What is complicated grief?
Losing a loved one is one of the most distressing and, unfortunately, common experiences people face. Most people experiencing normal grief and bereavement have a period of sorrow, numbness, and even guilt and anger. Gradually these feelings ease, and it’s possible to accept loss and move forward.
For some people, feelings of loss are debilitating and don’t improve even after time passes. This is known as complicated grief, sometimes called persistent complex bereavement disorder. In complicated grief, painful emotions are so long lasting and severe that you have trouble accepting the loss and resuming your own life.
Different people follow different paths through the grieving experience. The order and timing of these phases may vary from person to person:
- Accepting the reality of your loss
- Allowing yourself to experience the pain of your loss
- Adjusting to a new reality in which the deceased is no longer present
- Having other relationships
These differences are normal. But if you’re unable to move through one or more of these stages after a considerable amount of time, you may have complicated grief. If so, seek treatment. It can help you come to terms with your loss and reclaim a sense of acceptance and peace.
How common is complicated grief?
Please discuss with your doctor for further information.
What are the symptoms of complicated grief?
The common symptoms of complicated grief are:
- Intense sorrow and pain at the thought of your loved one
- Focus on little else but your loved one’s death
- Extreme focus on reminders of the loved one or excessive avoidance of reminders
- Intense and persistent longing or pining for the deceased
- Problems accepting the death
- Numbness or detachment
- Bitterness about your loss
- Feeling that life holds no meaning or purpose
- Irritability or agitation
- Lack of trust in others
- Inability to enjoy life or think back on positive experiences with your loved one
During the first few months after a loss, many signs and symptoms of normal grief are the same as those of complicated grief. However, while normal grief symptoms gradually start to fade over time, those of complicated grief linger or get worse. Complicated grief is like being in an ongoing, heightened state of mourning that keeps you from healing.
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.
What causes complicated grief?
Complicated grief is most commonly caused by the death of someone you love. If your significant other or a close family member dies suddenly, you may have trouble accepting your loss. You may feel intense sadness for years. Your relationships with friends, family, and coworkers may suffer. You may even completely withdraw from your personal and professional life.
Complicated grief doesn’t have any identified biological causes. Like depression, it may happen because of:
- Body chemistry
- Your environment
What increases my risk for complicated grief?
There are many risk factors for complicated grief, such as:
- An unexpected or violent death, such as death from a car accident, or the murder or suicide of a loved one
- Death of a child
- Close or dependent relationship to the deceased person
- Lack of a support system or friendships
- Past history of depression or other mental health issues
- Traumatic childhood experiences, such as abuse or neglect
- Lack of resilience or adaptability to life changes
- Other major life stressors
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is complicated grief diagnosed?
The normal process of grieving can become complicated grief when your symptoms show no signs of improvement over time.
Grieving is a highly individual process for each person, and determining when normal grief becomes complicated grief can be difficult. There’s currently no consensus among mental health experts about how much time must pass before complicated grief can be diagnosed.
Complicated grief may be considered when the intensity of grief has not decreased in the months following your loved one’s death. Some mental health professionals diagnose complicated grief when grieving continues to be intense, persistent and debilitating beyond six months.
There are many similarities between complicated grief and major depression, but there are also distinct differences. In some cases, clinical depression and complicated grief occur together. Getting the correct diagnosis is essential for appropriate treatment.
Your mental health professional may consider you to have complicated grief based on these criteria. You experience:
- The death of someone close to you
- A lack of any improvement in your symptoms over time
- A significant impact on your ability to function in daily life
How is complicated grief treated?
Your doctor or mental health provider will determine what treatment is likely to work best for you based on your particular symptoms and circumstances.
Complicated grief is sometimes treated with a type of psychological counseling (psychotherapy) called complicated grief therapy. It’s similar to psychotherapy techniques used for post-traumatic stress disorder (PTSD). Other counseling approaches also may be effective.
During therapy, you may:
- Explore such topics as grief reactions, complicated grief symptoms, adjusting to your loss and redefining your life’s goals
- Hold imagined conversations with your loved one and retell the circumstances of the death to help you become less distressed by images and thoughts of your loved one
- Explore and process emotions
- Improve coping skills
- Reduce feelings of blame and guilt
There’s little solid research on the use of psychiatric medications to treat complicated grief. However, antidepressants may be helpful in people who have clinical depression as well as complicated grief.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage complicated grief?
The following lifestyles and home remedies might help you cope with complicated grief:
- Stick to your treatment plan. Attend therapy appointments as scheduled and, if needed, take medications as directed.
- Exercise regularly. Physical exercise helps relieve depression, stress and anxiety and can redirect your mind to the activity at hand.
- Take care of yourself. Get enough rest, eat a healthy diet and take time to relax. Don’t turn to alcohol or illegal drugs for relief.
- Reach out to your faith community. If you follow religious practices or traditions, you may gain comfort from rituals or guidance from a spiritual leader.
- Practice stress management. Learn how to better manage stress. Unmanaged stress can lead to depression, overeating, or other unhealthy thoughts and behaviors.
- Stay connected with people you enjoy being around. They can offer support, a shoulder to cry on or a joke to give you a little boost.
- Plan ahead for special dates or anniversaries. Holidays, anniversaries and special occasions can trigger painful reminders of your loved one. Find new ways to celebrate or acknowledge your loved one that provide you comfort and hope.
- Learn new skills. If you were highly dependent on your loved one, for example, to handle the cooking or finances, try to master these tasks yourself. Ask family, friends or professionals for guidance, if necessary. Seek out community classes and resources, too.
- Join a support group. You may not be ready to join a support group immediately after your loss, but over time you may find shared experiences comforting and you may form meaningful new relationships.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Review Date: September 25, 2017 | Last Modified: December 8, 2019
Complicated grief. http://www.mayoclinic.org/diseases-conditions/complicated-grief/basics/definition/con-20032765. Accessed September 25, 2017.
Complicated Grief vs. Depression. https://www.healthline.com/health/depression/complicated-grief#overview1. Accessed September 25, 2017.