Complicated Grief

GinaMarie Guarino, LMHC

Complicated Grief

Complicated grief is a term used for grief that is difficult for people to expect. A person who suffers from complicated grief will struggle to work through their grieving process in a healthy way.

A person who suffers from complicated grief is suffering from grief that is not going away. The grief is chronic and is having a significant effect on the affected person.

A condition of complicated grief will become more severe as long as it is not properly addressed by a mental health professional.

Symptoms of Complicated Grief

People who suffer from complicated grief tend to experience significantly prolonged, delayed or worsening of symptoms. These symptoms will significantly impact the functioning of the affected person.

Symptoms of complicated grief are chronic. They are persistent and may fluctuate in severity. This fluctuation may depend on factors, like:

  • The time of year
  • Stress levels
  • Reminders of the person or object of loss

Symptoms of complicated grief include:

  • Delayed onset to bereavement
  • Difficulty understanding feelings of loss
  • Depression
  • Anxiety
  • Numbness
  • Feelings of helplessness
  • Feelings of hopelessness
  • Mood swings
  • Anger and aggression toward loved ones
  • Feeling conflicting emotions
  • Difficulty understanding how to properly grieve
  • Prolonged bereavement
  • Grief related to something that others do not understand
  • Nightmares
  • Difficulty moving on from lost loved one or object of affection
  • Avoidance of reminders of the object or person of loss
  • Onset or worsening of substance abuse
  • Insomnia

Causes of Complicated Grief

Uncomplicated grief is essentially caused by an interruption in the grieving process. Grief is a difficult feeling to cope with. It causes pain, fear and apprehension for the future.

Many people are able to learn to cope with their grief without professional help. Many others struggle to successfully process through the 5 stages of grief. This results in unresolved grief issues, or complicated grief.

Uncomplicated grief tends to occur in people who suffer from complicated loss. Some examples of complicated loss include:

  • Unexpected and sudden death or loss
  • Unconfirmed death and disappearance of a loved one
  • Unresolved issues with the person or object of loss
  • Guilt related to loss
  • Traumatic loss
  • Premature loss
  • Unjust loss
  • Substance abuse

Treatment Options for Complicated Grief

Complicated grief can be a serious issue. It permanently affects a person’s life without treatment. Untreated complicated grief can result in a number of other mental health issues, like:

  • Anger
  • Post-traumatic Stress Disorder
  • Depression
  • Alcoholism
  • Addiction
  • Anxiety
  • Panic Disorder
  • Agitated Depression
  • Insomnia

Treatment for complicated grief will reflect the principles of the 5 stages of grief:

  • Denial
  • Anger
  • Bargaining
  • Depression
  • Acceptance

People who suffer from complicated grief will struggle to move through each stage of grief. They will become stuck in one of the stages and will struggle to move forward.

In such a situation, a mental health professional will use a combination of different therapeutic techniques to meet the affected person’s unique needs. The therapist may use a combination of the following forms of therapy:

  • Complicated Grief Therapy. Complicated grief therapy approaches a patient similarly to a patient suffering from post-traumatic stress disorder or depression. The focus of therapy reflects triggers for grief-related issues. It utilizes techniques to help the patient find closure with the person or object of loss.
  • Cognitive-Behavioral Therapy (CBT). CBT focuses on irrational thoughts, feelings and behaviors that are triggered by symptoms of grief. CBT targets feelings of helplessness, hopelessness and difficulty moving forward. It uses cognitive and behavioral exercises to teach coping skills.
  • Exposure Therapy. Exposure therapy helps people with complicated grief face their feared new realities without the person or object of loss. It minimizes the emotional distress caused by the absence of the loved one. With exposure therapy, the patient is exposed to people, places, objects and situations that remind the patient of the loved one’s absence.
  • Spiritual Counseling. People who are suffering with complicated grief may consider spiritual counseling. This will depend on the affected person’s spiritual, religious and existential beliefs.

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