The doctor just told you that you have a chronic condition or maybe even a terminal condition. You have come home armed with pamphlets and a head full of ‘do’s and don’ts’.

In the coming weeks you may have scheduled appointments with more doctors and allied health professionals. The reality of your condition is now sinking in.

Do you recall how you felt when your serious illness, be it diabetes, rheumatoid arthritis, heart disease or cancer, was diagnosed? Were you overwhelmed or angry? Did you experience disbelief or guilt? Felt helpless, lost and confused?

Whatever you felt then, it was a natural response. After all, you were told that you had an illness that could impact you for the rest of your life.

Do you feel hopeless, thinking that life has no meaning now? Maybe you feel like you’ve just been given a death sentence. Don’t worry, you are not going crazy. These emotions are natural. They are what we call “grief”.

Grief is a normal and natural response to loss. We usually associate grief with the loss of a loved one through death or separation. However, we can also experience grief when we lose our health and the lifestyle we were accustomed to. "Hence it is quite normal to experience grief when you have been diagnosed with a life-threatening or life-altering disease, " says Ms Evelyn Boon​, Senior Principal Psychologist from the Department of ​Psychiatry​​ at Singapore General Hospital​ (SGH).

You may mourn the loss of “normal life” as you deal with all the changes (medications, doctor’s visits, dietary and exercise restrictions) needed because of your condition. You may express unhappiness and anger about all the restrictions and limitations. This is all part of the bereavement process.

Grief is not necessarily a bad thing. It allows us to process our experiences, and helps to open our eyes and change our attitude. However, before we can reap the benefits from grief, we need to work through its different stages.

The late Swiss-American psychologist Elisabeth Kubler-Ross proposed an abstract model of grief, also known as “The Five Stages of Grief”. These stages are, however, not as neat as she had described. People seldom move through the process in a straight line. You may find yourself in more than one stage at a time. You may move back and forth between stages, or even get stuck in one of them.

Denial – the initial reaction

You may initially refuse to believe your doctor. Maybe you requested more blood tests, or a second opinion. Perhaps you just disregarded what the doctor said and refused to take any medication or change your lifestyle. Denial can also be healthy as it prevents you from being overwhelmed by emotions, especially fear.

Anger – reality sets in

As the reality of your medical condition sinks in, feelings of anger, and a sense of unfairness begin to surface. You may feel resentment towards your loved ones and blame them. You may also feel angry with yourself, the medical team or even God for “letting” you have this chronic illness.

Bargaining – your head takes over

At this point, reason and logic take over. You realise that hiding your head in the sand is not going to make this disease go away. If your disease is linked to your lifestyle, you may have tried to delay starting medications by trying to lose weight or becoming very conscientious about what you eat. Or you may have tried to become more active and get more exercise outdoors. This is the beginning of a more proactive attitude.

Depression – the full impact sinks in

One day, the diagnosis hits you like a brick wall. Taking the example of diabetes, you fully get how serious it is and to what extent you’ll need to change your lifestyle. You may feel heavy-hearted by the very thought of this. It is common for newly diagnosed patients to feel depressed, overwhelmed, hopeless and helpless. You may even feel like crying for no reason.

Acceptance – at peace with yourself

This is the ultimate stage we aspire to reach. It means that you are now dealing with the reality of your illness and it has become part of your daily life. You have a sense of hope and a positive frame of mind and attitude in facing this disease.

1. Gather your friends
   • Identify some people whom you trust and let them know that you may need their moral support.
   • Surround yourself with caring people.
2. Ask for help
   • To ask for help does not mean that you are incapable or weak.
   • Don’t be afraid to accept the help of your friends and loved ones.
3. Talk
   • Do not keep things bottled up inside. It won’t help your situation.
   • Stress is bad for you and may worsen your condition, so talk out your stress and problems.
4. Allow yourself to feel emotions
5. • Let yourself feel sad, angry, and cry if you want to.
   • It is better to feel your emotions than to fight them.

1. When your grief starts to interfere with your daily routine.
2. When you neglect yourself and your health.
3. If you feel that you are no longer able to cope with your grief.

Ref: T12