Table of ContentsView AllTable of ContentsSymptomsIdentifying Complicated GriefComplicationsCausesTreatmentsCoping

Table of ContentsView All

View All

Table of Contents

Symptoms

Identifying Complicated Grief

Complications

Causes

Treatments

Coping

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A person with complicated grief might also display certain dysfunctional behaviors and might experience irrational thoughts, such as thoughts that the person who has died might come back to life. It’s a chronic form of grief that could impair one’s life. About 7% to 10% of bereaved people might experience complicated grief.

At a GlanceWhen grief lingers, complicated grief occurs. It can lead to feelings of profound, disruptive sadness that make it difficult to function in daily life. When left untreated, it can contribute to depression, anxiety, substance use, and an increased risk for suicide. In this article, let’s take a closer look at what complicated grief looks like, how it is diagnosed, and the treatments that can help.

At a Glance

When grief lingers, complicated grief occurs. It can lead to feelings of profound, disruptive sadness that make it difficult to function in daily life. When left untreated, it can contribute to depression, anxiety, substance use, and an increased risk for suicide. In this article, let’s take a closer look at what complicated grief looks like, how it is diagnosed, and the treatments that can help.

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Symptoms of Complicated Grief

The signs and symptoms of complicated grief are similar to normal grief. However, whereas symptoms fade with time with normal grief, people with complicated grief experience them more intensely and persistently.

Some signs to look out for include:

If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.For more mental health resources, see ourNational Helpline Database.

If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see ourNational Helpline Database.

Symptoms of complicated grief might also manifest physically. People with the condition might experience:

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How to Identify Complicated Grief

Complicated grief itself is not a recognized mental health condition. However, in the latest edition of the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5-TR), a new condition called prolonged grief disorder was added.

It is important to note that grieving is a highly individual process. There is no single “normal” way to grieve or a timeline that people must follow.

However, intense grief that is disruptive and lasts longer than you would expect may indicate complicated or prolonged grief. Symptoms of prolonged grief disorder include:

In addition to these symptoms, bereavement must last longer than one would expect based on the individual’s religious, cultural, or social norms.

Prolonged Grief vs. DepressionComplicated grief is sometimesmisidentified as depression.Depression tends to involve a more persistent, pervasive dysphoria that is combined with other symptoms like hopelessness and rumination. While loss can influence depression, other factor often play a role in its onset. Prolonged grief disorder, on the other hand, centers on the intense and persistent yearning for a person who has died.

Prolonged Grief vs. Depression

Complicated grief is sometimesmisidentified as depression.Depression tends to involve a more persistent, pervasive dysphoria that is combined with other symptoms like hopelessness and rumination. While loss can influence depression, other factor often play a role in its onset. Prolonged grief disorder, on the other hand, centers on the intense and persistent yearning for a person who has died.

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Complications of Complicated Grief

Many symptoms of complicated grief might look like symptoms of depression. In certain cases, complicated grief might even evolve into depression. Depression can occur alongside complicated grief and worsen the symptoms of the condition.

In cases where death is violent and sudden, a person might also experiencePTSD. When complicated grief goes untreated some complications might develop including:

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Causes of Complicated Grief

There is no identifiable cause of complicated grief, but some people might be more at risk of developing the condition than others. Certain risk factors might make a person more susceptible to experiencing the condition, including:

Interference with the healing process of normal grief could also cause complicated grief. Some types of loss might also cause complicated grief—for instance loss of a child or a person’s significant other.

Complicated grief has also proven to be more prevalent in older individuals. One study found that around 9% of older women experience complicated grief.

Treatment for Complicated Grief

The treatment of complicated grief focuses on helping people living with the condition begin their healing process. Your doctor will determine the best treatment plan for you. A combination of medication and therapy might be used to treat complicated grief.

Joining abereavement support groupcan also help to cope with feelings of loss and sadness you might be feeling. Learning that you are not alone and there are people who understand and are experiencing the feelings you have can help you feel better.

Types of therapythat can be helpful include:

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Coping With Complicated Grief

Grief is a difficult emotion to experience and in many cases, it’s harder to weather the feelings of loss and sadness that accompany it, on your own. Reaching out to friends and family who can understand what you are going through, is something you shouldn’t hesitate to do.

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7 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Szuhany KL, Malgaroli M, Miron CD, Simon NM.Prolonged grief disorder: Course, diagnosis, assessment, and treatment.FOC. 2021;19(2):161-172. doi:10.1176/appi.focus.20200052Nakajima S.Complicated grief: Recent developments in diagnostic criteria and treatment.Philos Trans R Soc Lond B Biol Sci. 2018;373(1754):20170273. doi:10.1098/rstb.2017.0273American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Kristensen P, Dyregrov K, Dyregrov A.What distinguishes prolonged grief disorder from depression?. Hva skiller forlenget sorg-forstyrrelse fra depresjon?Tidsskr Nor Laegeforen. 2017;137(7):538-539. doi:10.4045/tidsskr.16.0629Mason TM, Tofthagen CS, Buck HG.Complicated grief: Risk factors, protective factors, and interventions.J Soc Work End Life Palliat Care. 2020;16(2):151-174. doi:10.1080/15524256.2020.1745726Shear MK, Wang Y, Skritskaya N, Duan N, Mauro C, Ghesquiere A.Treatment of complicated grief in elderly persons: A randomized clinical trial.JAMA Psychiatry. 2014;71(11):1287. doi:10.1001/jamapsychiatry.2014.1242Duffy M, Wild J.A cognitive approach to persistent complex bereavement disorder (PCBD).Cogn Behav Ther.2017;10(16). doi:10.1017/S1754470X17000034

