same for everyone, but all of this is within the scope of normal within the first six months after a major loss or trauma. Disproportionate fight or flight responses are a thing, as are lots of other weird physical responses. Indecisiveness is a thing. Lethargy is a thing. Feeling lonely yet wanting to avoid socializing? Thing. And other than focusing on healing yourself, there is nothing you can do but wait it out.*

*If these symptoms last longer than six months, they can actually be a sign of caregiver PTSD, which requires professional help.
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