Indications that someone may be suffering with complicated grief vary with each individual and each situation, however some of the ways it can look are listed below. When reading through these descriptions, it s important to remember that to be considered complicated grief, the person must have remained stuck in their feelings for a significant period of time (usually in excess of several months), unable to experience further emotional reactions of grief or to make adjustments to adapt to the reality of their loss:
- The individual has difficulty speaking of the deceased without experiencing, renewed and intense grief.
- They constantly bring up themes of death and loss in even the most casual conversations.
- They have ongoing sleep problems sleeping too much or too little that persist for more than 6 weeks.
- They make sudden and radical changes in their lifestyle.
- They exhibit self-destructive behavior, for instance excessive drinking, substance abuse, or promiscuity.
- Without any real medical problems, they develop some of the same symptoms the deceased person experienced just before death.
- They avoid anyone or anything associated with the deceased, including friends, family, and previously shared activities.
- Even relatively minor events trigger an intense grief reaction.
- They have symptoms of depression, especially extreme and persistent feelings of guilt, hopelessness, and lowered self-esteem.
- Their ability to manage everyday responsibilities at work, school, or home is significantly impaired.
When grief remains unresolved, it can lead to other serious problems, including depression, anxiety disorders and even physical illnesses like heart trouble. Fortunately, for even the most severe cases, there is cause for hope. For those who find they are unable, for any reason, to come to terms with their loss, therapy can prove invaluable in moving through the grieving process and finally becoming able to come to terms with the full reality of the loss.
Complicated or Unresolved Grief
Grief impacts each person differently and prolonged grieving is not unusual. For some, during the first few months it can seem as though the feelings of grief are overwhelming and forever change all aspects of life. While there is no set formula for how long it takes to move through the grieving process, it usually takes a year after the death of a loved one to move through a wide range of grief-associated emotions and begin to come to terms with the loss.
Unfortunately, some individual’s response to significant loss remains stuck in an unresolved and long-lasting state. Sometimes referred to as complicated grief, this extreme version of the normal feelings experienced during life passage can have many of the same symptoms as post-traumatic stress disorder, including survivor guilt, extreme agitation, intense sensitivity to stimulus, and intrusive (uncontrolled and unwanted) thoughts.
Typically, complicated grief is not rooted in inadequate coping after the death, but rather in the original relationship with the deceased or the manner in which they died. Some of the more typical situations follow.
Sudden or Traumatic Death
When someone dies in a sudden, shocking, or what seems a preventable way–for example, suicide, homicide, a fatal accident, fatal illness, or murder it can cause such an intense cluster of overwhelming feelings, including rage, guilt, shock, disbelief, or a desire for revenge that the release of further feelings associated with grief and the eventual acceptance of the loss become blocked.
Shame, Embarrassment, or Social Stigma
When death is related to a socially sensitive cause, such as suicide, homicide, or AIDS, some people react by feeling such overwhelming shame or confusion that they feel too unsure to express or even allow themselves to feel what the loss means for them.
Unresolved Issues or Unfinished Business
Sometimes death occurs when there are important issues that remain unresolved, for instance, a son or daughter who has not spoken to their parent for many years following a disagreement, or a spouse who dies during a time of crisis in the marriage. In such cases, when death deprives a person of ever being able to work through old issues, or eliminates the chance to tell someone how they really felt, an individual can become so focused on the unfinished aspects of the relationship that they feel incapable of moving through the many other reactions to their loss.