September 26, 2018 Beyond The Dash

What is Complicated Grief?

When grief never seems to get easier

What is Complicated Grief?
Complicated Bereavement Disorder is a diagnosis someone can receive if their grief never subsides or gets better, even long after the death has occurred. (Shutterstock)

Though grief counselors and bereavement professionals will assure most mourners that there is no one predictable or linear way for anyone to experience grief, there are some limits. When someone suffers from grief for a prolonged period of time very intensely, it's possible that this bereavement is actually preventing them from healing. 

All grief is complicated. What's the difference?

Even healthy grief can feel extremely messed up. You can expect to feel unhinged for some time following the loss of someone who was important in your life. This loss will stay with you for the rest of your life, but the good news is that for most people the intensity of bereavement subsides within a few years. 

Those who continue to mourn intensely for much longer than is typical, without feeling any improvement, might be considered to have complicated grief, or Complicated Bereavement Disorder. 

This is an actual disorder that can afflict those who have a longer-than-expected or atypical reaction to grief. Using this term to describe someone's grief should be reserved for those who have a diagnosis. Extreme grief reactions can take years to completely, but this doesn't necessarily mean it's complicated grief. 

Because the first few months of healthy grief often look exactly like complicated grief, it is not possible to recognize it as complicated until several months have passed with no relief from acute emotional pain. 

What constitutes a "Complicated Bereavement Disorder"?

William Worden's Four Tasks of Mourning is a model of understanding bereavement. According to Worden, mourners typically move through four stages, with each task representing an emotional task to accomplish. The four tasks are:

1. To accept the reality of the loss

2. To work through the pain of grief

3. To adjust to the world without the deceased person

4. To find a way to maintain a connection to the person who died, while embarking on a new life.

Those who don't make progress on any of these four tasks within the first year following a loss may be considered to have complicated grief. 

Symptoms include: 

  • Intense and prolonged emotional pain

Even after the deceased has been long dead, the mourner cannot ignore their deep emotional pain. They may experience extreme depression, numbness, bitterness and pine for their loved one. 

  • Avoiding or ruminating 

Those with complicated grief may not be able to think of anything except their loved one and subsequent bereavement from their death. Conversely, some mourners will do anything to avoid thinking of these things. Both avoidance of and dwelling on a loss are normal reactions in the first few months following a loss. However, if either of these tendencies continue without improvement, the mourner may be experiencing complicated grief. 

  • Death wish 

Complicated grief may also be identified by a lack of will to live following the loss. If the mourner wishes for their own death, experiences suicidal thoughts, behaves recklessly in a way that endangers their life, or finds they can't enjoy any of the pleasures of life long after the death, it's essential to meet with a qualified grief counselor. 

These symptoms are serious—but can be overcome with the right level of support and assistance. Anyone experiencing a death wish as part of their grief reaction should consult a professional immediately. 

  • Difficulty functioning normally

Another sign of complicated grief is when the mourner is unable to accomplish basic tasks that they used to handle, such as personal hygiene, household duties, work or school responsibilities or social activities.

Preventing complicated grief

The circumstances surrounding a death might make grieving in a typical manner more complex. For example, preventable or unjust deaths can be the most difficult to process. Particularly when a mourner sees a way the death could have been prevented, this aspect of grief can be difficult not to dwell on. Complicated grief often comes about when this self-blame does not end. 

Everyone has different strategies for handling grief, but the following are general aspirations that mourners should adopt if they wish to move past intense grief feelings on a healthy timeline:

  • Share with loved ones

Express yourself to the people close to you and others who are mourning the same death. Tell happy stories, tell sad stories—and everything in between. Look at photos of the deceased person when you are ready. 

  • Get out of your head

Setting aside time to remember your loved one is very important the mourning process. That's why funerals, obituaries and memorials are included in mourning across the globe. But it's also important to know when is enough. Finding a healthy balance between ensuring your loved one is not forgotten and moving on with your own life is tricky, but worth the effort. 

If you find yourself dwelling too much on the death, distract yourself for a few hours. Exercise, spend time with friends, get out of the house or practice your hobby. Interrupting negative or painful thoughts for even half an hour can give your mind a much-needed break from stress. At first, you may not be able to fully engage with the activity you choose, but this will improve the more you do it. 

  • Get help

If loved ones have offered emotional or practical support, take them up on it. Sharing emotions is a difficult thing to do, but it get easier with time and will help you prevent complicated grief from prolonging your pain. 

If the intensity of grief hasn't waned after several months or a year, it is beneficial to seek out the assistance of a licensed grief counselor.

Don't rush

Getting through grief isn't something you can rush. Your progress likely won't be linear, and you'll notice bad days or weeks even after a year of mourning. Grief never feels healthy, but that doesn't mean you aren't coping correctly. If nothing seems to improve, or if it gets worse, it's a good idea to seek help to get back on track. 

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