The Grieving Process
Most everyone is familiar with the five stages of grief outlined by Dr. Elisabeth Kübler-Ross, which has served as a model for understanding the process by which people deal with tragedy and grief. These stages apply to any form of personal loss, whether it's the loss of a job, the death of a family member, or the diagnosis of an illness. We have all grieved various things in our lives to some extent, especially those things that have created unforeseen changes in our daily routines, such as losing a job or ending a relationship. Grieving the change in the status of your health is perfectly normal — even healthy. Acceptance comes by strapping on your boots and wading through the waters of your fears and uncertainty. Not everyone goes through each stage of grief outlined here or even in the prescribed order. Everyone deals with grief in his or her own way.
Denial is nature's way of letting in only what you can handle. When someone is in denial, she is experiencing shock and disbelief. Perhaps she feels numb or things don't seem to make sense. “How can this be happening to me?” she asks, or “I can't believe this!” she exclaims. These feelings are important; they serve to protect you from overwhelming feelings and circumstances. To fully comprehend a tragedy or loss in a short period of time would be too much for your psyche to take in.
Denial allows the newly diagnosed person to take a healthy timeout and to avoid feeling overwhelmed by his change in circumstances, but it shouldn't prevent him from making decisions regarding his care. If you've been prescribed one of the disease-modifying drugs by your neurologist, it is important to begin treatment early. Taking a proactive stance will play an important role in your treatment.
Anger often creeps in once you're feeling a little less vulnerable and have gotten on with the task of living. Most people are conditioned to believe that anger is unhealthy, but it is an important part of the grieving process. It is part of your emotional management.
What you're feeling when you're in the angry stage may not always be logical. You may be angry at yourself for not preventing the disease somehow; you might be angry at your doctor for telling you in the first place, or angry at your spouse for not being more supportive. But anger is a necessary stage in the healing process, and the best thing you can do is find healthy ways to express it. Consider speaking to a therapist or a clergyman — someone who will allow you to feel safe expressing your anger or bewilderment. Activities such as gardening, walking, or swimming will help you to externalize your feelings. It's okay to scream into your pillow, too.
Just as denial provides you with an opportunity to disconnect, anger allows you the opportunity to reconnect with your feelings and your sense of self. Let's face it — you have been assigned a task you neither expected nor asked for. The life you had envisioned has been irrevocably changed without any sense of fairness. That certainly gives you reason to be angry, and it's important to express it. But don't confuse anger with helplessness. Once you have dealt with your emotions (which can be a long process) you will grab the reins again and learn to propel those emotions in a healthy and constructive way.
Bargaining is the process of trying to avoid painful situations by saying, “If only …” It is also a process of magical thinking — wishing to go back in time and somehow recreate circumstances that would have resulted in a different outcome. People diagnosed with MS often wonder if there was something they did to create the condition in their lives, or wonder if there was something they could have done to prevent it. The answer to that question is “no.” There is no indication that lifestyle choices had any bearing on your diagnosis.
In the bargaining stage, you may also ask a higher power for reassurances. You may request that no other tragedies visit your family or that no other illnesses are sent your way, or assume that having been diagnosed with MS, you've somehow filled your lifetime quota for difficulty. Living in uncertainty is part of the human condition and people know intuitively that no such reassurances can be granted. But bargaining helps you get from one place to another, allowing you to feel that somehow, you can restore order to the chaotic circumstances in your life.
Part of dealing with MS is understanding that on some level, you are no longer completely in control of your own life. Part of the journey you will take in accepting the disease is learning how to balance what you can't control with what you can control. Treatment options, attitude, lifestyle choices — these things will always remain in your court.
MS does not have the power to steal your dreams, compromise your goals, or sabotage your life. The essence of who you are is not for sale. In the bargaining process, understand that life is unpredictable for everyone, but that most people, even in the worst possible circumstances, have learned to bring order to the chaos and empower themselves through the choices they make.
In the depression stage, grief moves into your life on a deeper level. The difficult feelings you tried to stave off with anger or bargaining have come to roost. People who experience depression often withdraw from life for a time, feel lethargic, or devoid of feeling.
Feeling depressed after sustaining a loss or adjusting to difficult life circumstances is normal. Sometimes you have to let the normal depression that comes with grief have its place in your life by acknowledging it and working through it.
Sadness is what you feel at certain times in your life, but it is important to distinguish between sadness and clinical depression, which is depression that doesn't go away or is seriously compromising the quality of your life. Finding a therapist to support you and help you deal with your emotions is a wise choice.
Acceptance doesn't mean that suddenly you're okay with what has happened in your life. (You might never feel “okay” about being diagnosed with a chronic illness.) Acceptance means that you've grasped the reality of your situation and you're ready to incorporate that reality into your life. You may feel ready to reinvest in your life again and expend less energy on your loss.
While it is important to grieve and sort out your feelings, it is also important to keep a healthy perspective. MS is an unpredictable disease; science cannot yet predict its course in any individual. Advances in research and treatment give you good reasons to be hopeful and confident about your future. Armed with knowledge, support, and a proactive plan, you too, will find a way to incorporate MS into your life.