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Understanding complicated grief: Causes, symptoms, treatment, and coping strategies

Understanding complicated grief: Causes, symptoms, treatment, and coping strategies

Grief is an inevitable part of the human experience, a natural response to the loss of a loved one, relationship, pet—anything that holds intrinsic value for the individual. It is a process that allows individuals to come to terms with their emotions and eventually find a way to move forward. 

However, sometimes grief takes a complex and enduring form known as complicated grief, which can have a profound impact on one’s life. In this extended exploration, we will delve deeper into understanding complicated grief, its causes, symptoms, and various treatment options, as well as coping strategies to help individuals navigate through this challenging emotional journey.


What Is Complicated Grief?

Complicated grief is characterized by the overwhelming and persistent feelings of intense grief that extend beyond what is considered normal grieving. Unlike the natural progression of grief, which gradually lessens over time, complicated grief remains a constant presence and can interfere significantly with day-to-day activities. 

Those grappling with complicated grief often find themselves preoccupied by thoughts and memories of the lost loved one, yearning for their return. According to the DSM-5 criteria, this condition is recognized when the intensity of grief does not subside in the passing months, resulting in persistent and debilitating sorrow.

Differentiating Normal Grief from Complicated Grief

It’s crucial to differentiate between normal grief and complicated grief, as the latter can have severe consequences on an individual’s mental and emotional well-being. In the case of complicated grief, the mourning process becomes protracted, and the person remains stuck in a state of profound anguish. 

While grieving is a personal and unique experience, complicated grief stands out due to its inability to diminish over time, causing significant disruption in the person’s life. This distinction is essential because recognizing complicated grief early on can pave the way for appropriate intervention and support.


Common Causes and Triggers of Complicated Grief

Understanding the potential causes and triggers of complicated grief is essential in addressing this challenging condition effectively. Common factors that can lead to complicated grief include:

  • The sudden and unexpected death of a loved one
  • The loss of a child
  • A lack of coping skills
  • Insufficient support from friends and family
  • Unresolved conflicts before the loved one’s passing
  • Coexisting mental health issues such as depression and anxiety

These triggers can make the grieving process more complex and overwhelming, requiring specialized attention and care.

Recognizing the Symptoms of Complicated Grief

Identifying the symptoms of complicated grief is crucial for early intervention and support. Some of the key indicators include:

  • Intense and persistent pain over the loss of a loved one that does not diminish with time.
  • Constant, intrusive thoughts and memories of the deceased.
  • Avoidance of reminders of the loved one’s passing.
  • Feeling emotionally detached from those around you.
  • Isolating oneself from family and friends, leading to social withdrawal.

Additionally, complicated grief can manifest through emotional and psychological indicators such as: 

  • Heightened irritability or anxiety
  • Difficulty concentrating
  • Changes in memory
  • Vivid dreams involving the deceased loved one

There are also physical manifestations, including: 

  • Shortness of breath
  • Chest or throat tightness
  • Disruptions in sleep patterns (either excessive sleep or insomnia)
  • Fluctuations in appetite (either overeating or loss of appetite)
  • Extreme fatigue or restlessness

Recognizing these symptoms can be the first step in seeking the necessary help and support.

What Are the Three Types of Complicated Grief?

Complicated grief can manifest in various forms, including:

  • Chronic grief: This type involves persistent and prolonged grief that continues without improvement.
  • Delayed grief: Delayed grief occurs when the grieving process is initially suppressed or delayed and resurfaces later, often unexpectedly.
  • Absent grief: In this form, the individual appears emotionally detached and unresponsive to the loss, often to an extent that it hinders their ability to adapt.

It’s essential to identify the specific type of complicated grief an individual is experiencing to tailor the appropriate treatment and support.

What Is the New Term for Complicated Grief?

In recent years, the term “prolonged grief disorder” has gained recognition as a more descriptive term for what was previously referred to as complicated grief. This updated terminology emphasizes the enduring nature of the condition and underscores the need for comprehensive intervention and treatment.

How Does Complicated Grief Happen?

Complicated grief occurs when the individual is unable to adapt to the loss of a loved one. This inability to adapt can be influenced by a variety of factors, including the circumstances of the loss, the individual’s coping mechanisms, and their support network. 

Understanding the unique combination of factors contributing to an individual’s complicated grief is crucial in tailoring effective treatment strategies.

