What is Complicated Grief?

Diane Carbo

Sep 11, 2023 • 7 min read

Navigating the Tangled Emotions

Grief is a natural response to the loss of a loved one, and it’s something that everyone experiences in their own way and at their own pace. Complicated grief is a disorder that can result from extreme, prolonged or unresolved grieving. It is a type of emotional distress that is more intense and longer lasting than normal grief reactions.

People with complicated grief can become stuck in their process of mourning, often unable to find solace or peace. They experience a range of intense and persistent emotions that can interfere with their quality of life, ability to work, and social functioning. It is important to understand the signs and symptoms of complicated grief so that individuals can seek help and start to heal.

Complicated grief can manifest in physical and mental symptoms. Physical symptoms can include fatigue, insomnia, difficulty concentrating, and a weakened immune system. Mental and emotional symptoms may include feelings of disbelief, loneliness, intense sadness, guilt and anger. In addition to this relentless sadness, people with complicated grief may also feel disconnected from others or feel as though the world doesn’t make sense anymore. They may have difficulty trusting others, have impaired judgment, and even contemplate suicide. It is vital to identify these signs as early as possible and begin treatment.

If you or someone you know is exhibiting any of the above symptoms, it is essential to talk to a physician or mental health professional right away. Early intervention and treatment are key elements in helping people manage complicated grief and learn to cope.

Mental & Physical Symptoms of Complicated Grief

Grief is a normal emotional response to a significant loss, but when that grief lingers and gets in the way of daily life it may be considered complicated grief. Though complicated grief affects individuals differently, there are some general mental and physical symptoms that are common among people who are experiencing it.

Physical Symptoms

The physical symptoms of complicated grief can include:

Insomnia, often accompanied by nightmares
Aches and pains
Trouble concentrating or making decisions
Weight loss or gain
Fatigue and exhaustion
Changes in appetite

These physical symptoms can have an impact on energy levels and can further interfere with everyday life activities.

Mental Symptoms

In addition to physical symptoms, people suffering from complicated grief will usually experience mental symptoms such as:

Persistent longing for the deceased
Preoccupation with thoughts of death and dying
Depressed mood
Anxiety about the future
Irritability or anger
Isolation

Mental symptoms can be particularly difficult to manage; they may lead to feelings of guilt, depression, and even suicidal ideation. It is important to remember that these symptoms are relatively common among those experiencing complicated grief.

Understanding the Causes of Complicated Grief

Complicated grief is a distressing emotional experience that goes beyond the normal grieving process. It is caused by a myriad of biological and environmental factors which can trigger the onset of complicated grief.

Various biological factors can contribute to the development of complicated grief. Certain genetic conditions, such as depression or anxiety can make an individual more likely to develop complicated grief after a loss. Additionally, hormonal imbalances and brain chemistry can play a role in the onset of complicated grief. Individuals who are already struggling with mental health issues before the loss may be more likely to experience complicated grief after the death of a loved one.

Environmental factors can also play a role in the onset of complicated grief. Having an emotionally tumultuous relationship with the deceased, being exposed to trauma, or being unable to fully process the death of someone can all lead to complicated grief. The type of support an individual receives from their family and friends after the loss is also important. People who lack the emotional or material resources needed to cope with a loss may also be more likely to develop complicated grief.

Understanding the causes of complicated grief can be challenging, but it is important to recognize that it is caused by a combination of biological and environmental factors. It is not simply a result of sadness or weakness, but rather a complex web of influences that can affect each individual uniquely.

Diagnosis

When it comes to recognizing the signs and symptoms of complicated grief, it is important to understand how it is diagnosed. The first step is to seek an evaluation from a mental health professional. The professional will begin with an assessment to determine the presence and severity of complicated grief, and to evaluate any other mental health issues that may also be present.

The criteria for diagnosing complicated grief include intense feelings of sadness and longing for the deceased, a preoccupation with thoughts of the deceased, difficulty moving on, and persistent avoidance of activities or events associated with the death. Other symptoms may include obsessive thoughts of the death, feeling that life is meaningless without the deceased person, and extreme emotional loneliness without the deceased.

Treatment therapies for complicated grief may include psychotherapy, medication, and activities that allow the person to re-engage in their life. Seeking out the support of friends and family can also be beneficial. It is important to remember that treatment is often an ongoing process.

