Processing your diagnosis through the stages of grief

A new diagnosis or changes in your lung condition can bring many intense emotions such as fear, worry, sadness, anxiety and even anger.  These feelings are all very normal and often a sign of grief. 

Grief is a natural emotional response to any loss. It can come in many forms and for different reasons. It could be the loss of a job, the end of a relationship, the passing of a loved one or any other change that alters life as you know it.   When you are faced with a life-limiting medical condition it is very normal to grieve.  You may grieve the loss of your health, the loss of your identity and independence, or loss of future life plans. As you process your diagnosis and adjust to a new “reality”, you can experience and move through different stages of grief, the most common being denial, anger, bargaining, depression, and acceptance.  These stages are often referred to as the “Five Stages of Grief”. 

While everyone grieves differently, identifying the various stages of grief can help you anticipate and comprehend some of the reactions you may have throughout the grieving process.  It can also help you understand your needs when grieving and find ways to manage them.   Ultimately, understanding the grieving process can help you work toward acceptance and coping.

Five Stages of Grief 

Denial  

A new diagnosis or a deterioration in your condition can bring on feelings of disbelief, numbness, and shock.  You may want to avoid thinking about what is happening or pretend that it does not exist. Denial can give you more time to gradually absorb the information and begin to process it. This is a common defence mechanism that helps protect you from an overwhelming situation.  As you process this stage of grief, your denial will begin to fade, and you will start to experience the emotions you may have hidden related to your diagnosis.    

Anger  

When faced with a life-limiting illness, anger is a very natural emotional response. It gives you a way to express big feelings, like anxiety, fear, frustration, and helplessness.  In this stage, you may ask, “Why me?” and think “life’s not fair”.  You may also feel anger and resentment towards your healthcare team, your friends and loved ones.  If you feel angry, let the people around you know, so they understand you are not angry with them, but the situation. You don’t have to pretend that everything is okay, it is important to allow yourself to feel and express your anger in a healthy way rather than holding it in. If you know you hurt someone’s feelings or stepped over a line, apologise like you normally would.  Most people will understand and do what they can to help you through this stage.  Anger is a natural and very necessary state of grief that can help you “get back” to reality, and as it subsides, you may start to think more rationally about what is happening.     

Bargaining  

When grieving, there are times when you can feel vulnerable and helpless. You might think your diagnosis is unfair and that you would do anything to “fix” it and return to life pre-diagnosis.   In these moments, you may try to bargain with yourself or a higher power to regain control and change your situation.  You might find yourself making a lot of “what if” statements, such as what if I went to the doctor 6 months earlier?  Or making a variety of promises to relieve the emotional and/or physical pain you are experiencing.  Bargaining may help to postpone the feelings of sadness and frustration.  In this stage of grieving, you gradually learn to come to terms with what you are facing.  

Depression   

During the grieving process, there often comes a time when your thought processes will calm down, you stop bargaining and start to look at the reality of your present situation.  When this occurs, it is not uncommon for people to experience a period of depression.  Depression is often characterised by persistent feelings of sadness, loss of enjoyment in everyday activities and low energy levels.  In this stage you may find yourself withdrawing from life, not wanting to talk to or be around others and experiencing feelings of hopelessness.   Being aware of and monitoring for signs of depression is very important throughout the grieving process, so appropriate treatment can be sought with your healthcare team or GP.    

Acceptance    

The last of the five stages of grief is acceptance. Acceptance does not mean you have moved past your grief or loss, but instead, your emotions may begin to settle. Often, you have come to terms with your “new” reality and your feelings have stabilised.   This stage is still a time of adjustment and fluctuating emotions where you will have ups and downs, good days, and bad days.  There will be times of grief and sadness, but you recognise that there are still good things in your life to appreciate and with acceptance, people often begin to enjoy life again and engage with their friends and loved ones.    

Coping with grief  

It’s important to keep in mind that everyone grieves differently, and there’s no correct way, or timeline, to grieve.  Not everyone will experience all the stages nor go through them in order, your ways of coping with grief will be unique.  It can be helpful to think about how you have coped with difficult situations in the past and try similar things now.  Below are some coping strategies you could try:

• Acknowledge your feelings.  Remind yourself that your feelings are normal and will change over time  
• Take it easy on yourself.  Be kind to yourself.  Accept that grief hurts, it’s hard and it takes time.  Feeling confused, overwhelmed, angry (or anything else) and having a good cry is okay.  You can learn more about Living with big feelings here.  
• Turn to friends and family. Now is the time to lean on the people who care about you, rather than avoid them.  Spend time together face-to-face and accept assistance when offered.   
• Accept that people may feel awkward when trying to support someone who’s grieving.  They may not know how to help or what to say.  It doesn’t mean they don’t care. Don’t let this be a reason to retreat into your shell and avoid social contact.  Let your loved ones know what you need and how they can support you.  See our Being a friend when someone is ill blog. 
• Join a support group and connect with others going through a similar situation.  Sharing your feelings with others who have also experienced loss can be helpful.   Find out more about Lung Foundation Australia’s peer support options here. 
• Talk to a social worker, psychologist or grief counsellor. An experienced therapist can help you work through the intense emotions of grief.  Your GP can provide you with a Mental Health Treatment Plan to access subsidised visits with a mental health professional.  You can find a psychologist who specialises in your area of need via the Australian Psychological Society https://psychology.org.au/find-a-psychologist  
• Look after your health.  Regular gentle exercise, eating a healthy diet and getting enough sleep can all help you start to feel better.  You can read more about exercising with a lung condition here. 
• Practice Mindfulness, the ability to be fully present in the moment.  Mindfulness activities, like meditation, reflection, yoga and body scanning can help decrease stress and sadness and increase your focus and happiness.   To get started, link in with Lung Foundation’s Mind Matters hub link here.  
• Draw comfort from your faith. If you follow a religious tradition, embrace the comfort it can provide.  Spiritual activities such as praying, meditation or going to church may bring calm.

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