Grief is a profound form of mental anguish, and with this anguish can come a variety of stress-related symptoms. Here are some of the more common symptoms you’re liable to see among grieving children:
- Sleep disturbances
- Changes in appetite
- Trouble concentrating
- Moodiness or irritability
- Excessive clinginess or separation anxiety
- Developmental regression
- Behavioral problems
- Social withdrawal
Children can display a variety of reactions to the loss of a loved one, and each child has their own unique methods of coping and grieving over the loss. Children may experience a variety of emotional reactions, such as sadness, fear, irritability, emotional withdrawal, or anger. They may appear to be in shock; show a change in crying, eating, sleeping or play patterns; and may also show a slowing or visible change in their development. (Papenbrock & Voss, 1995) Regression is quite common among children following the loss of a parent. A child who was potty-trained before the death may regress back to having regular accidents, or one who was pushing for their independence may regress back to a dependent state where they want to be babied.
Children generally show clear increases in crying and moodiness, irritability, sadness, depressive symptoms, and general dysphoria. They may experience psychosomatic complaints and other physical problems, such as stomach pain, bowel disturbances, enuresis (bed wetting), headaches, fatigue, eating and sleeping difficulties, nausea, or other ailments. They may endure panic attacks or suffer shortness of breath. (Emswiler & Emswiler, 2000) It’s common for children to show both separation anxiety and oppositional behavior. Learning impediments or problems in school are another common occurrence, as children struggle with the loss and are preoccupied with thoughts that make concentration nearly impossible. (Kaffman & Elizur, 1983; Van Eerdewegh et al., 1982; 1985; Silverman & Worden, 1992) They may display an increase or decrease in appetite, weight gain or weight loss, and weakness in general. (Worden, 1991) They may also exhibit decreased socialization or a general loss of passion for life.
Following the loss of a parent or loved one, children often become fearful and anxious about things such as who will take care of them (Shroeder & Gordon, 1991), where they are going to live (Combrich-Graham, 1989), and how they will survive in life. (Webb, 1993) Trust in the stability of love, support and comfort becomes disrupted. (Marrone, 1997) They may become fearful that those they love will be ripped away at any given moment. (Worden, 1996) As such, excessive clinginess to either the surviving parent or another preferred individual is common.
A study of preschoolers found that boys were more likely to report emotions such as anger and fear or to display behavioral problems while dealing with grief. These are known as externalizing problems, in that a child is expressing their anguish by projecting this pain outward against others. Girls, on the other hand, were at significantly greater risk of internalizing problems, such as depression and anxiety. (Kanzler et al., 1990)
This is a common pattern seen among children of all ages following any type of stressful experience. This pattern won’t hold true for every child (it’s usually around a 60/40 or 70/30 split among the genders when it comes to internalizing versus externalizing), but as a general rule, boys are more likely to lash out whereas girls are more likely to suffer internally.
How long do grief symptoms last in children?
A study of children in Israel who had lost fathers in the war showed clear increases in crying and moodiness, separation anxiety, somatic problems, oppositional behavior, and learning problems. Although obvious grief manifestations diminished during the first 2 years, behavioral problems persisted throughout the follow-up period, with about half of the children exhibiting “severe and maladaptive behavior” at each stage of the study. (Kaffman & Elizar, 1983)
Another study measured the welfare of bereaved children through parent interviews. They found that the proportion of children said by their parent to be exhibiting symptoms of acute grief (sadness, crying, etc.) declined across the two interview periods, from approximately half at the one-month point following the loss to around a quarter at the 13-month interview. Yet relying solely on parent reports for certain measures may have led to an overly optimistic view. Although the percentage of children reported by their parent to be experiencing sadness or crying did indeed diminish substantially over the 12 months between interviews, the frequency of other symptoms – depressive, somatic, and aggressive – generally remained stable or even increased. (Van Eerdewegh et al., 1982; 1985)
Silverman & Worden (1992) interviewed children and their surviving parents 4 months after parental death. The children reported that they were confused and unsure about how to respond in the days following the death, even when the loss had been expected. Most (91%) cried at some point during the day of the death. Some sought out friends or family members for support, while others chose to be alone. Ninety-five percent attended their parent’s funeral. By the time of the interview at 4 months, most of the acute grieving responses on the part of the children (such as prolonged crying, withdrawal, etc.) had substantially diminished, and they seemed to be doing reasonably well in both school and social relations. The most common somatic difficulties described by the children were headaches (74%) and sleep problems (30%). Seventy-nine percent reported still thinking about the lost parent at least several times per week.
The researchers also emphasized the profound impact that the loss had on the childrens’ way of life, pointing to shifts in roles of the surviving family members, as well as the children’s attempts to maintain a connection to the deceased in order to soften the transition into their new reality. Seventeen percent displayed significant problems at the 4 month mark after the death. Follow-up interviews conducted at 1- and 2-year anniversaries revealed a less optimistic view of the children’s adjustment, showing ongoing struggles on the part of both children and surviving parents to adapt to the loss. (Worden, 1996) At the two year interview, kids were more likely to fall below control groups on self-reported measures of social functioning. Many described feeling different from everyone else and poorly understood by their peers.
All of these studies point to a general pattern, one in which the symptoms of acute grief diminish as time passes, but which are often replaced by more persistent problems or disturbances in a child’s life that may last well into the future. Many of these problems can be attributed to ongoing detriments in a child’s environment that were created by the loss. In our focus on healing, we want to allow the acute grieving process to take its course while working to prevent these deeper problems, which are generally created by unresolved hurt or developmental needs left unfulfilled following the loss.