Summer 2024 Issue

Mental Health: The Loneliness of Grief
By Sue Coyle, MSW
Social Work Today
Vol. 24 No. 3 P. 26

For a generation of adolescents already struggling with their mental health and a feeling of disconnect, grief may not only elicit feelings of loneliness but also push the individual from loneliness to isolation.

Grief is an inescapable reality of life, and while one may hope that it’s something most commonly dealt with by adults, the truth is that millions of children and adolescents struggle with grief each year. The Childhood Bereavement Estimate Model found that “In 2021, 1,192 children were newly bereaved each day in the United States,”1 losing either a parent or a sibling. More lose a grandparent, friend, or other loved one before they reach adulthood.

That’s only taking into account the grief that stems from death. Young people may experience grief as a result of their parents’ divorce, a move, an injury that ends their planned future, and many other events.

The impact of grief on a young person, particularly an adolescent, can lead to a variety of emotions and responses. One of those often-unavoidable feelings is loneliness. Loneliness is a common accompaniment to grief, but while normal, it can also lead to isolation.

Social workers looking to help teenagers as they cope with grief and the loneliness that comes with it must first understand where those young people are coming from and the complexities of what they are feeling.

Adolescents and Grief
Grief is complicated at any age, but for adolescents, it intersects with a time of significant physical and emotional development. “Adolescence is a unique, highly sensitive developmental stage initiated by puberty. During this time, the biological imperative is to detach from family and move closer to peers,” according to a 2021 study of adolescent grief during the COVID-19 pandemic. “In more individualistic cultures, a core developmental task of adolescence is to determine ‘who am I?’ Adolescents seek a coherent, integrated, and stable sense of themselves, separate from the identity imposed on them by family.”2

It’s a time when, even as emotions run high, teenagers try to prove they can handle the challenges they face on their own, asserting their independence as they attempt to solidify who they are and hope to be.

When a major loss occurs during adolescence, young people are tasked with continuing to navigate their transition from childhood to adulthood while also processing a new set of complex emotions. The grief they experience can slow, if not derail, the transition. Adolescents dealing with grief may be more likely to struggle academically, act out, and withdraw from previously beloved activities.

What an adolescent will not do is respond like the adults around them or as an adult expects them to. “The tendency to impose adult models on children has generally led to a great deal of confusion and misunderstanding about children’s grieving. Although sharing some similarities with adults and even with monkeys … children’s reactions to loss do not look exactly like adults’ reactions, either in their specific manifestations or in their duration.”3 While an adolescent may be nearing adulthood and thus share more of their reaction with an adult than a young child, they are still in a unique developmental age that influences the way they respond to grief.

What’s more, as the young person pulls away from their families—a natural part of development—they may be unsure about how to turn to their peers for support or may find a support system that’s equally unprepared to handle such emotions.

Loneliness and Isolation
One of those emotions is often loneliness, which is defined as the “state of distress or discomfort that results when one perceives a gap between one’s desires for social connections and actual experiences of it.”4 It’s not an uncommon feeling, particularly in adolescence. Studies of adolescents and loneliness have reported varying degrees and amounts of the emotion in those surveyed, but there’s no question that many young people experience loneliness at increasing rates. One national survey found that feelings of loneliness increased by 50% between 2012 and 2017 in adolescents. The COVID-19 pandemic is known to have increased teens’ loneliness as well.

Within grief, loneliness can stem from the actual loss of an individual or, if, for example, a young person has moved, from the loss of a social group and what’s known and comfortable to them. But it is more than that, as well. Grief is a unique experience, with no one individual having the same response as another, even as they suffer the same loss.

Grief often ebbs and flows over time, with individuals having periods of feeling better and periods in which it seems they may never feel better. Imagine being in one of your roughest times and seeing a person you thought was feeling the same, seemingly doing okay. Imagine being a teenager who lost one parent, seeing their surviving parent smile and laugh through a holiday in which the adolescent wants nothing but to cry.

Loneliness can exist as a result of any number of feelings and circumstances that accompany grief.

While a feeling of loneliness is normal during grief, it’s still something to be alert to and monitor in grieving adolescents. Young people who feel lonely and are grieving may withdraw from their families and their friends, turning away from what once brought them joy. Social isolation such as this can lead to depression and anxiety, as well as other mental health concerns.

Today’s Adolescents
Compounding the combination of grief and loneliness is the state in which so many teens will have been before the loss. The United States is and has been for several years experiencing a mental health crisis in young people. In 2021, the Surgeon General issued an advisory about youth mental health, noting that “Recent national surveys of young people have shown alarming increases in the prevalence of certain mental health challenges—in 2019, one in three high school students and half of female students reported persistent feelings of sadness or hopelessness, an overall increase of 40% from 2009.”5

Rates of depression, anxiety, and suicidal ideations in adolescents have all risen in recent years. For example, rates of anxiety in children and adolescents rose 27% between 2016 and 2019, and rates of depression rose by 24% in that same timeframe. The COVID-19 pandemic also attributed to a rise in depression and anxiety throughout the country, as reports of mental health concerns in young people rose at and after that time.

In addition, individuals of all ages, but particularly young people, report feeling more disconnected from their peers. If online, they’re confronted with polished and largely unreal images of perfection while connecting with their friends through and with these images. If not on social media, they feel isolated and out of the loop, unable to connect in the way that has become the most prevalent.

While not all adolescents are struggling with their mental health, and certainly not all who experience a loss will be struggling beforehand or during, this understanding of and data about young people, in general, is important for social workers to keep in mind when working with adolescents today.

Supporting Adolescents
Supporting young people through grief and loneliness is challenging. There have been approaches developed, though as a 2022 analysis of conversations about loneliness points out, “interventions were targeted, most often, at those considered to be at risk of loneliness, such as those with social skills deficits, as opposed to those identified as experiencing loneliness. Such foci highlight a misunderstanding about what adolescent loneliness is.”6

The most impactful interventions will be individual-specific, with social workers listening to the adolescents about their experiences and meeting them where they are in their grief and loneliness. Trying to force a young person into feeling better and, for example, returning to a social activity, as social workers know, does nothing to better the adolescent.

It’s also important that social workers watch for signs that adolescents’ experiences with grief and loneliness may be edging toward greater isolation or hinting at other mental health concerns. Grief can seem like the big picture—the reason for all that is wrong. But grief does not stop the rest of one’s life. It exists within it.

— Sue Coyle, MSW, is a freelance writer and social worker in the Philadelphia suburbs.

References
1. Childhood Bereavement Estimation Model. Judi’s House website. https://judishouse.org/research-tools/cbem/. Updated 2024.

2. Weinstock L, Dunda D, Harrington H, Nelson H. It’s complicated — adolescent grief in the time of Covid-19. Front Psychiatry. 2021;12:638940.

3. Bereavement during childhood and adolescence. In: Institute of Medicine (US) Committee for the Study of Health Consequences of the Stress of Bereavement; Osterweis M, Solomon F, Green M, eds. Bereavement: Reactions, Consequences and Care. Washington, D.C.: National Academies Press (US); 1984.

4. Loneliness. Psychology Today website. https://www.psychologytoday.com/us/basics/loneliness

5. The US Surgeon General. Protecting Youth Mental Health. https://www.hhs.gov/sites/default/files/surgeon-general-youth-mental-health-advisory.pdf. Published 2021.

6. Verity L. Yang K, Nowland R, Shankar A, Turnbull M, Qualter P. Loneliness from the adolescent perspective: a qualitative analysis of conversations about loneliness between adolescents and childline counselors [published online July 11, 2022]. J Adolesc Res. doi: 10.1177/07435584221111121