Reviewed by Aaron Horn, LMFT
Losing a loved one can change your life dramatically. First, you experience bereavement or loss. Then, you go through a grieving process. That process never completely ends, but you learn to accept your loss and face life again if it goes well. However, if grief gives way to complicated grief, you might need treatment to achieve a state of acceptance. However, before you can get treatment, you need to know what types of treatment are available and where to get help.
Do You Need Treatment For Complicated Grief?
Knowing you need help with complicated grief isn’t essential to getting help. It’s perfectly alright to talk to a therapist or go to a grief support group even if you aren’t quite sure. However, if you understand what to look for and recognize your symptoms, you may be more motivated to get the help you need.
Taking A Complicated Grief Test
You can start your journey of discovery with a simple complicated grief test. This online test only takes a few minutes to complete. You don’t have to know anything about the subject to take the test. You just have to know about your own thoughts, emotions, behaviors, and experiences surrounding the loss of a loved one. The results will tell you whether you are suffering from complicated grief.
Recognizing The Signs Of Complicated Grief
Think about your own grief experience in light of the established guidelines for recognizing complicated grief. Therapists recognize CG by the following symptoms, how long they last and whether they’re interfering with your daily functioning.
- Intense pain and sorrow
- Dwelling on the loss and how it happened
- Thinking of little else besides the death
- Being always on the lookout for reminders of the loved one
- Avoiding any reminders of them
- Continually longing for them
- Not being able to accept death.
- Feeling numb or detached
- Having bitter feelings about the loss
- Not being able to find meaning or purpose after the loss
- Not being able to trust others
- Not being able to enjoy your new life or remember good times with your loved one
- Having trouble keeping up with everyday routines
- Isolating from others
- Avoiding social situations
- Feeling depressed, sad, or guilty
- Thinking the death happened because you did something wrong
- Obsessing about how you could have prevented their death
- Feeling that life is no longer worth living now that they’re gone
- Wishing you had died with them
- Continuing to be in a state of disbelief that the loved one died
- Having trouble making necessary plans for the future
- Not experiencing normal grief reactions
- Feeling desperately lonely or alone
ANXIETY SYMPTOMS ASSOCIATED WITH CG
Many people with complicated grief experience symptoms of anxiety. This is especially true if you already had an anxiety disorder before the death of a loved one. Some symptoms to watch for include:
- Worrying more than usual
- Fatigue or tiredness for no apparent reason
- Trouble sleeping
- Muscle tension
- Social anxiety
- Experiencing fear of forgetting or betraying your deceased loved one
- Intense fear that you can’t handle life’s practical challenges without your loved one
Two specific types of anxiety often happen along with grief. These are PTSD and separation anxiety. PTSD is especially common after a sudden or violent death. Separation anxiety usually occurs if you were very close to or dependent on your loved one before they died.
Depression Symptoms And CG
You may have noticed that many of the symptoms of complicated grief sound a lot like depression. For example:
- Feelings of guilt
- Inability to enjoy things you once found pleasurable
- Isolating yourself
- Thoughts of dying
Grief isn’t the same thing as depression. However, grief can be complicated by depression. Maybe you had Major Depressive Disorder before your loved one died. Alternatively, perhaps the depressive symptoms didn’t show up until after the loss. Either way, depression can interfere with the grieving process. If you are unsure whether you’re having symptoms of depression, you can also take a depression test online. A therapist can determine whether your symptoms are due to depression or complicated grief.
Grief Complicated By Substance Abuse
Grief can sometimes lead to substance abuse or alcoholism. You may have seen a movie or TV show where a character reacts to losing a loved one by drowning their sorrow in alcohol or drugs. If you lost someone close to you at least six months ago, you might have grief complicated by substance abuse if you have the following symptoms.
- Feeling the need to drink or use drugs regularly
- Intense urges
- Needing more of the substance to get the same effect
- Spending money you can’t afford to buy it
- Failing to meet responsibilities at work or home due to drugs or alcohol
- Spending less time on social or recreational activities that don’t involve drinking or using drugs
- Continuing to use the substance even when it’s affecting your health or your life
- Engaging in risky behaviors or doing things you wouldn’t normally do
- Trying to stop using without success
Complicated Grief Treatments
Treatment for complicated grief can bring relief of symptoms and help you move on with your new life. CG is usually treated with psychotherapy and support groups, although there may be situations in which medications can also help.
