How to Cope with the Fear of a Loved One Dying

One memorable patient, whom I saw years ago while training at a cancer center, was a young entrepreneur, wife, and mother to three young kids. She was at the center because her husband had just been diagnosed with brain cancer.

I tried to consider how she must be feeling and couldn’t fathom how she continued to function so well. Don't get me wrong: She did worry about her family's future and her husband’s health. But we worked on finding meaning and balance in a way that honored her very reasonable fears while also allowing her to continue to live her life.

So, what did this brave woman do to put an end to her profound worries? How can we calm our own anxiety that a loved one will someday die? Or how do we cope if we know that day may be approaching sooner rather than later?

The two types of anxiety over a loved one's death

Let’s get concrete about this topic because spinning around in the “what ifs” can paralyze anyone with existential fear. To start, let’s be clear about an important distinction. There are two major types of anxiety about a loved one’s death:

1. When a loved one has a severe illness or is at high risk of dying, and you are anxious about their impending death.
2. When your loved ones are not particularly at risk for dying, but you can’t stop worrying about them dying anyway.

These two types of anxiety are very different and require different responses.

Scenario 1: Worrying when a loved one is at a higher-than-usual risk of dying

It’s one thing to understand that death is inevitable and that things may be out of your control, but it’s another to be at peace with that knowledge. Don’t expect yourself to be perfectly rational and poised when thinking about death. Allow yourself to feel anxiety and grief.

At the same time, make sure your natural anxiety and grief don’t turn into a state of paralysis or preoccupation. It may be time to take some steps if you find yourself:

• Unable to engage in proper self-care.
• Unable to manage the basics in life.
• So preoccupied with thoughts about your loved one's death that you can’t enjoy your time with them now.

Source: Imtmphoto/Shutterstock

Let's look at two things you can do to help yourself.

Climb down from the what-if tree. Whatever your loved one’s prognosis, the best way to make the most of your time together is to live in the moment. Slow down with the to-do lists, get rid of distractions, and most important, get down from the what-if tree.

The what-if tree has a sturdy trunk with strong roots at the bottom—that’s the present moment. It’s safe there; you feel grounded. As you climb the what-if tree, with each branching what-if scenario the branches get thinner and your footing gets shakier. This place poses more of a risk. At some point, it’s not useful to think that far ahead.

Of course, you may have practical matters at hand. Medical decisions and contingency plans need to be made. But keep these tasks only to the essentials. Set aside specific decision-making time rather than stewing on decisions whenever they enter your consciousness. Consider these decisions as tasks to do rather than a new anxiety-fueled way of living your mental life. Whenever it’s not your specified decision-making time, set those thoughts aside.

Don’t ignore conversations about death. We hate talking about dying. Sometimes, well-meaning family members shut down conversations about their loved one’s death. But denial and dismissal actually prevent your loved one from expressing their very real feelings, which likely makes them feel alone when they need closeness the most. They may be feeling afraid, sad, angry, accepting, or a range of emotions, and they need you to hear and understand this.

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A recent study asked palliative care nurses about the most common reflections they hear from the dying. They found that many dying patients want to recount their experiences and express their concerns. When we ignore conversations surrounding death, we prevent our loved ones from expressing their feelings at a profound moment in their life.

Scenario 2: Worrying about someone’s death when they’re unlikely to die

Have you ever worried about someone’s death so intensely that by the time they walked in the door and explained they were late because of car troubles you'd worked yourself into a panic?

It’s not “crazy” to be worried about a perfectly healthy partner or loved one. We may be more prone to this type of worry if we've experienced an unexpected loss in the past or if we're feeling particularly stressed, upset, or vulnerable.

Another common reason for preoccupation with a loved one’s unlikely death is generalized anxiety disorder (GAD). People with this disorder spend a lot of time worrying about bad things happening, to the point where it interferes with their day-to-day functions.

No matter the source of your worry, there are ways to lessen the hold it has on your life.

Understand that worry is your brain’s way of trying to feel safe and in control. Often, people with GAD believe, consciously or not, that worrying helps prevent bad things from happening. When we worry, we feel like we’re doing something proactive, which distracts us from our feelings of panic or helplessness.

But the idea that worry somehow helps or prevents tragedy is an illusion. Worrying can’t change the situation at hand.

We may also worry as a way of purposely keeping ourselves in a negative mental state. That way, if the worst really does happen, we're prepared for it. This is another illusion the brain cooks up for us. If our loved one dies unexpectedly, we'll be no less devastated if we’ve imagined their hypothetical death many times before.

Understand that there is a scientific reason for why your brain comes up with constant worries. You’re getting an illusion of control, which keeps you searching for more. Stay grounded by reminding yourself not to indulge in the act of worrying.

Understand that thoughts are just stories your brain tells you. Now that you know why your brain comes up with persistent worries, you can start to let them go. The key is to realize that thoughts are just stories.

Think to yourself, "I'm a blue giraffe." Now check a mirror. Did thinking "I'm a blue giraffe" make the thought true? Did thinking it somehow make the phrase meaningful or useful? I'm willing to bet you're not gazing at the reflection of a blue giraffe right now.

Now, think of the stories your brain tells you, like, "She's never late, so she must've gotten in an accident." It’s okay if these thoughts pop into your head sometimes—you can’t control that. It’s okay to sit with them to see if they’re meaningful. But consider whether you’re reading too much into them. Ask yourself, “Are these thoughts based on the facts I have right now … or are they just thoughts?”

Be patient and kind to yourself. All the strategies we talked about today are easier said than done. We must show ourselves patience and kindness. Remember that you're experiencing deep, existential anxiety.

One trick for figuring out how to be kind to yourself is to ask what we would do for a child who's worried his sibling is going to die. You wouldn’t tell him to “toughen up” or “just be logical.” You'd give him a hug, tell him you understand how scary his worries must feel, and then help him to understand what’s really happening. That might include reminding him that nightmares, like anxieties, are just stories the brain makes up.

When worries threaten to overwhelm you, treat yourself with the same kind of compassion.

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