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As a society, we typically reserve the term grief for those who have lost a loved one. However, you may be surprised to know that you may be experiencing varying stages of grief at this time. The loss of a normal world or normal life suddenly disappearing has created numerous challenges. It may be uncomfortable to accept that we are grieving, however, David Kessler, an expert on grief, explained that “change is actually grief and grief is usually a change we didn’t want.”1

Five Six Stages of Grief

The classic five stages of grief by Elisabeth Kübler-Ross include denial, anger, bargaining, depression and acceptance.2 David Kessler recently created a sixth stage of grief after experiencing significant loss - meaning.1 These stages are tools that help identify what we may be feeling, but they are not completed in a linear timeline. Not everyone shares the same experience or progress in the same order.

  1. Denial. Denial is the first stage of grief. It is a common defense mechanism to give one time to process the loss. Denial and shock help us to cope and make survival possible. It is your body’s way of letting you only deal with what you can handle. As you accept the reality of the situation, you become stronger and the denial begins to fade.2
  2. Anger. According to David Kessler, anger is a necessary step of the healing process. Allow yourself to feel your anger, even if it may seem endless. The more you are willing to feel anger, the more it begins to dissipate allowing for more healing. Your anger may extend to friends, your family, yourself and even to God. Underneath anger is pain. Pain of feeling deserted and abandoned. If someone lashes out towards you, keep in mind that they may be going through this stage of grief.2
  3. Bargaining. During intense emotions of vulnerability and helplessness, it is common to try to find ways to regain control. In the bargaining stage of grief, you may find yourself creating a lot of “what if” and “if only” statements. We want life returned to what it was.2
  4. Depression. After bargaining, our attention moves squarely into the present. You may be able to embrace and work through your emotions or you may choose to isolate yourself from others in order to fully cope with loss. Depression may feel overwhelming. You may feel foggy, heavy, and confused. It may feel as though it will last forever. This type of depression is not a sign of mental illness. It is the appropriate response to a great loss. If grief is a process of healing, then depression is one of the many necessary steps along the way.2
It is important to state that the clinical depression is different from complicated grief. Symptoms of complicated grief include:
  • a powerful pain when you think of your lost loved one
  • heightened focus on reminders of your lost loved one
  • an overall feeling of numbness
  • a feeling of bitterness when you think about your loss
  • a loss of purpose or motivation
  • a loss of trust in friends, family, and acquaintances
  • an inability to enjoy life.3
Symptoms of clinical depression can be similar, however clinical depression can cause other unique symptoms, such as:
  • Constant sadness, anxiety, or feelings of emptiness
  • feelings of guilt or helplessness
  • loss of interest in hobbies
  • insomnia or oversleeping
  • physical aches that don’t go away with treatment
  • suicidal thoughts or suicide attempts.3

You can have symptoms of both grief and clinical depression at the same time. However, grief and clinical depression must be treated differently. Contact your primary care provider (PCP) if you believe you may be experiencing clinical depression. People with preexisting mental health conditions should continue their treatment and be aware of new or worsening symptoms. If you think someone is at immediate risk of self-harm or hurting another person, call 911. If you think someone is considering suicide, get help from a crisis or suicide prevention hotline such as the National Suicide Prevention Lifeline at 1-800-273-8255.

  1. Acceptance. Acceptance does not mean that one is “all right” or “OK” with what has happened. It doesn’t mean you have moved past the grief or loss. It does however mean that this new reality is the permanent reality. We will never like this reality, but eventually we accept it. Finding acceptance may be just having more good days than bad ones. Instead of denying our feelings, we listen to our needs; we move, we change, we grow, we evolve.2
  2. Meaning. David Kessler noted from his personal experience of grieving that finding meaning beyond the stages of grief can transform grief into a more peaceful and hopeful experience. Finding ways to honor the memory of a lost loved one or achieving a personal goal during this pandemic can bring healing.2

What You Can Do

Sadly, many people are losing their lives due to this pandemic. Your life may be touched by such a loss. The grief process is never easy to handle, but is very important in the maintenance of mental health. Should you lose a loved one, allow yourself to grieve. Here are just a few suggestions:

  • Give yourself the opportunity to talk to others about your loved one and your sadness.
  • Take time out of each day to feel your sadness. Cry, sit with your memories of the things you will miss.
  • Do something to honor your loved one.
  1. Draw a picture.
  2. Write a letter.
  3. Write a poem.
  4. Write a eulogy.
  5. Sing a song.
  6. Make a setlist and record it.

