Complicated Grief

One of the most upsetting and regrettably frequent situations people go through is losing a loved one. Most persons going through typical grief and loss experience sadness, apathy, and sometimes even guilt and resentment during this time. These emotions eventually pass, making it easy to accept the loss and go on.

Some people's grief-related sentiments are crippling and don't go better with time. Complicated grieving, also known as chronic complex bereavement disorder, is what is causing this. It is difficult to get past the loss and resume your own life when you are experiencing complex sorrow since the painful feelings are so intense and long-lasting.

Various people go through the grief process in different ways. Individuals may differ in the sequence and timing of these phases −

  • Recognising the truth of your loss

  • Allowing oneself to feel the loss's discomfort

  • Getting used to the new reality of the deceased being absent

  • Possessing more relationships

These variations are typical. But, if more than a year has passed since the death of a loved one and you still can't go through these stages, you could be experiencing difficult grieving. If so, get medical help. It may assist you in accepting your loss and regaining a sense of acceptance and tranquillity.

Complicated Grief: Causes

What causes complex grief is unknown. It may be influenced by your surroundings, your personality, genetic qualities, and the chemical composition of your body, as is the case with many mental health issues.

Complicated Grief: Symptoms

In the first several months following a loss, difficult grieving and normal sorrow share many signs and symptoms. Yet, difficult mourning symptoms persist or worsen over time, in contrast to regular sorrow symptoms, which eventually start to subside. A continuing, heightened sense of sadness that prevents you from moving past it is what complicated grief is like.

Complicated grieving may exhibit the following signs and symptoms −

  • Intense grief at the loss of a loved one, anguish, and reflection

  • Concentrate only on your loved one's passing.

  • Excessive concentration on or avoidance of memories of the departed

  • Intense, ongoing yearning or pining for the dead

  • Accepting death is difficult.

  • Unease or detached feeling

  • Resentment for your loss

  • Feeling that there is no point or value to existence

  • A lack of faith in people

  • Inability to savour life or recall happy memories with a loved one

Signs of complicated sadness −

  • Have difficulty doing daily tasks

  • Shun social interactions and retreat from them.

  • Feel depressed, unhappy, guilty, or guilty of yourself

  • That you did anything wrong or that you might have done something to stop the death

  • Feeling that without your loved one, life isn't worth living.

  • I wish I had passed away with my loved one

You may have physical, emotional, and social effects from complicated grieving. Without the proper care, issues might arise such as −

  • Depression

  • Suicidal ideas or actions

  • PTSD is a kind of anxiety

  • Significant snoring issues

  • Increased likelihood of contracting medical ailments such as high blood pressure, cancer, or heart problems

  • Chronic difficulties with everyday tasks, relationships, or employment

  • Addiction to alcohol, nicotine, or other drugs

Complicated Grief: Risk Factors

Women and elderly people are more likely to experience complicated bereavement. Complicated sorrow may be more likely to develop as a result of several factors, such as −

  • A sudden or violent death, such as one caused by a vehicle accident, or the murder or suicide of a family member

  • Child's death

  • Having a close or reliant connection with the departed

  • Loss of friends, a support network, or social interaction

  • Sadness, separation anxiety, or post-traumatic stress disorder in the past (PTSD)

  • Traumatic experiences throughout childhood, such as abuse or neglect

  • Other significant life pressures, such as severe financial difficulties

Complicated Grief: Diagnosis

Each person's experience with the grieving is very unique, and it can be hard to tell when normal sadness turns into complex grief. How long before severe grieving can be identified is a topic on which mental health professionals are currently divided.

When the depth of your grieving hasn't subsided in the months following the loss of a loved one, you may be experiencing complicated grief. When sorrow is severe, persistent, and incapacitating after a year, some mental health practitioners identify complex grief.

Complicated bereavement and serious depression have many characteristics, yet they can differ significantly. Clinical depression and difficult sorrow can occasionally coexist. A thorough physical and psychological examination is frequently performed since determining the right diagnosis is crucial for receiving the right therapy.

Complicated Grief: Treatment

Your specific symptoms and situation are taken into account by your doctor or mental health expert when establishing the most effective course of therapy for you.


A form of psychotherapy known as difficult grief therapy is frequently used to address complicated sorrow. Yet, it is tailored particularly for difficult sorrow. Psychotherapy procedures used for depression and PTSD are comparable to this. Both an individual and a group therapy session for this condition may be successful.

While in treatment, you might −

  • Find out what difficult grieving is and how it's handled.

  • Examine issues including difficult mourning symptoms, coping with loss, and rethinking your life objectives.

  • To lessen your grief when you see or think about your loved one, have imaginary talks with them and recount the events of their demise.

  • Examine and reframe your ideas and feelings.

  • Hone coping mechanisms

  • Minimize your sense of guilt and blame

You can treat additional mental health issues like depression or PTSD, which can coexist with difficult sorrow, with the use of different forms of psychotherapy.


There is little conclusive evidence supporting the use of psychiatric drugs to manage complex grieving. Antidepressants, however, could be beneficial for those who are dealing with difficult grieving in addition to severe depression.

Complicated Grief: Prevention

How to avoid difficult grief is unclear. Early therapy following a loss may be beneficial, especially for those who are more likely to experience difficult grieving. In addition, support and therapy can help carers get ready for death and its emotional consequences while providing end-of-life care for a loved one.

  • Talking. You may avoid being mired in your melancholy by talking about your grief and allowing yourself to cry. As terrible as it may be, have faith that if you allow yourself to feel your suffering, it will often start to subside.

  • Support. You can seek assistance from family, friends, social support groups, your religious community, and others to help you get through this difficult time. You might be able to locate a support group that is dedicated to a specific kind of loss, such as the loss of a spouse or child. Ask your doctor for suggestions on nearby services.

  • Therapy for grieving. You may examine your feelings around your loss and develop healthy coping mechanisms by seeking counseling as soon as possible following a loss. This might aid in preventing the emergence of unfavorable thoughts and beliefs that are tough to shake.


Those with complicated mourning are more likely to experience negative health effects; they should be identified, their risk of suicide and any coexisting disorders like depression and posttraumatic stress disorder should be evaluated, and they should be given treatment consideration.

Dr. Durgesh Kumar Sinha
Dr. Durgesh Kumar Sinha


Updated on: 30-Mar-2023


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