Complicated Grief: When A Broken Heart Doesn't Heal

So far in our grief series, we have focused on the loss of a loved one, which is what first comes to mind when one thinks of grief. However, there are many types of loss that may cause a person to grieve; from a serious illness or injury, miscarriage, loss of a job, end of a friendship or relationship, change in lifestyle, loss of independence, and more.

It’s important to note that no one cause of grief is more valid than another. Grief is relative and deeply personal. We cannot predict how grief will affect us or anyone else, or for how long. So, it goes without saying, that we should never judge or criticize how someone else is coping with their grief.

Having said that, there is cause for concern when severe grief lasts for a prolonged period. This is called “complicated grief” and often requires treatment. So how do you know when to seek help for yourself or on behalf of a loved one?

Let’s learn the difference between what is considered normal grief and complicated grief.

What is considered “normal” grief?

Grief is a natural response to the loss of someone or something that we love. It can affect us emotionally, spiritually, cognitively and physically. There are many types of grief, and our grief journey is just as varied and unique. Be that as it may, there are typical effects of grief that we can expect to experience along the way.

After experiencing a significant loss or trauma, a person may temporarily experience:

• Shock or disbelief
• Overwhelming emotion. Feelings of anger, guilt, loneliness, depression, emptiness, sadness, irritability, etc. Crying, sobbing or lashing out.
• Change in sleep patterns. Difficulty falling asleep or sleeping too little or too much.
• Change in appetite. Not feeling hungry, overeating, or comforting with junk food.
• Lethargy. An overall lack of energy.
• Feeling indifferent, disconnected or numb. Lack of concern in carrying out daily tasks or taking part in life in general.
• Withdrawal. Lack of interest in usual social interactions and relationships
• Difficulty concentrating, focusing, or remembering. Feeling “foggy - headed”.
• Questioning spiritual or religious beliefs or major life choices.

That all sounds pretty “normal”, right? … just your ordinary run-of-the-mill emotional kick in the gut.

Be assured, grief feels anything but “normal”. However, it is temporary - or at least it’s meant to be. It is the severity and duration of grief that differentiates normal grief from complicated grief.

With “normal” grief, acute emotions ease over time and a person can work through the grief process to heal and move forward in their lives.

Steps in the grief process include:

• Accepting the reality of loss
• Allowing oneself to experience the pain of their loss
• Adjusting to a new reality
• Moving forward with other experiences and relationships

For people experiencing complicated grief (CG), this process feels impossible.

What is “complicated grief”?

Complicated grief is usually associated with the loss of a loved one. It is a prolonged, intense state of mourning that keeps the mourner from moving through the grief process and healing. In essence, they get stuck in the acute pain and trauma of their loss. Grief becomes all-consuming and inhibits the mourner from finding any joy in life without their loved one.

It is a common misconception that complicated grief is usually associated with a troubled relationship with the deceased, one in which there may have been words left unsaid, feelings that weren’t shared, or even an argument, which prevents the mourner from moving forward because of guilt or remorse. This, of course, can be true. However, it is much more common for people experiencing complicated grief to have had an incredibly close and loving relationship with the deceased. The loss of that unique bond leaves the mourner with a despair so deep that they often can’t find healing on their own.

What are signs and symptoms of complicated grief?

Over time, the intensity of grief symptoms should become less severe and frequent. If, however, after 6 months or more, symptoms remain persistent and/or become more burdensome, it would be wise to seek help, even if just from a friend, family member, minister or support group - though, counseling is highly encouraged. If symptoms remain overwhelming after 14 months, it is definitely time to seek professional help.

Symptoms of complicated grief start out the same as normal grief, but rather than becoming less acute, they become more chronic and debilitating. In addition to normal grief symptoms, there are seven key indicators that help health professionals diagnose complicated grief.

The seven key indicators of complicated grief include:

• Intrusive memories or fantasies about the deceased loved one
• Strong pangs of emotion related to the lost relationship
• Powerful yearnings or wishes that the departed person was still present
• Intense feelings of loneliness or emptiness
• Avoidance of people, places, or activities that remind the grief sufferer of the deceased
• Recurrent sleep interference and disturbance
• Significant loss of interest in work, social, personal, or recreational activities

If 14 months after a loss, 3 or more of these symptoms persist for 30+ days, complicated grief treatment is needed.

How do you know when to seek help for yourself or on behalf of a loved one?

If you are experiencing complicated grief, please reach out to a mental health professional or medical professional for help. There are many different types of treatment that can be effective in treating complicated grief, from counseling, support groups, behavior therapy, medication, and more. Together, you and your health professional will collaborate on a treatment plan that is right for you. Through treatment, you will be guided along your grief journey to accept your loss, process your grief, adopt healthy coping strategies and eventually find hope and happiness for the future.

If you are concerned that a loved one may be experiencing complicated grief, please encourage them to get help. People sometimes worry about overstepping their bounds when others are grieving - and, indeed, we should respect others’ privacy in such times … initially at least. However, if after six months, you still see your loved one struggling with acute grief, they may need your love, support, and a gentle, but firm nudge to seek treatment.

If your motives are pure and your actions are motivated by love, respect, and concern, it is never wrong to express your concern for someone and offer assistance in getting them help.

Losing a loved one may be the most difficult thing in life, let's help each other through it.

“Where there is deep grief, there is great love.” - Unknown

More Articles In Our Grief Series 

Grief Series: Let's Talk About Grief

Carrying Grief ... In The Trunk Of The Car

Reality of Grief and Hope Moving Forward