Psychiatry.

Anniversary grief reaction

Saturday, 8 February 2014 5:01 pm

Fifty year old Jamey comes to your GP clinic for her regular health check up and she has high blood
pressure .you have been her GP for quite some time now and you have not noticed any emotional
disturbances in her so far . But this time , during consultation she became tearful and started crying .
So your tasks -
A. focussed history
B. likely diagnosis
C. Explain the condition to the patient
D. Management

When a patient cries , offer a tissue , glass of water

Ask her if she needs another appointment or if we could continue
Ask for any other reasons or stresses for you?
Does she feel like this only at this time ? ( rule out depression)
Ask for any sense of guilt / self blame /
Any person with whom you can confide .

Any other medical or surgical conditions

Smoking. / alcohol
Explain to the patient

• What you have is anniversary grief

Normal psychological behaviour when a loved one passéS away
Grief is like a bruise which heals with time .
Feelings of sadness and helplessness are quite common during grief and
crying acts as a ventilation to grief.

Management
• You can ask her to acknowledge her grief and try yourself to become upset. Donot try to
run away from the grief .
• You can try to create a routine around your grief .
Try cleaning your husbands room , study and be creative and do not keep everything for
yourself .
• Most importantly , share your thoughts and future plans with someone whom you can
trust.you could confide your worries with someone
• Family meetings
• Support groups : I could give you contact numbers f groups .you can be comfortable among
this group members , people who have had the same experiences .
• Advise her on controlling her blood pressure , lifestyle changes etc.
• Reassure : I will always be there to assist you .

STAGES OF GRIEF
A.Shock or disbelief- numbness , emptiness , anxiety , fear And some sort of hallucinations .
B. Sense of guilt and self blame / anger / social withdrawal/ suicidality
C.adaptation and acceptance: look for feature of depression ( usually in 6 weeks to 6 months )

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