The Takeaway

The key to understanding grief is realizing that no one experiences the same thing. What we are experiencing is loss and are feeling the sadness. If we name it, we are allowing ourselves to feel the sadness.4 Suppressing the emotions is not healthy or healing. If grief is left unrecognized and shoved away, it can negatively affect “every aspect of our being – physically, cognitively, emotionally, spiritually.”5 Grief is very personal and does not come with a time limit. Life has changed dramatically in the last few weeks, of course this brings up many feelings including grief. Let yourself feel it, and then keep going.  

By: Sudin Thomas, MSN, FNP-BC



References (2020). COVID-19. (2020). The five stages of grief.

3Jewell, T. (2017). Complicated grief vs. Depression.

4 O’Neill, S. (2020, March 27). Coronavirus has upended our world. It’s OK to grieve. Kaiser Health News.

5Holland, K. (2018, September 25). What you should know about the stages of grief.

managing anxiety


Dear Stevenson family,

2020 has turned out to be much different than most (if not all) would have expected. As more information about Coronavirus unfolds, a wide range of thoughts, feelings, and reactions may appear. Below are some information and resources that we hope will be helpful.

Common Reactions

Everyone reacts differently to stressful situations. How you respond to the outbreak can depend on your background, the things that make you different form other people, and the community you live in.

· Fear and worry about your own health and the health of your loved ones

· Stress about leaving the house for essential reasons

· Changes in sleep or eating patterns

· Difficulty sleeping or concentrating

· Worsening of chronic health problems

· Increased use of alcohol, tobacco, or other drug1

Ways to Support Yourself

Taking care of yourself, your friends, and your family can help you cope with stress.

· Stay informed with accurate information from a reputable source by checking the dedicated CDC website.

· Take breaks from watching, reading, or listening to news stories, including social media. Hearing about the pandemic repeatedly can be upsetting.1

· Stay healthy. Adopt healthy hygienic habits such as washing your hands with soap and water or an alcohol-based hand sanitizer, frequently, and certainly after sneezing or before/after touching your face or a sick person.2 Remember that social distancing is not just for those who have an underlying medical condition or seniors.

· Take care of your body. Take deep breaths, stretch, or meditate. Eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs.1

· Practice mindful thankfulness. Daily journaling has been shown to improve your mental well-being.3 The Mayo Clinic Health System has created a four-week virtual program to discover gratitude that begins on March 30 to May 1st. Click here for the link.

· Connect with others. Talk with people you trust about your concerns and how you are feeling.1

· Call your healthcare provider if stress gets in the way of your daily activities for several days in a row.

· People with preexisting mental health conditions should continue with their treatment and be aware of new or worsening symptoms.

· Be mindful of your assumptions about others. Someone with a cough or a fever does not necessarily have coronavirus. Self-awareness is important in not stigmatizing others in our community.2

· Keep your expectations low and be kind to yourself. Not every day will be a good day. For example, if it is raining, dark and gloomy outside, your mood may be affected. If you find that you’re feeling down multiple days in a row regardless of the weather outside, then refer to your healthcare provider.

Click here for more self-care suggestions!

Stay Positive!


By: Sudin Thomas, MSN, FNP-BC



1 Center for Disease Control and Prevention. (2020). Stress and coping. Retrieved from

2 University Health Services Tang Center. (2020). Managing fears and anxiety around Coronavirus. Retrieved from

3 Mayo Clinic Health System. (2020). Discover gratitude. Retrieved from

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