It’s Personal: Anxiety as a Sixth Stage of Grief

Forty-two has been a difficult year for me. Two weeks after my birthday in September, my dear grandmother passed away. She and I had always been particularly close; growing up, I spent every summer at her home in St. Louis, and then when I started college, on a different continent from my parents, it was my grandparents’ house that became home base – the place I went to for long weekends, Thanksgiving breaks, and even to recuperate from surgery. My grandmother was like a second mother to me, and though her death was expected — she’d been in hospice care for months — it broke my heart. In the days leading up to her death, when we were told it was imminent, I knew I had to let her know how I felt and so I wrote a letter to her. Since she’d gone almost totally deaf in recent years, letters had been our main source of communication between yearly visits, and eventually, after a series of strokes, she was no longer even able to write. But I continued writing to her, and then I sent a final note to tell her how much she’d always meant to me, how being her granddaughter was one of my life’s biggest privileges. After she died, I wondered if the note reached her in time.

“She got it,” my aunt confirmed, “I read it to her and she loved it.” She died in her sleep a few hours later.

The morning after she died, I woke up in some of the most aggressive pain I’d ever experienced next to childbirth. I’d been diagnosed with shingles the day before — an infection often triggered by stress (including emotional stress). The doctor said my case was mild and I wouldn’t be too terribly uncomfortable. She was wrong. Taking a single step was excruciating; I was bedridden for nearly a week and missed my grandmother’s funeral.

A month to the day after my grandmother died, I made the heart-wrenching decision to euthanize my cat Simone whom I’d had for over 19 years, since she was just a few days old and I bottle-fed her. Fortunately, her demise was quick and not drawn-out. One day she was fine — or, as fine as a 19-year-old cat can be — and the next day she was disoriented, walking in circles, and falling down. The next day her back legs were paralyzed, and the day after that the vet at the ER said if I didn’t euthanize her immediately, right there on the spot, she might suffer extreme and unnecessary pain. I made the only humane choice there was and it broke my heart.

Both of these losses were devastating but not unexpected, and I went through the usual stages of grief — cumulative grief that probably felt bigger than either loss might have felt on its own. Winter was hard but I was trucking along. I started therapy to address the grief, but also to address some parenting challenges I was having, and to help me manage my stress and anxiety in a healthy, functional way. And then in February one of my best friends died from injuries suffered after a horrific car accident — a death that was very tragic and decidedly not expected — and my anxiety has skyrocketed in the months since.

The anxiety is nearly debilitating. I can’t sleep, I worry about everything, I have a hard time making decisions about even the most basic thing like what to make for dinner. While I don’t consciously think it regularly, the worry is constantly there: anyone I love could die at any moment. I could die at any moment. And I need to prepare for this! If I can prepare myself for this, then I can have some sense of control. And if I can have some sense of control, I will feel better, more secure. And so my life becomes a cycle of trying to control the uncontrollable which, for me, means lying awake all night long, every night, thinking about all of the things and what I can possibly do to control as many of the things as possible (I must be so much fun to live with).

The other day, a friend shared an article on Instagram called “Why Anxiety Should Be Added to the 5 Stages of Grief.” In it, the author, a grief therapist, says that grief and anxiety are inextricably linked, and “we experience anxiety after a loss because losing someone we love thrusts us into a vulnerable place. It forces us to confront our mortality, and facing these fundamental human truths about life’s unpredictability causes fear and anxiety to surface in profound ways.”

That’s the bad news. The good news is that grief and anxiety can be dealt with – they can be processed and survived, and one can function fully and happily on the other side. One of the best ways to process these emotions is to talk about them (and the loss/es that led to the emotions), as well as the thoughts around our own mortality that such loss may bring to the forefront (perhaps for the first time). And so that’s what I’m doing here (and also not here). I share my experience in active grieving in hopes that it not only helps me heal, but also, in a tiny way, helps to de-stigmatize grief in general.

Grief is one of the most universal human experiences. We all have or will experience loss – some expected and some unexpected. There is no timetable for grieving the loss. There is no linear movement through the stages of grief. Even loss that doesn’t directly impact your day-to-day life (say, losing a grandmother who lives several states away, or a long-distance close friend you hadn’t seen in a year) can have an enormous impact on your psyche and your heart and your general well-being. It may give you shingles. It may keep you awake at night. You are normal. You will get through this. And you will come to realize — perhaps right away — that you will never be the same again. This is the price — and the benefit — of loving deeply.