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Kubler-Ross Stages of Grief

When you or someone you love is diagnosed with a Bipolar Disorder, people often go through the stages of grief. You may be grieving the loss of the life you had before Bipolar Disorder or the early mania that was so enjoyable. For families they may be grieving the loss of the loved one they once knew or the future they hoped for their family member. People will often move through the stages of grief in order, but may move to previous stages when they become overwhelmed. Below is a description of each of the stages of grieving.

1. Denial
• “Denial and shock help us to cope and make survival possible. Denial helps us to pace our feelings of grief.”
• “There is a grace in denial. It is nature’s way of letting in only as much as we can handle. These feelings are important; they are the psyche’s protective mechanisms. Letting in all the feelings associated with loss at once would be overwhelming emotionally. To fully believe at this stage would be too much.”

2. Anger
• Anger does not have to be logical or valid. You may be angry that you didn’t see this coming and when you did, nothing could stop it.
• Family member you may be angry at the person for getting sick.
• You may be angry at this unexpected, undeserved, and unwanted situation in which you find yourself.
• Anger is a necessary stage of the healing process.
• “You may have many subsequent visits with anger in its many forms. The truth is that anger has no limits. It can extend not only to your friends, the doctors, your family, yourself, ...but also to God.”

3. Bargaining
• The person is trying to prolong the process to avoid acceptance (1997).
• “Most bargains are made with God and are usually kept a secret or mentioned between the lines (p.95).”

4. Depression
• When the grieving person’s numbness and rage have subsided, the person will often feel a “sense of great loss (p. 97).” This is when depression sets in.
• The person is in the process of losing everything that they knew before and all of their hopes for the future.
• There are two types of depression that a person may experience;
i. preparatory depression
1. This involves going through a depression to deal with the reality of the change in their life. It is often a quiet depression.
ii. Reactive depression.
1. This is a reaction to all of the changes and stressors that have been caused by the illness. If a person goes through reactive depression it makes acceptance easier.

5. Acceptance
• As a person has time to process their loss, they express and work through their feelings at each stage of grief. They then reach the stage of acceptance.
• When a person reaches acceptance, it is not a happy stage, but rather a stage without feeling.
• “Acceptance is often confused with the notion of being all right or okay with what has happened. This is not the case. It is the new norm with which we must learn to live. This is where out final learning and adjustment can take a firm hold, despite the fact that healing often looks and feels like an unattainable state (P.24-25)”
• Acceptance is a process that we experience, not a final stage with an end point. We begin to live again, but we cannot do so until we have given grief its time. P.28

Further Reading:
Kubler-Ross, E. & Kessler, D., (1997). On Death and Dying. New York: Scribner, Simon & Schuster.

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