Grief is a strong emotion, one that is common after a brain injury. So much has changed, and there is a sense of loss that is completely normal to feel. Grief can lead to profound sadness, discounting remaining abilities, and thinking about ‘what could have been’.

As a friend/family member and now as a caregiver, you are going to be feeling grief too. Your life has also changed, and it will never be the same again.

While it’s normal to experience grief, it’s important not to let it consume either of you. Acknowledge how you’re feeling and the changes you have experienced but find ways to celebrate the victories in your lives. Look for ways to remind yourself of the positives: for example, you can take some time at the end of each day to record the good things that happened.

It’s not a quick process. There will be good days and bad days, and grief may linger for several months. But with time, patience, and commitment to taking care of yourself and your friend/family member, it will improve.

The five stages of grief

A brain injury is life-altering for everyone involved. It is normal to experience grief surrounding the changes. Please note: not everyone experiences all the common stages of grief, and they may not experience them in order.

When someone is in denial, it means they are not acknowledging what happened. This could be a sudden change or a sudden loss, both of which can happen when someone you care for acquires a brain injury. These sudden changes cause intense feelings that many people find too difficult to cope with right away, so they deny that anything is wrong. For example, you may know that the person has a brain injury but subconsciously not see the changes in them.

Denial isn’t something you can ‘fix’. It’s a normal part of the grief process and it may be awhile before you move to another stage. While it’s a part of grief, it’s important to work towards recognizing denial. You may not be ready to face what is happening, but you also don’t want to hurt the feelings of others (particularly the person with a brain injury) by refusing to acknowledge their changing needs. Talk to a therapist or family may be helpful in this stage.

Anger during grief is often either internalized or misdirected at other people or circumstances because the person is angry at their situation and can’t cope with it. Anger can appear as rage, but it can also present as resentment, aloofness or a bitter attitude.

You may direct anger towards loved ones, the doctors who provided the diagnosis, or the rehabilitation team because you aren’t seeing progress in your friend or family member. You know it’s not their fault and that you have no reason to be angry with them, but you still feel this incredibly strong emotion. You may even experience periods of anger towards the person with the brain injury or the cause of the injury. This can be particularly hard, especially when it feels like your friend or family member is a totally different person.

It’s important to do your best to make sure that you don’t direct your anger in a harmful way . It can help to ask questions about your anger: why am I angry, who am I angry at, what can I do about my anger, etc. You can write down your answers in a journal as a cathartic exercise. You can also speak to a therapist about what you’re experiencing.

Eventually anger will fade and other emotions will come to the surface.

Bargaining is also called making a deal, and it’s something people experiencing grief will do all the time. They may try to bargain with the deity of their religious belief, with doctors, or with others. They may also start making wistful statements that suggest they could have gone back and changed the outcome of the situation

You may use bargaining to try and take back control. For example; “what if I had done this instead?” or “if only I had been there.” This is another stage of grief that puts off the negative emotions associated with the situation and is often a mechanism to give you more time to process the changes.

Depression is the name given to the stage when someone experiences all the emotions associated with the cause of their grief. This could cause someone to enter a depression and isolate themselves.

There is no set time limit on how long you will be in this stage (if you experience it). It’s not an easy stage of grief to cope with either. You will feel overwhelmed, emotional, lost and alone. But it’s important to work to move beyond this stage by talking with friends, family, and mental health professionals.

Many people confuse the acceptance stage with positive feelings – but what it really means is that you have come to terms with your new situation. It doesn’t mean those negative feelings and thoughts are gone or that you’re happy every day.

When you reach the acceptance stage, you will be doing your best to focus on moving forward, helping your friend or family member with recovery, and finding the good in each day. Acceptance doesn’t have to be reached alone: your family, friends and healthcare team can all help.

You may not go through all these stages for the same length of time, or at all. You may even find yourself going backwards or experiencing some stages at the same time. Processing grief is unique for everyone, and there’s no right or wrong way to do it.

Mental health resources