Losing a child can be the worst trauma a person can experience. While this is not a very common experience in the United States (an estimated 10,000 children between the ages of 1 and 14 died in 2018), the frightening potential of losing a child is great. And while reassuring, the numbers also make clear why the death of a child brings so much suffering and why it is so feared, painful and stigmatized.
"The death of a child is considered the worst stressor a person can go through," he saysDeborah Carr, Ph.D., Chair of the Department of Sociology at Boston University. “Fathers and mothers feel particularly responsible for the well-being of the child. So when you lose a child, you don't just lose someone you loved. They are also missing out on the years of promise they were hoping for.”
As parents mourn the loss of a child, they experience many thingsClassic grief reactions— the usual battery of psychological, biological, and social impacts — there are many unique challenges. The trauma is usually more intense, the memories and hopes are harder to give up. Therefore, the grieving process takes longer and the likelihood of recurring or near-constant trauma is much greater.
“The death of a child brings with it a diverse and ongoing set of challenges for individuals and families. Everyday questions like, “How many children do you have?” it can trigger intense distress,” he saysFiona MacCullum, Ph.D., Professor of Clinical Psychology at the University of Queensland, Australia. “Some people find ways to live with the loss. Others struggle to find meaning in life.
Biological implications: How the death of a child changes the body of the parents
im 2018,Frank Infurna, Ph.D.and colleaguesexamined general health and physical functioningof 461 parents who lost children older than 13 years. "We've seen some decline over time, followed by a general rebound or recovery," said Infurna, who studies resilience to major stressors at Arizona State University.paternal. Physical functioning focused on the ability to perform various daily tasks, and "we didn't see big changes in that," says Infurna. But when he examined bereaved parents' self-reports of whether they felt they were getting sick frequently or whether they expected their health to improve or worsen, he found poorer perceptions of health.
As with all major grief reactions, the trauma of losing a child can trigger physical symptoms, including abdominal pain, muscle spasms, headaches, and even irritable bowel syndrome.a handful of studiesfound weaker links between unresolved grief and immune disorders, cancer andlong-term genetic changesat the cellular level.
One surprising effect often seen in parents grieving the loss of a child is broken heart syndrome, a condition that eerily presents itself as a textbook heart attack. Symptoms include "chest contusion, pain, ST segment elevation on the electrocardiogram, and elevated cardiac enzyme markers on the lab results," says Fuller.citing his previous written work on the subject. "In response to emotional or physical stress, the body naturally releases catecholamines, also known as stress hormones, which temporarily paralyze the heart muscle."
Chronic stress can even impair brain function, as prolonged exposure to the stress hormone cortisol has been shownassociated with brain cell death. And in a cruel turn of neurobiology, theBrain regions responsible for processing grief, such as the posterior cingulate cortex, frontal cortex, and cerebellum, are also involved in the regulation of appetite and sleep. This could explain why bereaved parents develop eating and sleeping disorders after the loss.
"There are many, many studies that have looked at the ongoing health effects of high levels of chronic stress," he says.Gail Saltz, M, D,, Psychiatrist at NY Presbyterian Hospital Weill-Cornell School of Medicine. "And when you look at lists of stressful life events, this one is at the top."
Psychological consequences: How the trauma of child loss damages the psyche
The implications of this tragedy are not just biological. Oddly enough, however, very few studies have looked at the nightmare of a child's death. Most research on the psychological response to death focuses on the loss of a spouse or parent. Presumably, this is partly due to the difficulty in finding study subjects and also the potential difficulty in recruiting participants for some longitudinal study.
"Although there have been significant advances in our scientific understanding of grief, we still have a long way to go," says MacCullum.
This does not mean that we are without literature.A study from 2015Of 2,512 bereaved adults (many of whom were grieving the loss of a child) immediately after the tragedy, 68% of respondents found little or no evidence of depression. About 11% initially suffered from depression but got better; about 7% had depressive symptoms prior to the bereavement that persisted unabated. For 13% of the bereaved, chronic grief and clinical depression only began after their lives were turned upside down. (If these numbers seem low, remember that it's entirely possible to be deeply sad without becoming depressed.)
Unfortunately, research suggests that the psychological damage caused by the death of a child often does not heal over time.A study from 2008found that even 18 years after the loss of a child, bereaved parents "reported more depressive symptoms, worse well-being, more health problems, and more frequent depressive episodes and adultery." While some parents improved, "recovery after loss ... was not related to time since death."
