GRIEF

What is grief?

Grief is your emotional reaction to a significant loss. The words sorrow and heartache are
often used to describe feelings of grief. Whether you lose a beloved person, animal,
place, or object, or a valued way of life (such as your job, marriage, or good health),
some level of grief will naturally follow.
Anticipatory grief is grief that strikes in advance of an impending loss. You may feel
anticipatory grief for a loved one who is sick and dying. Similarly, both children and
adults often feel the pain of losses brought on by an upcoming move or divorce. This
anticipatory grief helps us prepare for such losses.
What is grieving?

Grieving is the process of emotional and life adjustment you go through after a loss.
Grieving after a loved one's death is also known as bereavement.
Grieving is a personal experience. Depending on who you are and the nature of your
loss, your process of grieving will be different from another person's experience. There is
no "normal and expected" period of time for grieving. Some people adjust to a new life
within several weeks or months. Others take a year or more, particularly when their daily
life has been radically changed or their loss was traumatic and unexpected.
What are common symptoms of grief and grieving?

A wide range of feelings and symptoms are common during grieving. While you are
feeling shock, numbness, sadness, anger, guilt, anxiety, or fear, you may also find
moments of relief, peace, or happiness. And although grieving is not simply sadness,
"the blues," or depression, you may become depressed or overly anxious during the
grieving process.
The stress of grief and grieving can take a physical toll on your body. Sleeplessness is
common, as is a weakened immune system over time. If you have a chronic illness,
grieving can make your condition worse.
How is grieving treated?

Social support, good self-care, and the passage of time are usually the best medicine for
grieving. But if you find that your grief is making it difficult to function for more than a
week or two, contact a grief counselor or bereavement support group for help.
If you have trouble functioning for longer than a couple of weeks because of depression
or anxiety, talk to your doctor. Treatment with medicines or counseling can help speed
your recovery.

FAINTING
Fainting, which medical professionals call syncope (pronounced SIN-ko-pea), is a temporary loss of
consciousness. Fainting is caused by a temporary loss of the brain's blood supply and can be a sign
of a more serious condition.
People of any age can faint, but elderly persons may have a serious underlying cause.

Fainting accounts for a small portion of emergency department visits and 6% of hospital admissions.

The most common causes of fainting are vasovagal (a sudden drop in heart rate and blood pressure) and
cardiac conditions. In a large number of cases of fainting the cause is unknown

CAUSES
Fainting (syncope) has many different causes:

Vasovagal syncope: Also known as the "common faint," this is the most frequent cause of syncope.
It results from an abnormal circulatory reflex. The heart pumps more forcefully and the blood vessels
relax, but the heart rate does not compensate fast enough to maintain blood flow to the brain. People
older than 45 years of age rarely experience a first "common faint." Causes of vasovagal syncope
include the following:

Environmental factors: Most commonly in a hot, crowded setting

Emotional factors: Stress or the sight or threat of injury

Physical factors: Standing too long

Illness: Fatigue, dehydration, or other illnesses

Situational syncope: This is a type of vasovagal syncope that only occurs in particular situations.
Causes of situational syncope include the following:

Cough syncope occurs in some people when coughing forcefully.

Swallow syncope occurs upon swallowing in some people with disease in the throat or esophagus.

Micturition syncope occurs when a susceptible person empties an overfilled bladder.

Carotid sinus hypersensitivity occurs in some people when turning the neck, shaving, or wearing a tight collar.

Postprandial fainting can occur in elderly people when their blood pressure falls about an hour after eating.

Postural syncope: This occurs when a person lying down, who feels perfectly well and alert,
suddenly faints upon standing up. The brain's blood flow decreases when the person stands due to a
temporary drop in blood pressure. This sometimes occurs in people who have recently started or
changed certain cardiovascular medications. This type of fainting results from either or both of the
following causes:

Low circulating blood volume, caused by blood loss (external or internal), dehydration, or heat exhaustion
Impaired circulatory reflexes, caused by many medications, disorders of the nervous system, or congenital
problems

Cardiac syncope: Heart disease causes a person to faint by a variety of mechanisms. Cardiac
causes of fainting are generally life-threatening and include the following:

Cardiac rhythm abnormality (arrhythmia): Electrical problems of the heart impair its pumping ability. This
causes a decrease in blood flow. The heart rate may be either too fast or too slow to pump blood well. This condition
usually causes fainting without any warning symptoms.

Cardiac obstruction: Blood flow can be obstructed within the blood vessels in the chest. Cardiac obstruction
can cause fainting during physical exertion. A variety of diseases cause obstruction, including heart attacks, diseased
heart valves, pulmonary embolism,cardiomyopathy, pulmonary hypertension, cardiac tamponade, and aortic
dissection.

Heart failure: The heart's pumping ability is impaired. This lowers the force with which blood circulates through
the body and may decrease blood flow in the brain.

Neurologic syncope: This syncope can be due to a neurologic condition or event listed below.

Stroke (bleeding in the brain) can cause syncope associated withheadache.

Transient ischemic attack (TIA or mini-stroke) can cause fainting, usually preceded by double vision, loss of
balance, slurred speech, orvertigo (a spinning sensation).
Migraines can cause fainting on rare occasions.

Psychogenic syncope: Hyperventilation from an anxiety disorder can cause fainting. Rarely, people
pretend to faint to minimize stress or for some recognized gain. The diagnosis of psychogenic
syncope should only be considered after all other causes have been excluded