The complexity of grief and dealing with the death of a loved one during Covid-19 lockdowns.

The coronavirus pandemic has completely altered our daily lives including the lives of those grieving the loss of a loved one. With social distancing and lockdown in place, the latter are "twice bereaved" says Ali Madeeh Hashmi, Associate Professor of Psychiatry at the Lahore-based King Edward Medical University (KEMU).

"We are telling them they cannot gather together, cannot console each other, except perhaps over Zoom or Skype, cannot hug or sit together and do all of those things that lessen their pain. They have lost a loved one but are forbidden from gathering and consoling each other," he says.

For Sarah*, the lockdown has come as a godsend as she comes to grips with the sudden passing away of her 65-year-old mother, earlier this month. "I and my brother don't have to face scores of people coming to comfort us," says Sarah, adding that she cannot deal with the 'how did she die' question. "Responding to the same question over and over again would have taken a toll on me emotionally," she says.

"It's not that they don't mean well, but I am still coming to terms with the reality of her not being there," says the 39-year old HR professional. For her and her brother who is three years younger than her, it's like reliving the pain as 10 years ago their father had passed away in exactly the same, sudden manner - dying in his sleep. Neither parents had any underlying health conditions. Both times it was her brother who was the first to find the parent to be no more.

Clinical psychologist, Dr Asha Bedar, points out that the healing process for grieving individuals and families may have been disrupted by the circumstances and the absence of an "external support system" that involves "meeting people, talking about the deceased, turning to friends and family to cry with, receiving practical support such as help with arrangements, meals, and legal requirements".

"The exercise of mourning for the death of a loved one gives comfort and helps in processing the grief," agrees Dr Ayesha Mian, Associate Professor at the Aga Khan University Hospital. "Cultural rituals, norms, the human touch, the last words, the idea that you were there to comfort them and bid them goodbye are all ways to soldier through the grief that is to come," she adds.

"Guilt, non-closure, helplessness due to the inability to tell the deceased how much they were loved is a complicated bereavement and can occasionally lead to a depressive episode," says Dr Mian, adding: "People are feeling that now. I have had calls and communications from patients and others about their anxieties around their elderly loved ones; the stories of people dying alone that are coming from our physician friends and colleagues in the US and UK, away from loved ones, and the sheer helplessness to do anything about it is heartbreaking."

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