"In the first year after losing a young child, parents have an increased risk of suicide and everything from deep depression to complicated grief," Saltz says. Complicated grief differs from expected normal grief in that "there are more intense symptoms alternating with seemingly no symptoms (a numbness) that may interfere with your ability to function."
"A parent who is suffering without serious complications such as suicidal thoughts or self-injurious behavior would be the best scenario," he says.dra Kirsten Fuller, Physician and Clinical Writer for Center of Discovery Treatment Centers. "The worst-case scenarios would be suicidality, psychosis, or developing a mental or eating disorder."
Predictors: How the child's age and other factors affect surviving parents
A handful of studies have attempted to identify the main factors that affect how well parents adjust after the loss of a child.A study from 2005found that child age, cause of death, and number of children remaining were strongly related to the level of parental grief, while depression was related to gender, religion, and whether the bereaved sought help. Subsequent studies have found other predictors of lower grief responses:a strong sense of purpose in lifeand hadthe chance to say goodbye.
"It depends on the psychological makeup of the parents, whether they have a history of mental illness, their coping skills, and their level of social support," says Saltz. External factors can also play a role. Suicide is often more difficult, but a terminal illness can be accompanied by recurrent trauma over a long period of time.
Saltz also suspects that gender may be part of the puzzle. "That will certainly change, but in the past mothers were the primary caregivers and it's more likely that their identity is involved in being a mother," she explains, adding that this could lead to stronger reactions from women who have children lose.
One of the most important predictors of trauma is the child's age.abortionsand stillbirth is devastating and is made worse by the fact that the loss is often eclipsed by the public perception that a fetus is not a fully developed child. But “is it as devastating as the death of a child who has lived many years? I don't want to downplay that experience, but I don't think so," says Carr.
However, when a child is born, the script changes. Older adults who outlive their children often have it easier than parents who lose their very young children. "The child's age is really important because it's a promise," says Carr. When a child dies, that promise dies with them: "Graduation, grandkids, marriages, that's lost too."
But older adults can also experience intense grief after the death of an adult child. "You can meet a 75-year-old who loses a 50-year-old kid and it's still heartbreaking," says Carr. “There is this belief in the natural order. A father must die first. Although age matters, older parents are still quite heartbroken. You're just missing out on that long-term promise."
Social Impact: How losing a child makes (or breaks) families.
Major life stressors naturally affect marriages. Butdivorceafter the death of a child is not inevitable. "It's very important to emphasize that the death of a child will not ruin a marriage," says Carr. “He usually aggravates a troubled marriage, and astrong marriageget better.” When it comes to illness or addiction, spouses who disagree about the best treatment are particularly at risk.”
There are also factors beyond the couple's control that can endanger or save the marriage. "Pain, trauma andDepressionthey impair the ability to participate in all meaningful relationships,” says Saltz. "But I've seen couples where the opposite was the case. They reach out, support each other. That's the only person who can really understand how you're feeling."
Mothers and fathers who lose a child often have to deal with surviving siblings as well. Figuring out how to be a parent after losing a child is a unique challenge. Again, experts agree that outcomes for both the surviving children and the parents are highly dependent on the state of the relationship prior to the trauma. Death can unite a family or tear it apart.
With terminally ill children there is a particular risk that other siblings may feel abandoned or overburdened with too much responsibility while the parents focus only on the suffering child. A sick child "constantly gets more attention because they need it," says Carr. "Sometimes other children's needs are not met, or they are treated like small adults, given more chores, or expected to provide emotional support for their children ." Parents".
“That can be really worrying for them. Or it can be empowering but difficult.”
Coping: How to seek comfort after the death of a child
After the death of a child, those left behind can experience depression, biological and neurological changes, and a destabilizing family and marriage. "If you're in this situation and your ability to function is impaired, you should seek treatment," Saltz says. “Parents who fall into deep depression will not be able to raise other children or marry. Psychotherapy can be helpful andmedicineYou can too, at least in the short term.”
The best friends and family of bereaved parents can do is be present, available, and supportive. If the griever talks about suicide, take them to the emergency room; If the situation is less serious but the pain doesn't go away over time, help him make an appointment with a professional or join a support group with other grieving parents. Because even the most sensitive souls are rarely able to help parents deal with a loss of this magnitude, and no matter how hard you try, you're unlikely to truly understand.
This is where the value of a support group really shines. "The one thing people who have lost a child hate to hear from others is, 'I know what you're going through,'" says Carr. "You can't know."
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