What Happens When Grief Gets Complicated?

man with grief crying

After the death of a loved one, you may come across various terms and definitions of grief as you attempt to make sense of your unique bereavement experience.

You may be shocked and frustrated to discover that much of the resources and literature around grief (both on and offline) can be confusing and sometimes even anger-inducing. 

You may ask yourself questions like, is the way I grieve “normal”? Is there a right way to grieve, and if so, does that make my unique style of mourning abnormal or pathological?

Whatever information you come across will either have a soothing effect when faced with these questions or make things even more confusing.

Making sense of your grief

Grieving the loss of a loved one is traumatising enough without having our feelings and emotions pulled apart and contained within a set of bereavement “symptoms.”

Many books, abstracts and articles are awash with grief symptoms, but what happens when our mourning differs from “the norm”? Does that mean we are doing something wrong, or is something wrong with us?

There is no right or wrong way to grieve.

Grief can tear our world apart, obliterating all that once felt safe and familiar. 

But unfortunately, many grievers are also faced with a chronic kind of trauma that never truly dissipates once a loved one dies, even after the most unbearable feelings become slightly more bearable.

The thought of “permanent absence” is enough to take our breath away.

Just the idea of a world without your loved one seems overwhelming and surreal, not to mention downright frightening, so it’s natural for you to have varying responses as you acclimate to a strange new world without your loved one.

What is grief?

woman with intrusive thoughts buried face in hands

There are various ways to describe “what grief is”, and some explanations are more helpful than others.

However, perhaps the most valuable description is from grief recovery experts John W. James and Russell Friedman, “grief is the conflicting feelings caused by the end of or change in a familiar pattern of behaviour” (John. W James and Russell Friedman, The Grief Recovery Handbook, 1988).

Let’s stick with this grief paradigm for a while.

Other types of grief

If grief is “the ending of a familiar pattern of behaviour”, this translation alone opens up a whole new meaning to the mourning experience. 

With this in mind, a person may experience grief after the ending of a significant relationship or when an individual goes on holiday to a far-out exotic location.

The above examples signify changes to a person’s sense of familiarity and behavioural pattern.

The grief model

Friedman and Russell’s grief paradigm describes mourning well because it can be applied to various bereavement experiences that are not generally associated with grief.

However, these bereavement types all share similar underlying components. 

For example, a person may experience profound symptoms of grief when going through a divorce, moving house, or even changing jobs.

The feelings and emotions associated with “non-death losses” are unlikely to be as severe as those associated with the death of a loved one, but that doesn’t make them any less valid.

Transitional experiences such as moving home, changing jobs or ending a long-term relationship can elicit grief and anxiety. However, these types of mourning are not as accepted in broader society as other, more obvious forms of grief.

How does grief feel?

It might help if you remembered that how you grieve will be as unique as you are. So when attempting to make sense of your particular bereavement experience, you must keep this in mind.

So much distress is tied up in mourners comparing their bereavement experiences to others; for example, siblings grieving the loss of a parent may compare their feelings of sadness or despair.

For instance, a brother may ask himself why he struggles to feel anything while his sibling is consumed with anxiety and sorrow.

There are no absolutes in grief – and comparing your feelings to someone else only adds to the distress.

Symptoms of grief

Key signs of burnout

Although individual grief experiences vary, several feelings and emotions can unite people in mourning. 

For example, you may experience the following after the death of a loved one:

  • Intense sadness and emptiness
  • Severe anxiety and depression
  • Numbness, shock, despair, disbelief and guilt
  • Anger towards the world or your loved one for leaving you
  • Decreased confidence and self-esteem
  • Loss of self – some people report they no longer recognise themselves in the mirror after the death of a loved one.
  • PTSD symptoms – mainly if the death was traumatic such as a car accident, suicide, or chronic illness
  • Inability to function as you ordinarily would – you may find specific tasks particularly challenging, such as cooking, going to work, or bathing. 
  • A lack of trust in the world and those around you
  • Hallucinations – for instance, you may spot your deceased loved one in a crowd or hear their voice.
  • Withdrawal and social isolation
  • A lack of concentration
  • Changes in your relationships

What happens when grief gets complicated?

As if “normal” grief isn’t challenging enough, many have complicated grief reactions that may elicit more profound, long-lasting clinical outcomes.

Losing a loved one under any circumstances is one of the most traumatic and distressing experiences a person will ever have to face (and, unfortunately, all too common).

Most grievers experience a combination of different emotions that may continue to oscillate back and forth, including sorrow, despair, anger and sadness. At times, a person may even struggle to feel anything at all.

Researchers say these unbearable feelings gradually ease after a while, where moving forward and accepting the loss becomes possible.

Complicated grief

However, for some people, the sense of loss and devastation is pervasive and crippling and does not improve with time.

In the world of mental health, psychologists call this type of mourning “complicated grief” or persistent complex bereavement disorder.

How mental health professionals differentiate “complicated” grief from “typical” grief is the presence of severe and long-lasting painful emotions where the individual struggles to recover from the loss and has trouble resuming their life.

Different people follow different paths.

