A lot of loss has been experienced during the pandemic. A psychologist shares her best strategies for how to make it through. (For Spectrum Health Beat)

The U.S. is getting a harsh lesson in the mathematics of mourning.

There’s grief surrounding the hundreds of thousands American lives lost to the pandemic in 2020. Daily deaths from COVID-19 now routinely top 3,000, roughly equivalent to the 9/11 attacks happening every single day.

And COVID-19 hasn’t been the only killer in 2020. People have seen worsening outcomes this year from diabetes, Alzheimer’s, high blood pressure and heart disease, according to a The New York Times analysis.

It’s been a very different experience to mourn these deaths.

Many are unable to do some of the things that normally mark the death of loved ones. Restrictions make it difficult if not impossible to gather for funerals or huddle at gravesides. Even dropping off a casserole could prove challenging.

Hugs have been off-limits. Hospital visitations have often been restricted.

“This has been a very difficult time to process loss,” said Allyn Richards, PhD, a psychologist at Spectrum Health.

Some have deferred memorial services, hoping to honor their loved ones when restrictions ease.

But while that’s made sense for many families, it’s important not to delay the grieving process, Dr. Richards said.

“Even without formal ceremonies, people need to give themselves permission to feel all the feelings that come with loss—whether that’s sorrow, grief, numbness or even anger,” she said.

Name that feeling

The most important first step? Recognize that grief, painful as it is, is 100% necessary, Dr. Richards said.

“Burying feelings doesn’t lead to them going away and it may only prolong the intensity of grief over the long-term,” she said.

It’s often helpful to name and claim the different feelings, whether by saying them out loud or journaling about them, she said. Some may own their feelings through various forms of artistic expression, such as poetry, art or dancing.

Even listening to music can help the feelings flow.

It’s healthier than keeping things bottled up.

Rice University researchers measured the cellular immune function of grieving spouses and found those who expressed emotions had stronger immune systems than those who kept a stiff upper lip.

It’s important to remember that no one gets over a death all at once and there’s no right way to mourn a loss, Dr. Richards said.

Don’t get wrapped up in outward signs of mourning. People who don’t cry when they lose loved ones, for example, sometimes worry it means they didn’t love that person.

Others cry so much they fret they’ll never stop.

Don’t lose sleep over this one, experts say. For some people, a good cry does make them feel better. For others, it makes them feel worse.

The point, Dr. Richards said, is that mourning is both unpredictable and personal.

“Grief may come in waves,” she said. “There may be relapses into periods of deeper grief, just as there may be periods of joy and happiness.”

4 practical steps to make it a little easier:

1. Maintain a daily routine

A consistent sleep and wake cycle, regular meals and daily walks are all important ways to maintain some sense of control. They also reduce the risk of subsequent depression and anxiety.

2. Lean on others

Seeking support before the pandemic might have meant visiting others. But amid COVID-19, people need to find other supportive connections, whether by phone, Zoom or virtual support groups. Learn more about connecting with these groups at Spectrum Health Bereavement Services.

The CDC also offers resources for those struggling with loss.

3. Adapt rituals

Even without wakes, funerals and other traditions, there are important ways to remember a loved one who has died, by honoring their accomplishments and sharing those connections with others.

Virtual celebrations of life, livestream graveside services and shared websites are all possibilities.

There are private rituals too.

“Try writing a letter or leave a voicemail for your loved one, letting them know what they meant to you and saying good-bye,” Dr. Richards said.

These rituals don’t cure grief, of course.

“But they do help process it and make it clear to you how much—and why—you valued this person and why the loss is so painful,” Dr. Richards said.

4. Seek professional support

Closure is a confusing word for many, especially since grief follows different timelines for different people, Dr. Richards said.

It’s important to notice if symptoms seem to get worse or intense over weeks or months, instead of less pronounced.

One concern? Some people may develop complicated grief, or prolonged grief disorder. Without help, they are at an increased risk for substance abuse, sleep disorders, impaired immune functioning and even suicidal thinking, according to the American Psychological Association.

“If grief is making it hard to function in your daily life or you don’t have other social connections available, consider speaking with a professional,” Dr. Richards said.