Psychotherapy is usually the most effective form of treatment for people with complicated grief. Various types of talk therapy can be used to help people reduce or deal with their symptoms. Treatment may also help you move on to a more comfortable experience of loss.
Complicated Grief Therapy
Complicated Grief Therapy (CGT) was recently developed to help people deal with complicated grief’s specific challenges. This type of therapy combines attachment theory with Interpersonal Therapy and Cognitive Behavioral Therapy. Sometimes elements of Exposure Therapy are also used.
CGT promotes a gradual adaptive process. This process helps the bereaved person progress from acute grief to a more livable state of grief. The Cognitive Behavioral Therapy aspect of the therapy focuses on reducing painful and intrusive memories and decreasing behavioral avoidance. The Interpersonal Therapy part of CGT is to help you re-establish essential relationships. IPT can also help you reassess and commit to new or adapted life goals.
Other Types Of Psychotherapy
Other therapy types can also be beneficial, especially if you have a co-occurring mental disorder like anxiety disorder, a depressive disorder, or substance abuse disorder. The following therapy types can address complicated grief and help the bereaved person face and accept the loss. These therapies can also help with restructuring and finding new meaning in your life.
- Supportive therapy – treatment that improves your self-esteem, self-reliance, and psychological well-being.
- Client-centered therapy – treatment in which you take an active part in and direct your own therapy with a counselor helps increase your self-esteem and openness to experience.
- Meaning-oriented therapy – an existential therapy that uses positive psychology to make your life more meaningful.
- Brief dynamic therapy – a short-term dynamic therapy that focuses on specific issues and goals.
- Cognitive-behavioral therapy – challenges negative thoughts to change unhelpful behaviors.
- Interpersonal therapy – therapy that focuses on your relationships with others.
- Pastoral counseling – therapy that helps you make sense of your loss in terms of your spirituality.
- Play therapy – therapy for children that allows them to express and communicate feelings about the loss.
- Logotherapy – therapy is designed to help you find meaning even while suffering.
- Writing therapy – helps you use journaling and other writing techniques to express and deal with your feelings.
- Virtual reality therapy – therapy that uses virtual reality to expose you to distressing situations and memories.
Many therapists use an eclectic approach, drawing on any or all of these therapies as needed. If you would like to pursue a specific treatment, you can search for counselors who specialize in it. Otherwise, you can simply talk to your therapist about the types of therapy that might help you.
Support groups can help you deal with grief and provide insight into the grief process. You can go to a grief support group, whether you are in counseling with a mental health professional or not. Some of the support groups for complicated grief include general grief support groups, grief support groups for parents and grandparents, Alcoholics Anonymous, and Narcotics Anonymous. NA and AA meetings are focused on the addiction, but you can also talk about how your loss has impacted your life and how it impacts your addiction.
Do Medications Help?
Usually, medications are not required for people dealing with complicated grief. Yet, sometimes, the depression or anxiety symptoms disrupt your life enough to warrant taking a medication for a short time. The medications used for this most often are antidepressants and anxiety meds.
The Center for Complicated Grief can be an excellent resource for dealing with CG and those training to help people with this condition. The center researches grief-related subjects and training for mental health professionals. To help the public, especially those facing CG, they offer education about complicated grief and treatments. You can find information from this center on social media and in many of the major news publications.
Treatment Goals – Integrated Grief
The goal of treatment for complicated grief is not to forget about the loved one entirely. You may have bittersweet feelings from time to time for many years to come. Instead, many therapists suggest integrated grief as one of the most desirable goals of treatment for CG. Integrated grief means that those memories and feelings of loss are still in the background, but they don’t overwhelm you. When you reach this stage, you can carry out your daily activities more easily, connect with other people, plan for the future, and feel more positive about life in general.
If you’re experiencing complicated grief, something is interfering with your process of healing. In most situations, it’s beneficial to get help from a counselor and support groups. You can then overcome the problems that are getting in your way, accept your loss, and build a more satisfying life.