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 recovering from 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 these stages more than a year after the death of a loved one, 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.
Signs of Complicated Grief
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.
Signs and symptoms of complicated grief may include:
- Intense sorrow, pain and rumination over the loss 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
- Lack of trust in others
- Inability to enjoy life or think back on positive experiences with your loved one
Complicated grief also may be indicated if you continue to:
- Have trouble carrying out normal routines
- Isolate from others and withdraw from social activities
- Experience depression, deep sadness, guilt or self-blame
- Believe that you did something wrong or could have prevented the death
- Feel life isn't worth living without your loved one
- Wish you had died along with your loved one
How is Complicated Grief Treated?
It's not clear how to prevent complicated grief. Getting counseling soon after a loss may help, especially for people at increased risk of developing complicated grief. In addition, caregivers providing end-of-life care for a loved one may benefit from counseling and support to help prepare for death and its emotional aftermath.
- Talking. Talking about your grief and allowing yourself to cry also can help prevent you from getting stuck in your sadness. As painful as it is, trust that in most cases, your pain will start to lift if you allow yourself to feel it.
- Support. Family members, friends, social support groups and your faith community are all good options to help you work through your grief. You may be able to find a support group focused on a particular type of loss, such as the death of a spouse or a child. Ask your doctor to recommend local resources.
- Bereavement counseling. Through early counseling after a loss, you can explore emotions surrounding your loss and learn healthy coping skills. This may help prevent negative thoughts and beliefs from gaining such a strong hold that they're difficult to overcome.
WHEN TO SEE A MENTAL HEALTH PROFESSIONAL
Mental health issues are real, common, and treatable. According to the National Alliance on Mental Illness (NAMI) 1 in 5 adults experience mental illness and 20% of those are considered serious. 17% of 6-17 year olds experience a mental health disorder. So the first thing to remember is this: You are not alone.
If you feel that you are suffering from a mental illness, and particularly if those issues are preventing you from living life to the full or feeling yourself, you may want to consider professional help which can make an enormous difference.
And to be clear, you don't need to be going through a crisis in order to justify getting help. In fact, it can be advantageous from a treatment perspective to identify and deal with issues early and before they have a major impact on your life. Either way you should feel encouraged and able to seek help however you are feeling.
Mental health professionals such as licensed therapist can help in a range of ways including:
- Help you identify where, when, and how issues arise
- Develop coping strategies for specific symptoms and issues
- Encourage resilience and self-management
- Identify and change negative behaviors
- Identify and encourage positive behaviors
- Heal pain from past trauma
- Figure out goals and waypoints
- Build self-confidence
Treatment for mental health issues, and psychotherapy (sometimes known as 'talk therapy') in particular, frequently helps people to feel better, manage, and even get rid of their symptoms. For example, did you know that over 80% of people treated for depression materially improve? Or that treatment for panic disorder has a 90% success rate?
Other treatment options include medication which, in some cases, can be highly effective when administered in combination with psychotherapy.
So what is psychotherapy? It involves talking about your problems and concerns with a mental health professional. It can take lots of forms, including individual, group, couples and family sessions. Often, people see their therapists once a week for 50 minutes to start with and then reducing frequency as time goes on and issues subside. Treatment can be as short as a few weeks or as long as a few years depending on your particular situation and response.
Never think that getting help is a sign of weakness. It isn't. In fact, it can be a sign of strength and maturity to take the steps necessary to becoming you again and getting your life back on track.
WHEN TO GET EMERGENCY HELP
Are you in distress? If so, or if you think that you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately.
Also consider these options if you're having suicidal thoughts:
- Call your mental health specialist.
- Call a suicide hotline number — in the U.S., call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).
- Seek help from your primary doctor or other health care provider.
- Reach out to a close friend or loved one.
- Contact a minister, spiritual leader or someone else in your faith community.
If a loved one or friend is in danger of attempting suicide or has made an attempt:
- Make sure someone stays with that person.
- Call 911 or your local emergency number immediately.
- Or, if you can do so safely, take the person to the nearest hospital emergency room.