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When there has been a conflicted parent-child relationship or a child exhibited difficult behavioral issues, guilt can be particularly profound. Guilt may occur when parents feel some sense of relief that the conflict or behavioral issue no longer must be worried about. Guilt can even emerge when older children have moved away from home, often times causing communication to falter as the child moves into a new stage in life with new friends and, possibly, even a new family.

Even knowing that the causes for any feelings of guilt are irrational or not based on reality does not make the feelings any less intense.

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Guilt feelings are difficult to share. However, it is helpful for grieving parents to find someone with whom they can share these feelings, especially if the guilt feelings are intense and prolonged. Bereaved parents also should try to learn to forgive themselves so they are not haunted by the guilt. Guilt and regret are common emotions of grief.

Anger is another common reaction. Parents may feel angry toward the health care team for not saving their child or for poor communication that left the parent confused and unsupported. Although difficult to express when a child dies by suicide, parents may feel anger toward the child for not sharing their emotional state, for not seeking help, or for they themselves believing they should have seen signs.

Some may feel anger towards friends who have children and the friends having the good fortune to be able to watch them grow older and reach particular milestones such as graduation or marriage. A mother who has a miscarriage, stillbirth, or whose infant dies of a birth defect or acute illness can feel anger towards friends or relatives who continued risky behavior during pregnancy, such as smoking or drinking, and still gave birth to a normal infant.

Couples who experience a miscarriage may experience their grief all alone, as few people may have known of the pregnancy loss. You can have another baby. Even though things said may be insensitive and even hurtful, they are not said to try and inflict additional hurt but rather to try and console. It is just that unless you have lost a child yourself, you have no idea that these phrases are hurtful rather than helpful.

One of the most devastating comments said to me was actually a question. Many bereaved parents have directed their anger in positive ways, by working to change laws, build foundations, raise money, fund scholarships, and other avenues serving as a catalyst for positive change.

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Death of a child may shatter parental beliefs and assumptions about the world and cause stress. Initially, I did not want to leave the house. I did not feel safe in the outside world as I feared something else terrible would happen. I then did not feel comfortable staying at home so near the pool where Tony drowned. Some parents have questions about religious beliefs. Sometimes this causes anger toward God or a higher spiritual being.

This can be confusing, difficult to accept, and a source of guilt or anxiety. Yet, questions and confusion about spirituality and life in general is a common and normal response. With support and time, the resulting feelings can usually be resolved. However, if anger toward God, confusion over religious beliefs, and loss of meaning persist, parents should try to share them with a trusted person, particularly an understanding clergy or member of your religious community. Feelings of anger can be difficult to deal with because the reasons for that anger may be hard to express and share because they are often not socially acceptable.

Anger that is not expressed may lead to a general feeling of irritability that is hard to understand and very hard to shake. A father may become grouchy at work or with surviving children. A mother may find herself shouting at her husband or at a friend. As with guilt, it is important to be able to talk about anger issues with someone who cares and understands.

Parents have reported finding relief from their anger by such behavioral responses as throwing eggs at a tree or finding a private place to scream. When I returned to work, I already knew I had a much, much shorter temper than I had previously. Knowing this, I warned by co-workers and employees. I told them that I was angry and short tempered but it was not against them personally. I then asked them to help me know when I became this way. Fear or generalized anxiety could be a manifestation of grief. This sometimes stems from a deep concern that something else terrible and devastating is going to happen.

It leaves one feeling even more vulnerable. Fear can be particularly intense when a child has died suddenly, tragically, or unexpectedly as in SIDS, a vehicular accident, homicide, or suicide. Fear can lead to lingering doubts about the safety of other children, a spouse, or, in the case of a subsequent pregnancy, the next baby.

If such fear persists, parent can become overprotective towards children, interfering with their children forming external relationships and their social development.

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Facing feelings of fear can be helped by journaling or sharing these feelings with others. I did not journal everyday but I did journal from time to time. I found it very helpful to write down what I was feeling. This not only helped me in the moment, but also helped when I picked up the journal to write again. Often on this grief journey, we look ahead and think of what we are no longer able to do that we had previously been able to.

What I would forget is how far I had actually come in my journey.

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When looking at past writings, it reminded me of the success and improvement made rather than just looking ahead to what I still could not achieve. Many have reported feeling empty, dead inside, almost as if a part of them died, too. When my child died, a part of me died with him. For a long time, parents may find themselves preoccupied with thinking about their child and how they died.

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Some are haunted by the memory of the child at the time of death or during an acute illness. With a sudden violent death, parents may be haunted by visions of how the death happened or the last moments their child was alive, whether the parent was present or not. I wondered feverishly if he suffered or was aware that he was drowning.

I would go to sleep at night with this my last thoughts and awaken with it my first thoughts.

It was exhausting. After many months, I thought of his death less and more of his life. At times, it may feel as if your child is still around. When a child was chronically ill, parents may feel a deep void when their caregiving role has stopped. They may automatically get up at night to check on their child or to give a medication, only to be suddenly faced with the reality of the death all over again.

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It was very difficult for my oldest son who lived in another state. For him, he only saw Tony when he and his family would come home for a visit. On the other hand, as a way of coping with painful memories and the pain of grief, some may try to escape triggers of memories by avoiding places that evoke particular memories or by not talking about their child. It is impossible to completely escape these triggers.

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Parents will often encounter reminders of their child such as a favorite song or TV program. When parents see a child the same age, there may be an intense desire to hold and touch that child and, at the same time, a desire to run away to avoid being near the child. It is important to know that all of these feelings are normal, unless exaggerated or prolonged. Some ways of moving to this point in your grief journey is to include finding family and friends willing to share stories and memories, continuing special rituals on birthdays and anniversaries, making scrapbooks, and starting to journal.

Memorials to the child, such as a tree planting or creating a scholarship fund, have helped many parents. There will be periods of feeling blue and unhappy, preoccupation with sad thoughts, fatigue, and bouts of confusion. Most grieving people do have a period when they feel disorganized and find it difficult to concentrate on tasks or to keep up with work. If parents work outside of the home, they may find it difficult to manage the demands of their jobs.

Prolonged sadness and depression may lead to subtle bodily distress and physical symptoms. It is not unusual for a grieving parent to have difficulty sleeping, to have a diminished appetite, to become easily fatigued or to develop frequent headaches. Sexual interest may be greatly diminished or impotence may occur. Medical problems such as ulcers, allergies, or blood pressure elevations may appear.

In order to cope with the difficult emotional feelings and the nagging physical symptoms, some may turn to the use of drugs or alcohol to help shut out the pain.