What Is Complicated Grief? Symptoms, Causes, & Treatment

What is Complicated Grief

Complicated Grief Disorder, sometimes known as Persistent Complex Bereavement Disorder, is a medically recognized disorder where symptoms of grief do not lessen over time. Feelings of sorrow, despair, anger, and guilt are all completely natural after the loss of a loved one, but in most cases, these emotions begin to subside given enough time.

If, however, these symptoms remain severe and become long-lasting, it can make it impossible to accept and adjust to a new reality. In these instances, symptoms become debilitating and medical intervention may be necessary.

During the normal grieving process, there are a number of stages that should be passed through in order to regain a sense of peace. These include accepting the reality of loss, allowing yourself to experience the pain, adjusting to a new reality, and finally forging new relationships. The timing of these stages will likely be different for each individual griever, but it is generally advised that if a year after your loss you have been unable to work through these stages, then you should seek medical advice.


Symptoms of Complicated Grief

In the first few months after a death, it can be difficult to determine between the normal grieving process and complicated grief. If symptoms don’t improve or even get more severe, this can signify the latter. Persistent complex bereavement disorder can be characterized as feelings of intense pain and sorrow or a fixation on the bereavement with an inability to focus on anything else.

Other signs can include excessive avoidance of reminders of your loved one or their death, persistent and intense longing for your lost one, bitterness, numbness, or struggling to accept the loss. You may also feel that life is not worth living without your lost one or that it has no meaning. Symptoms of depression or feelings of self-blame and guilt are also common with this disorder. You may notice yourself withdrawing from social interaction and struggling to carry out everyday tasks and routines. Any of these over a prolonged period of time may indicate a more complex issue than they first seem.

If untreated, persistent complex bereavement disorder can also significantly impact your emotional and physical health. It may lead to other mental health conditions such as PTSD, anxiety, and depression, or even suicidal thoughts. It may also cause significant sleep disturbances and put the sufferer at higher risk of physical health conditions such as high blood pressure, heart disease, and even cancer. Some sufferers may also be more likely to partake in substance abuse.

Causes and Risk Factors

Persistent complex bereavement disorder is much more common in older people and occurs more frequently in women than in men. While it is not known exactly what causes this condition, it is theorized to be a combination of your specific genetic makeup and inherited traits, and the circumstances surrounding the death. Other risk factors include:

  • A death that was sudden or unexpected
  • A particularly violent death
  • The death of a child
  • Dependent relationship to the deceased
  • Past history of mental health disorders such as depression or PTSD
  • Past history of substance abuse
  • Social isolation of lack of support system
  • Past traumatic experiences, such as child abuse
  • Other stressful events coinciding with the death


Treating Complicated Grief

The main treatment recommended for complicated grief is therapy or bereavement counseling. This can sometimes be offered as a preventative measure in cases where a bereaved person has one or more risk factors for the disorder.

Therapy after diagnosis can take place in either an individual or group setting. The therapist can help the patient to process their emotions, improve their coping skills and reduce feelings of guilt if this is an issue.

Seeking social interaction and turning to friends for support can also be instrumental in helping sufferers breakthrough and begin to enjoy life again.

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