The death of a loved one is one of life's most stressful events, a loss that's magnified during the holiday season.
"You sit around the Thanksgiving table and you think about who's around the table and you think about who's not around the table," said the Rev. Jay Turner, director of pastoral care at Central Maine Medical Center in Lewiston.
Turner himself first faced loss when he was 11 years old and his best friend died of cancer. When Turner was 12, his father had a heart attack so severe that he was confined to the hospital for three months and nearly died.
The grief "led me to do some deep thinking and have lots of questions that I suspect on some levels I'm still exploring," he said. "At 11 years old, knowing that our lives could end is not a typical 11-year-old thought. But all of us have to deal with that reality, inevitably, at some point."
And everyone copes with it differently.
Dennis Sicotte, bereavement coordinator for Androscoggin Home Care and Hospice, knows of grief-stricken people who have sprinkled their loved one's ashes into vials to wear as necklaces. He's met people who have had their wedding bands reshaped into hearts and turned into necklaces after losing spouses. Others have tattooed footprints of beloved babies on their chests.
"Each one of us grieves in our own way and in our own time," Sicotte said. "The only way to get through it is to go through it."
He knows from experience.
Sicotte lost his 39-year-old son to suicide two years ago. To help cope, Sicotte's family had his son's thumbprint turned into jewelry. Sicotte keeps his pendant in a clear pocket in his wallet.
"So every time I open it, I see it, and every time I see it, I think it. It's there all the time," he said. "It's not that if I didn't have that I wouldn't remember, because you do. You don't ever, ever, ever forget your loved ones. But having those reminders just makes it a little ... I just like having that comfort of having that close to me."
Elyse Pratt-Ronco lost her best friend and University of Maine at Farmington roommate more than a decade ago. The young woman had a heart condition and died in her sleep in their apartment.
"I was completely blindsided," Pratt-Ronco said.
More than a decade later, the loss still hurts. It's partly why Pratt-Ronco, now assistant director of Upward Bound for UMF, started a grief support group in January 2012 to help UMF students coping with loss. She knows the kind of struggles they face.
"It was a long time that I walked around with it," she said. "I experienced that same thing that my students in my group are thinking. Just, like, how do you lead with this? This is the most important part of who you are at this moment, and you meet someone and you just want to blurt it out. You want to say, 'My heart is broken and my life is a mess,' and yet you don't want to put that on someone."
The weekly, hourlong support group gives university students a place to say those things. Pratt-Ronco provides the same opportunity to children and teenagers with a support group in Wilton through Androscoggin Home Care and Hospice.
Julie Libby helps lead a bereavement support group in Farmington, too, this one for adults. Libby lost three family members within months, including her mother and grandmother.
The group has helped her cope, but so has a newfound spirituality. Her belief in an afterlife was sparked by what she determined to be a sign from her mother. Since then, Libby has researched the issue of life after death and she's come to a conclusion.
"I wasn't convinced that there is more, but now I am," she said. "It's there. It's real."
Experts say there is no "normal" when it comes to dealing with grief. Some people turn spiritual while others turn away from their faith. Some can't stand to look at their loved one's belongings while other people can't bear the thought of letting them go. Some need to talk about the loss, while others can't speak of it.
A person's gender doesn't really matter.
"Sometimes support groups work far better for women, although I've been in some pretty chatty prostate support groups," Turner said.
Time doesn't matter, either. The second year after a death can be more difficult than the first. A milestone a decade later can bring up grief all over again.
"It comes and it goes," said Sister Suzanne Beaudoin, director of pastoral care and grief support group leader at St. Mary's Regional Medical Center in Lewiston.
"You can be feeling OK and all of a sudden you hear a song on the radio that was a song that you sang or played or enjoyed together with your spouse and it makes you start crying," Beaudoin said.
Experts say there's one thing everyone must do: Deal with the loss. Somehow. In some way. Because ignoring it makes it worse in the long run.
When people come to Beaudoin's support group crushed, in shock and exhausted, she tells them their grief will get better. But she also acknowledges that life won't be the same as it was before.
"We grieve because we've loved," she said. "Is it better not to have loved and so you don't grieve? Of course, they say no."
If you're dealing with grief, experts say:
* Don't try to avoid the grief. It always finds a way through. Accept your emotions and express your feelings.
* Make sure you eat, drink and sleep. Be patient with yourself.
* Feel free to change holiday traditions and rituals if you want to, and know that you can always go back to them. Just because you can't bring yourself to put up a Christmas tree this year, for example, that doesn't mean you'll never put up a tree ever again.
* Avoid making big, hasty decisions in the months after losing a loved one.
* Find someone with whom you can vent, cry and generally be honest and personal about your grief. That could be a friend, a family member, a support group, clergy member or a counselor. It may not be best to seek all your support from someone dealing with the same loss; they're struggling with their own grief.
* Know that crying is not a sign of weakness for anyone of any age. And not crying isn't a sign of not caring.
* Know that you aren't crazy. You may reach for the phone to call your loved one, forgetting that they've died. A song might spark a memory and suddenly make you sob years after you thought you'd dealt with your grief. You may feel physically sick for weeks or may be numb to any emotion for a while. Everyone reacts differently to loss and it's all normal.
* Know that a new loss can bring up the pain and issues from past losses.
* Know that grief doesn't end in a year. And those famous five stages of grief? They're not like stairs that you climb and then you're done. Grief lasts a lifetime, and anguish, anger, depression and other emotions can pop up even when you think you're over them, particularly at holidays and milestone events.
* Recognize that you may need professional help to deal with your grief, particularly if you need alcohol or drugs to cope, if you're thinking about suicide, if you haven't been able to function for an extended period of time or if your rage, guilt, bitterness or other reactions are so extreme that they scare you.
If you know someone dealing with grief, experts say:
* Don't say things like "It was God's will," "She's in a better place now," "You can always have other children" or "I know what you're going through." Platitudes aren't comforting, even if you mean them to be. A simple "I'm sorry" is usually the best thing you can say.
* Don't try to fix their sadness. You can't. Just be there and listen.
* Don't just ask them to call if they need something. That's too open-ended and requires someone who's grief-stricken to recognize what they need and ask for it. That can be too overwhelming. Instead, be proactive. Tell them what you're going to do to help, then do it. For example, "I'm going to bring dinner over for you tomorrow night."
* Be honest with children when someone dies. Tell them the person died, explain what it means to die and, in an age-appropriate way, tell them how the person died. Young children need repetition and may ask the same questions over and over. Older children are interested in the mechanics of death. Teenagers are likely to feel isolated in their grief.
For help dealing with loss and grief:
* Visit Androscoggin Home Care and Hospice at www.ahch.org/OurServices/BereavementSupport.aspx or its resource list at www.ahch.org/Portals/0/Grief%20and%20Bereavement%20Resources.pdf
* Visit the Center for Grieving Children at www.cgcmaine.org
* Call 211 or visit www.211maine.org to find a support group
* Call your local church, funeral home, hospital or hospice center and ask about resources and support groups in your area.