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 accepting 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 one or more of these stages after a considerable amount of time, 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.

Symptoms Causes Risk factors Complications Prevention

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 and pain at the thought 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
  • Irritability or agitation
  • Lack of trust in others
  • Inability to enjoy life or think back on positive experiences with your loved one

When to see a doctor

Call your doctor if you've recently lost a loved one and feel such profound disbelief, hopelessness or intense yearning for your loved one that you can't function in daily life, or if intense grief doesn't improve over time.

Specifically, you may benefit from professional help if, over time, you continue to:

  • Have trouble carrying out normal routines
  • Withdraw from social activities
  • Experience depression or deep sadness
  • Have thoughts of guilt or self-blame
  • Believe that you did something wrong or could have prevented the death
  • Have lost your sense of purpose in life
  • Feel life isn't worth living without your loved one
  • Wish you had died along with your loved one

If you have thoughts of suicide

At times, people with complicated grief may consider suicide. If you're thinking about suicide, talk to someone you trust. If you think you may act on suicidal feelings, call 911 or your local emergency services number right away. Or call a suicide hotline number. In the United States, call the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255) to reach a trained counselor.

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