7 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Szuhany KL, Malgaroli M, Miron CD, Simon NM.Prolonged grief disorder: Course, diagnosis, assessment, and treatment.FOC. 2021;19(2):161-172. doi:10.1176/appi.focus.20200052Nakajima S.Complicated grief: Recent developments in diagnostic criteria and treatment.Philos Trans R Soc Lond B Biol Sci. 2018;373(1754):20170273. doi:10.1098/rstb.2017.0273American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Kristensen P, Dyregrov K, Dyregrov A.What distinguishes prolonged grief disorder from depression?. Hva skiller forlenget sorg-forstyrrelse fra depresjon?Tidsskr Nor Laegeforen. 2017;137(7):538-539. doi:10.4045/tidsskr.16.0629Mason TM, Tofthagen CS, Buck HG.Complicated grief: Risk factors, protective factors, and interventions.J Soc Work End Life Palliat Care. 2020;16(2):151-174. doi:10.1080/15524256.2020.1745726Shear MK, Wang Y, Skritskaya N, Duan N, Mauro C, Ghesquiere A.Treatment of complicated grief in elderly persons: A randomized clinical trial.JAMA Psychiatry. 2014;71(11):1287. doi:10.1001/jamapsychiatry.2014.1242Duffy M, Wild J.A cognitive approach to persistent complex bereavement disorder (PCBD).Cogn Behav Ther.2017;10(16). doi:10.1017/S1754470X17000034

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Szuhany KL, Malgaroli M, Miron CD, Simon NM.Prolonged grief disorder: Course, diagnosis, assessment, and treatment.FOC. 2021;19(2):161-172. doi:10.1176/appi.focus.20200052Nakajima S.Complicated grief: Recent developments in diagnostic criteria and treatment.Philos Trans R Soc Lond B Biol Sci. 2018;373(1754):20170273. doi:10.1098/rstb.2017.0273American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Kristensen P, Dyregrov K, Dyregrov A.What distinguishes prolonged grief disorder from depression?. Hva skiller forlenget sorg-forstyrrelse fra depresjon?Tidsskr Nor Laegeforen. 2017;137(7):538-539. doi:10.4045/tidsskr.16.0629Mason TM, Tofthagen CS, Buck HG.Complicated grief: Risk factors, protective factors, and interventions.J Soc Work End Life Palliat Care. 2020;16(2):151-174. doi:10.1080/15524256.2020.1745726Shear MK, Wang Y, Skritskaya N, Duan N, Mauro C, Ghesquiere A.Treatment of complicated grief in elderly persons: A randomized clinical trial.JAMA Psychiatry. 2014;71(11):1287. doi:10.1001/jamapsychiatry.2014.1242Duffy M, Wild J.A cognitive approach to persistent complex bereavement disorder (PCBD).Cogn Behav Ther.2017;10(16). doi:10.1017/S1754470X17000034

Szuhany KL, Malgaroli M, Miron CD, Simon NM.Prolonged grief disorder: Course, diagnosis, assessment, and treatment.FOC. 2021;19(2):161-172. doi:10.1176/appi.focus.20200052

Nakajima S.Complicated grief: Recent developments in diagnostic criteria and treatment.Philos Trans R Soc Lond B Biol Sci. 2018;373(1754):20170273. doi:10.1098/rstb.2017.0273

American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.

Kristensen P, Dyregrov K, Dyregrov A.What distinguishes prolonged grief disorder from depression?. Hva skiller forlenget sorg-forstyrrelse fra depresjon?Tidsskr Nor Laegeforen. 2017;137(7):538-539. doi:10.4045/tidsskr.16.0629

Mason TM, Tofthagen CS, Buck HG.Complicated grief: Risk factors, protective factors, and interventions.J Soc Work End Life Palliat Care. 2020;16(2):151-174. doi:10.1080/15524256.2020.1745726

Shear MK, Wang Y, Skritskaya N, Duan N, Mauro C, Ghesquiere A.Treatment of complicated grief in elderly persons: A randomized clinical trial.JAMA Psychiatry. 2014;71(11):1287. doi:10.1001/jamapsychiatry.2014.1242

Duffy M, Wild J.A cognitive approach to persistent complex bereavement disorder (PCBD).Cogn Behav Ther.2017;10(16). doi:10.1017/S1754470X17000034

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