Every person grieves differently. One person might sob every time they hear the deceased’s name, while another person might mourn in silence. This makes it difficult to distinguish normal grief from complicated grief. Even mental health experts struggle to make this distinction.

Grief should slowly decrease in intensity. Time may not heal all wounds, but it does lessen them. Complicated grief is usually seen when a person continues to struggle a year after the loved one passes. Their grief continues to be intense and debilitating.

Complicated grief might actually be mistaken for major depressive disorder. They are separate conditions with similarities. However, they can coexist. Moving forward begins with getting the right diagnosis, so the person can get the complicated grief treatment they need.

Symptoms of Complicated Grief

The core symptom of complicated grief is a constant yearning and longing for the deceased that does not improve over time. This manifests as intense pangs of separation distress, including brokenheartedness, intrusive thoughts of the loved one, and trouble accepting the death. Typical grief symptoms, like sadness and crying, may also persist unrelentingly.

Other common symptoms include feeling shocked, stunned, or emotionally numb, avoiding reminders of the loss, detachment from others, anger, guilt, loss of identity or purpose, and suicidal ideation. Sleep disturbances, loss of appetite, and health problems can also occur.

Causes

There are several factors that can contribute to the development of complicated grief reactions. These include:

· The nature of the death, as a sudden or traumatic loss raises the risk significantly

· A close kinship to the deceased, as the loss of a spouse, child, or parent is more likely to lead to complication

· Lack of social support after the death

· Insecure attachment styles from childhood

· Concurrent mental health issues like depression or anxiety

· Personality traits like negativity and emotional dependency

Diagnosis

Complicated grief is diagnosed through clinical evaluation and ruling out uncomplicated bereavement. The criteria for complicated grief focus on separation distress, such as constant yearning/longing for the deceased, trouble accepting the death, and feeling stunned by the loss. Symptoms must persist at least 6 months after the loss and be associated with functional impairment in relationships, work, health, or other key areas.  

A diagnosis is made based on clinical evaluation and ruling out uncomplicated bereavement. It’s crucial to distinguish complicated grief from depression, though they often co-occur. Assessing specific symptoms around yearning and preoccupation with the deceased can aid in differential diagnosis. Self-report measures like the Inventory of Complicated Grief are also used.

Treatment

Research shows that a combination of psychotherapy and medication produces the best results in treating complicated grief. The following are some effective treatment options.

·Cognitive-behavioral therapy focuses on identifying and modifying dysfunctional thoughts and behaviors related to the loss. Exposure therapy helps desensitize to avoided reminders.

· Support groups provide validation and community with others experiencing complicated grief. Group therapy fosters sharing and healing.

· Antidepressants like SSRIs can be prescribed off-label to help manage symptoms. However, medication alone is rarely sufficient.

· Treatment often involves confronting the reality of the loss, retelling the story of death, and fostering positive coping. Restoring engaging routines and pursuing new meaningful activities is also therapeutic.

· Self-care practices like journaling, exercise, meditation, and social connection help build resilience when combined with professional treatment.

The journey through complicated grief requires time, courage, trial and error, and deep compassion. But with proper diagnosis and support, healing is absolutely possible. The pain can give way to peace, and the path ahead opens once more.