Coping Strategies for Complicated Grief

Coping with complicated grief is a challenging process, but there are strategies that can help individuals navigate this difficult journey:

  • Honoring and remembering: Finding ways to honor and remember the lost loved one through rituals, memorials, or creative expressions can provide a sense of closure and connection.
  • Seeking support: Allowing others to be there for you during this challenging time is vital. Don’t hesitate to lean on friends, family, or support groups for emotional support.
  • Socialization: Isolation can exacerbate complicated grief. Make an effort to engage with friends and family to combat feelings of loneliness and detachment.
  • Joining support groups: Support groups specifically tailored to complicated grief can provide a safe space to share experiences and receive guidance from others who have walked a similar path.

Self-Care Techniques and Practices

In addition to coping strategies, self-care plays a pivotal role in managing complicated grief. Here are some self-care practices to consider:

  • Spend time with others: Surrounding yourself with loved ones and engaging in social activities can provide emotional comfort and distraction from grief.
  • Listen to your body: Pay attention to your physical and emotional needs. Rest when you’re tired, eat when you’re hungry, and give yourself permission to grieve.
  • Lower your expectations: Understand that grieving is a process, and it’s okay not to be your usual self during this time. Lowering expectations for yourself can relieve unnecessary pressure.
  • Take time: Grief doesn’t follow a set timeline. Give yourself the time you need to heal and process your emotions.
  • Do familiar things: Engaging in familiar activities that you used to enjoy can provide a sense of normalcy and comfort.
  • Pamper yourself: Treat yourself kindly and indulge in self-care activities that bring you joy and relaxation.

Seeking Support from Friends and Family

The support of friends and family can be invaluable during the journey of complicated grief. Here’s how you can seek and receive support:

  • Open communication: Talk about your loss, share your memories, and express your experience of both the life and death of your loved one. Encourage open conversations with those close to you.
  • Express your needs: Don’t hesitate to ask others for what you need, whether it’s a listening ear, help with daily tasks, or simply companionship during difficult moments.

How to Seek Professional Help for Complicated Grief

Sometimes, seeking professional help is essential to effectively address complicated grief. Here’s how you can take that step:

  • Primary care provider: Reach out to your primary care provider, who can provide referrals to therapists or medication providers for mental health support.

The Role of Grief Counselors and Therapists

Grief counselors and therapists specialize in helping individuals process their feelings and emotions while navigating the stages of grief. They play a crucial role in facilitating healing and adaptation to a new life without the loved one—don’t hesitate to explore counseling or psychiatric options to use as comprehensive and powerful tools for grief recovery. 

Support Groups and Community Resources

Support groups and community resources can provide essential emotional support and a sense of belonging during the grieving process. You can explore specific groups related to your type of loss online, attend in-person sessions at local outpatient facilities, or contact your insurance provider for recommendations.

Complicated grief is a profound and challenging emotional experience that can have a lasting impact on an individual’s life. Recognizing the signs, seeking support, and employing coping strategies are essential steps in managing this complex condition.

Whether through the support of friends and family, the guidance of grief counselors and therapists, or the comfort of support groups, individuals dealing with complicated grief can find the help they need to navigate this challenging journey towards healing and adaptation.

  • Medical writer
  • Editorial writer
  • Medical reviewer
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Armeshia Lawrence

Armeshia Lawrence is a Board-Certified Psychiatric-Mental Health Nurse Practitioner. She provides a wide range of services to adults, children, adolescents, and their families including diagnosing mental health conditions, conducting therapy, and prescribing medications for patients with mental health conditions or substance abuse problems.

Armeshia Lawrence

Armeshia Lawrence is a Board-Certified Psychiatric-Mental Health Nurse Practitioner. She provides a wide range of services to adults, children, adolescents, and their families including diagnosing mental health conditions, conducting therapy, and prescribing medications for patients with mental health conditions or substance abuse problems.

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Jason CrosbyMental Health Writer

Jason Crosby is a Senior Copywriter at Thriveworks. He received his BA in English Writing from Montana State University with a minor in English Literature. Previously, Jason was a freelance writer for publications based in Seattle, WA, and Austin, TX.

We only use authoritative, trusted, and current sources in our articles. Read our editorial policy to learn more about our efforts to deliver factual, trustworthy information.

  • Shear, M. K. Et al. (2011, February). Complicated grief and related bereavement issues for DSM-5. PubMed Central (PMC).

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