This article will examine what complicated grief means. He will discuss his symptoms, complications and how doctors are treating him. He will also discuss the difference between complicated grief and typical grief, as well as complicated grief versus depression.
What is complicated grief?
Complicated grief is another term for prolonged grief disorder (PGD) or complicated grief disorder. It’s the type of grief that lingers after the loss of a loved one, making it difficult for a person to function as they usually would.
If you are experiencing complicated grief, you can:
- having grief that does not lessen in intensity for an extended period of time, such as 6 months or more
- yearn deeply for the presence of the deceased
- have fixed thoughts about them
- feel angry
- feel numbness, grief, and guilt for months after losing them
Feelings of loss are often debilitating. It may seem like you can’t find the strength to let go and go back to your normal life.
The American Psychiatric Association (APA) recently added this disorder to its latest edition of the Diagnostic and Statistical Manual of Mental Disorders, Fifth edition (DSM-5). According to a 2021 study, approximately 10% of bereaved people will develop complicated grief.
However, not all experts agree that it is a mental condition. For example, a 2018 study indicates that only 24.8% of more than 2,000 mental health professionals agree that complicated grief is in the International Classification of Diseases (ICD-11).
What are the symptoms of complicated grief?
People with complicated grief find it difficult to come to terms with their loss and return to their usual activities. They may have signs and symptoms, such as:
- feel like a part of themselves is dead
- feel a sense of disbelief that the person is dead
- avoid reminders of the person and their death
- feel intense emotional pain, such as:
- having difficulty reintegrating and engaging in daily life and relationships
- feel emotional numbness
- the feeling that their life has no meaning
- feel intense loneliness
Complicated grief can occur with other disorders, such as post-traumatic stress disorder (PTSD) or depression. It can also increase the risk of having suicidal thoughts or behaviors.
If someone you know is at immediate risk of harming themselves or others, or at risk of committing suicide:
- Ask the question: “Are you considering suicide?” even if it’s hard.
- Listen without judgment.
- Dial 911 or your local emergency number.
- Stay with them until help arrives.
- Try to remove any weapons, drugs or other potentially harmful objects.
If you or someone you know is having suicidal thoughts, contact the National Suicide Prevention Lifeline:
- Call 988
- Chat with the lifeline
This service is available 24/7.
Sometimes emotional pain can affect physical health and cause symptoms such as:
A 2018 study says the condition also correlates with other physical symptoms, such as headaches and high blood pressure.
What causes complicated grief?
Researchers have not identified the exact cause of complicated grief. However, some studies have identified risk factors that may contribute to its development.
Risk factors for complicated grief include:
- sex assigned at birth, as women are more likely to experience complicated grief
- nature of the relationship with the deceased
- history of anxiety, pessimism and neuroticism
- history of mental health issues, such as depression and PTSD
- an individual’s sense of resilience
- level of social and emotional support available
- family functioning
Learn to deal with sudden death.
Complicated grief vs typical grief
Research on complicated grief is still in its infancy. As such, there is not yet a standard definition of typical grief. However, we know that people grieve differently. Complicated grief also has certain characteristics that distinguish it from typical grief.
Complicated grief vs depression
Although the symptoms of complicated grief overlap with some symptoms of depression, they are not the same. Complicated grief symptoms often center on the pain of loss.
People with depression typically feel helpless and lack enthusiasm, emotion, or motivation. On the other hand, people with complicated grief tend not to believe that the person is dead. They may also feel like a piece of themselves is dead.
It is important to note that depression can occur alongside complicated grief, making symptoms worse. Complicated grief can also occur with anxiety and post-traumatic stress disorder.
Learn more about depression.
How to diagnose complicated grief?
There are different criteria for diagnosing complicated grief, but one of the most important is duration. Other criteria focus on symptoms of complicated grief, such as:
- emotional pain
- nostalgia for the deceased
- difficulty accepting death
Mental health professionals diagnose complicated grief based on the symptoms an individual experiences. From the symptoms, they can also determine whether complicated grief occurs with depression or other mental health conditions.
What are the complications of complicated grief?
Complicated grief can lead to other physical and mental health issues. A 2013 study indicates that people with complicated grief may have a higher risk of developing adverse health effects, such as depression and PTSD.
Without treatment, complications of this condition can include:
- suicidal thoughts
- a higher risk of physical illness, such as:
- sleep problems
How do you deal with complicated grief?
The APA recommends using cognitive behavioral therapy (CBT) to treat complicated grief. This talk therapy helps people change their behavior and thought patterns.
Therapists also use a specific form of CBT, complicated grief therapy (CGT), to treat complicated grief. This therapy focuses on restoration and helping the person come to terms with the reality of their loss.
Studies from 2013 show that behavioral activation can also be an effective treatment for complicated grief. Behavioral activation focuses on the fact that complicated grief can lead to avoidance of situations, places, and people. The therapy encourages a person to gradually re-engage with these things, decreasing their avoidance and isolation.
Sometimes healthcare professionals prescribe medication to help treat symptoms. This practice is more common when complicated grief occurs alongside depression or anxiety.
Complicated grief is a condition that can cause debilitating symptoms. Some experts object to defining it as a mental health disorder. However, studies have shown that it can lead to mental and physical health complications, impacting quality of life. This may require medical intervention.
If you or your loved one are feeling emotional pain from a loss, remember that grief is a part of life. However, consider contacting a professional if your symptoms increase, do not improve over time, or seriously affect your daily life.