Medical detox at Centres for Health and Healing

We all follow different paths and trajectories as we navigate life after the death of a loved one.

Our timeline of grief and how we move through these different phases varies but can involve:

  • Allowing ourselves to process and experience the pain of loss
  • Adjusting to a new reality in which our loved one is no longer present
  • Cultivating other relationships
  • Accepting the reality of the loss

We all move through these stages at our own pace – however, bereavement specialists say that if an individual cannot move through these stages more than a year after the death of a loved one, they may be suffering from complicated grief.

If you cannot move forward or feel stuck in your grief, treatment can help. 

Various forms of therapy can help you regain a sense of acceptance, peace and ultimately fulfilment where your feelings of loss no longer consume you.

Complicated grief symptoms – what to look out for

One of the most challenging aspects of complicated grief is that some signs and symptoms can be similar to the initial symptoms of normal loss.

However, as time passes, the initial feelings of normal loss gradually ease. Unfortunately, however, complicated grief tends to linger or worsen over time.

Complicated grief can feel like you are stuck in a bubble of ongoing pain, preventing you from living your life and moving forward. 

You may also experience the following symptoms:

  • Incapable of focusing on anything but your loved ones’ death
  • Bitterness about the loss
  • Detachment or numbness
  • Intense pain, sorrow or rumination related to your loss
  • Intense longing or persistent yearning for the deceased
  • A lack of purpose or meaning, for example, believing that life has no meaning after the death of a loved one
  • Inability to experience joy or reflect on positive experiences with your loved one
  • A lack of trust in others
  • Failure to accept the death

In addition, psychologists also look out for the following symptoms of complicated grief disorder:

  • Deep depression, sadness, and guilt
  • Self-blame, for instance, a person may believe they did something wrong or that they could have prevented the death
  • Difficulty carrying out regular daily routines
  • Withdrawal from social activities and isolation from others
  • A person may wish they had died with their loved one

Reaching out for help and support.

group therapy hand on shoulder

If you have any symptoms of complicated grief, you must speak to your doctor or mental health professional for advice and support.

Sharing your feelings with a trusted person, like a friend or counsellor, can help you process your emotions and may make you feel less alone.

It would help if you remembered that support is always available and reaching out is the first step to processing your grief and getting the help and support you deserve.

What causes complicated grief?

Various studies have been conducted to understand complicated grief better (and its causes). Like many mental health conditions, complicated grief often includes a combination of multiple factors, such as:

  • Your personality
  • Inherited traits (genetics)
  • Your environment
  • Your response to things (such as stress or trauma)

Risk factors

Studies show that complicated grief is more prevalent in women than men. Additionally, you might be more at risk for complicated grief due to the following reasons:

  • A dependent or close relationship with the deceased
  • Childhood trauma, such as neglect or abuse
  • An unexpected death, such as a murder, car accident or suicide
  • The loss of a support system or social isolation
  • A history of mental illness, such as post-traumatic stress disorder, depression or separation anxiety
  • Death of a child

Preventing complicated grief disorder

Research shows that preventing complicated grief disorder can be as complex as the condition itself.

However, there are some things you can do to minimise your risk of developing complicated grief, including:

  • Bereavement therapy or counselling – engaging in treatment soon after your loss can help you process and explore your emotions allowing you to learn healthy coping skills. Counselling may prevent you from spiralling into profound negativity, enabling you to maintain a sense of clarity and control.
  • Maintaining a healthy support system – talking about your loss with family, friends, and the community may help you work through your grief. Bereavement support groups benefit those dealing with specific types of loss, such as the loss of a parent or child. It will help if you speak to your doctor, who may recommend certain groups or resources.
  • Speaking about your loss – depending on the circumstances, talking about your grief can be challenging. However, making space for your grief is essential and may prevent you from getting “stuck” in your feelings. You must allow yourself to feel your emotions, as frightening as this can be, and have faith that by doing so, you will eventually start to feel a bit better.

Centres for Health and Healing

The Centres for Health and Healing team can help if you think you are struggling with complicated grief disorder symptoms.

We specialise in treating various mental health disorders and provide a safe, nurturing space for all who visit any of our treatment centres.

Our team is compassionate, caring and committed to providing high-quality treatment programs for all.

You do not have to feel alone in your grief – our team is always around to lend a listening ear.

Please speak to our dedicated team today.

Additional resources

  1. Complicated grief – Symptoms and causes, Mayo Clinic
  2. Recognising the Symptoms of Grief and How to Deal with Them, Nikki Moberly, PCC, CBC, BetterUp, October 7, 2021
Lisa Davies - Program Director of Vaughan Recovery and Kirby Estate

About Lisa Davies

Lisa is the Program Director at Centres for Health and Healing. She lived for most of her life in the Durham region, before moving to Peel five years ago.

Lisa is a Master Hypnotist and is certified in Hypnotherapy (2008), Self-Hypnosis and in 5-phase Advanced Therapeutic Healing. As a Member of National Guild of Hypnotists, she is also specialized in hypnosis training in pediatrics, pain management, neuro-linguistic and stage programming.

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