Berlina Arreola continues to visit an impromptu shrine of a tragedy that struck her family personally.

A gunman shot and killed her granddaughter, Amerie Jo Garza, 18 other Robb Elementary School students, and two teachers on May 24 in Uvalde, Texas.

"It's getting harder and harder as the days go by missing our loved ones," Arreola said. "I mean, I miss Amerie dearly."

The road ahead is still tough for families.

Jessie Rodriguez's daughter, Annabell, was another victim.

"The last time I talked to her, I was waiting for a big job to come in so I could pick her up and go shopping, you know," Rodriguez said. "She took my phone and said, 'Let's do a selfie daddy.'"

Rodriguez, who is self-employed, finds it hard to motivate himself to get back to work.

"It kills me every day, you know?" Rodriguez said. "I mean, I'm not the man I was, just not the same."

Victims' families have needs, whether they be emotional, medical, or financial.

State Sen. Roland Gutierrez says strangers have opened their pocketbooks to Uvalde, donating nearly $14 million to date.

"We saw already there are initial efforts, but we want to be able to get an idea of when families are going to get disbursements," Sen. Gutierrez said. "I'm bringing in some folks that are going to advocate for them to maximize those funds as best we can."

He said he's learned lessons from past relief efforts after mass shootings, like the Sutherland Springs church attack in 2017.

"I hope that we can get these organizations, these funds, that have been collected, people that are running these organizations, to understand that we need to be able to do at least try to change the lives of these parents," Sen. Gutierrez said.

The tragedy struck an already vulnerable community. Census data says close to 25% of people in the county are uninsured. Much live pay check to pay check, and paying for medical bills for survivors is simply a bridge too far. That's where these funds fit in.

"In 2012 after the Aurora theater shooting, survivors of that event came to us at the National Center for Victims of Crime and said that they didn't like how their fund was being administered, and they asked us to set up a new fund for them," Jeff Dion, executive director of the National Compassion Fund, said.

The National Compassion Fund, or NCF, is a group founded after a gunman murdered 12 and injured 70 in the Aurora, Colorado theater shooting almost 10 years ago.

One of those victims was Micayla Medek. When donations did not reach families in need, her cousin was moved to action.

"The first $200,000 went to 10 area nonprofits, and we found out that they were a victim relief fund; [it] was not actually going to go directly to the victims," Anita Busch with Victims First said. "We had kids with brain injuries and no insurance, and we have 12 people to bury."

Busch works alongside the NCF. The foundation says its role is to make sure victims and survivors get direct assistance from every dollar donated.

"But nobody really is planning for donation management, and we know that this happens just about every time," Dion said.

The foundation has overseen collection efforts for 23 mass casualty events and helped disburse more than $100 million.

"So we had to get up off our knees in grief and fight so that the donations would actually get to the victims," Busch said.

These echos the sentiment Arreola has — that there is no price tag on bringing back loved ones.

"The bills don't stop... for a broken, unfortunately," Arreola said.

Newsy is the nation’s only free 24/7 national news network. You can find Newsy using your TV’s digital antenna or stream for free. See all the ways you can watch Newsy here.

The last 12 months were some I would rather not repeat, filled with layers of loss and heartache. I can say with certainty 2022 wasn't exactly a banner year for me and maybe it wasn't for you either.

In May, we said goodbye to my dad after he lost a two-year battle with ALS. For anyone who has lost a parent, you can understand the complex range of emotions that come with losing someone like that. My dad was a great guy.

Losses continued.

In August, my partner and I said goodbye to our horse, Mia.

I thought that was it.

But 2022 offered one final sad blow a few weeks back, when we had to say goodbye to our beloved dog, Cooper, a 12-year-old yellow lab with a heart of gold.

I write all this not in search of sympathy.

When we think about loss and grief, death is usually the first thing that comes to our minds. But as so many of us learned during the pandemic, there are plenty of other experiences and things in life we grieve the loss of outside of death.

"Grief is our natural response to loss there are so many things we lose that are not just through death of someone," said Litsa Willians, a licensed clinical social worker and co-founder of a website called What’s Your Grief?.

The website was launched in 2014, long before the pandemic, when online mental health services weren't widely available. Williams and co-founder Eleanor Haley realized most of us only really dealt with grief in traditional settings like cemeteries or funeral homes.

"We really didn’t do a good job as a culture of creating a space for people to know how to be present with losses," Haley said.

So, what are other types of losses we grieve? The loss of friendships is one—it's a loss Williams and Haley have seen more of lately.

"In recent years, we’ve seen friends and families divided over politics and other issues where there have been real estrangements. People are grieving that loss, but also that belief we are able to understand other people in the world," Williams said.

Changes in careers, job loss or retirement also can become a source of grief.

"People look forward to retirement, and then suddenly, they realize there is this huge loss that’s been left where their job once was. There’s a tremendous grief that comes with that," she added.

It’s also possible to grieve the loss of something we don’t have—a future we imagined for ourselves.

"If I always believed I would have children and I’m battling with infertility, I never had that life and it’s a huge loss to say goodbye to that future," Williams explained.

These two women are trying to give all of that grief a platform. On their website are non-traditional avenues for Americans nationwide to express their grief, like expressing grief in six words or expressing grief in a recipe.

The hope is to give people a space to explore mental health options outside of a traditional therapy session.

"People want to do things. They’re less interested in talking about their emotions; they want something to do."

As people enter into a second holiday season in the COVID-19 pandemic, so many are dealing with the loss of a loved one.

Dr. Ruth Benca, a psychiatrist with Atrium Health Wake Forest Baptist in North Carolina, said she's seen significantly higher rates of depression, anxiety, stress-related illnesses and trouble sleeping over the course of the pandemic. Now, she and other mental health professionals are anticipating the holidays will only add to those issues.

"There are probably many layers of guilt, particularly with these losses," Benca said. "They think, 'I shouldn't be having a happy time right now because I'm here.' That's survivor's guilt. So I think it's really important to face that, but not do that to yourself. Not beat yourself up. It's important to be accepting of yourself and also be accepting about what you do feel able to do or not over the holidays."

Benca said self-checks and self-care are critically important over these next few weeks. She recommends prioritizing sleep and taking time for yourself to work out or just get outside to absorb some sunshine.

The doctor also said, when checking in with friends and family, to attempt some kind of face-to-face contact. She said phone calls are helpful, but the most effective way to connect would be over FaceTime or in-person.

The holidays also bring up a lot of traditions with loved ones. For many, COVID-19 meant the sudden loss of that person you had a tradition with or the inability to visit them. Benca said you have two options: either continue doing those traditions in honor and memory of them OR find a new tradition that will bring you joy. She reminds patients they can always come back to those previous traditions in a few years when they feel more manageable.

Benca said if the feelings are overwhelming to a point of a crisis, to see professional help. You can also always call the National Helpline at 1-800-273-8255.