There are some common mistakes made in diagnosis when it comes to complicated grief. It is important to note that it is not the same as depression and should not be treated as such. Additionally, people experiencing complicated grief may not seek help due to fear of being judged or misunderstood. It is important to recognize complications such as substance abuse, physical health problems, or suicidal thoughts, and to seek appropriate intervention.

Finally, it is important to provide appropriate support to those in the midst of complicated grief without pathologizing their responses or trying to “fix” them. Allowing oneself to understand and express the natural grieving process can help reduce the intensity of complicated grief.

Coping Strategies for Complicated Grief

Complicated grief can feel overwhelming, and it is important to have coping strategies to manage the intense emotions that come along with it. It is often beneficial to reach out to supportive friends and family, as they can provide emotional as well as practical support. Additionally, seeking professional help can be instrumental when it comes to managing complicated grief. Here are some of the ways to cope with complicated grief.

Self-Care Techniques

Self-care is essential when it comes to complicated grief. Taking care of yourself physically, mentally, and emotionally can help you cope with the difficult feelings associated with complicated grief. Self-care can involve activities such as getting adequate sleep, eating a balanced diet, and taking time to relax and unwind. Additionally, it can also include engaging in pleasurable activities such as going for walks in nature or playing sports.

Supportive Friends and Family

Having supportive friends and family who understand your needs and emotions can be one of the best ways to manage complicated grief. They can provide a listening ear, as well as practical help such as taking you to appointments, providing emotional support, and offering reminders of happy memories of the deceased. It is important to create a support system that you can rely on when you are feeling overwhelmed by your grief.

Therapy

Seeking out the help of a mental health professional can be advantageous for those suffering from complicated grief. Therapy from a licensed therapist can provide the space for individuals to process the trauma associated with the loss and manage the intensity of the emotions they are experiencing. Cognitive-behavioral therapy and eye-movement desensitization & reprocessing (EMDR) have both been found effective in treating complicated grief.

Medication

Medications such as antidepressants can help individuals experiencing complicated grief. These medications can help reduce intense emotions that can make it difficult to cope. However, it is important to speak with a doctor about the potential benefits and side effects of taking medication before starting any type of medication regimen.

Cultural Impact and Interpersonal Dynamics

As with most emotional struggles, cultural practices and beliefs can have a huge impact on how complicated grief is perceived and experienced. Different cultures may have vastly different ways of dealing with grief and loss, and this can result in different outcomes for those struggling with complicated grief. Additionally, cultures that are highly individualistic or emphasize emotional stoicism may make it more difficult to openly express feelings associated with grief, further complicating the condition.

Interpersonal dynamics can also influence one's experience with complicated grief. A supportive network of friends or family may be instrumental in helping an individual cope with their loss, while an unsupportive environment may only worsen the emotions associated with complicated grief. It is important to build strong relationships and seek out supportive individuals when dealing with complicated grief.

Furthermore, certain interactions between individuals can make the experience of complicated grief worse. For example, some people may feel pressure to repress their feelings or “get over it” when they are struggling with complicated grief, leading to feelings of guilt and shame. Additionally, certain people who have never experienced complicated grief may struggle to understand it, leaving the individual without the necessary support.

In summary, cultural and interpersonal dynamics can have a big impact on the experience of complicated grief. It is important to remember that every situation is unique and to seek out supportive relationships when possible.

Complicated grief is an often misunderstood mental health condition in which a person experiences persistent and intense distress. It is important to understand the symptoms, causes, and treatments of complicated grief in order to seek appropriate help. The following resources can provide further support and education on the topic:

Support Groups: Being part of a support group, whether online or in-person, can be beneficial for those experiencing complicated grief. Sharing experiences and perspectives can help people to feel seen and heard by their peers.

Counseling & Therapy: Finding a therapist that specializes in complicated grief can help to develop healthy coping strategies for processing the trauma associated with loss and grief.

Educational Resources: There are many educational materials available that discuss the most effective therapies, the latest research, and the typical course of treatment for those struggling with complicated grief.

Hotlines: A number of hotlines provide 24/7 access to support and crisis services, such as the American Foundation for Suicide Prevention’s toll-free number (1-800-273-8255).

For those who are struggling, it is important to remember that help is out there. Complicated grief is a difficult condition, but it is possible to find the help one needs to manage the symptoms.