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Tuesday, February 5, 2013

Could It Be Complicated Grief? Part One

This is Part One of a two-part post about complicated grief.  This part will define uncomplicated grief and complicated grief and discuss the risk factors that may make someone more likely to experience complicated grief.

It is important to know the signs of complicated grief in order to seek out treatment to prevent more serious psychological or physical disorders.  However before discussing these signs it is important to note that I am neither a psychiatrist nor a medical doctor.  Whenever there is any question about an individual’s well-being a trusted member of the medical community should be consulted.
The Psalm tells us that there is “…a time to weep, and a time to laugh; a time to mourn, and a time to dance.” (Ecclesiastes 3:4, King James Version).  If we live long enough most of us will experience the feelings of grief when we lose a loved one.  It is socially accepted that after the death of a loved one that those left behind will participate in a short period of public mourning. It is pretty evident by the typical business policy for funeral leave of between 1 to 3 days off no matter the relationship of the deceased loved one that our culture expects people to “get over it” and “move on.”  However that isn’t the reality and private grief is veiled in mystery because it is different for each individual and the type of relationship that individual had with the deceased loved one. 
There has been research into “normal” grieving or better termed uncomplicated grief and the similarities in experiences among those grieving.  From this research and reports from the grieving individuals themselves there have been a loosely agreed-upon definition of grieving and the experiences of grieving (Bolen, P. A. & van den Bout, J., 2008, January 15).  With uncomplicated grief the grieving person begins to adjust to life without the deceased love one.  It isn’t a recovery but a process of changes and adjustment that now allows the individual to live a different life.  It can dramatically alter the person however they are able to find meaning and purpose and allow themselves to have hope for the future.
Some of the study results have shown that treatment or intervention for uncomplicated grief is not helpful and there are professionals who believe it is not only unnecessary but harmful to the natural progression.  My personal opinion is that grief is different for each individual and therefore options for support and treatment are individual and should be decided by the grieving individual. 
There are some people who may find grass-roots support groups, run by those who have also experienced loss, most helpful; others may find more formally-run bereavement educational groups, usually held at funeral homes, hospitals, and hospices, a good fit; and others may find talking to a grief counselor or mental health counselor something that is helpful and fits their needs.  There are other individuals who have family and friends’ support that don’t feel the need for other support but many people don’t have this type of support and may need to reach out to these other avenues of support.
Approximately 10% to 20% of all bereaved individuals will develop complicated grief (Lobb et al., 2010).  Complicated grief is sometimes called abnormal grief, chronic grief, or prolonged grief. Complications that can co-occur or happen during complicated grief are depression, anxiety, post-traumatic stress disorder, risks of heart disease, high blood pressure, and cancer.  In addition the individual may continue to struggle with coping with daily life functions and may also begin to abuse drugs, alcohol, and nicotine.
There may be some risk factors that can cause someone to be more susceptible to moving into chronic grief.  Some of these risk factors include when the death is unexpected, violent, or due to suicide; when there is a minimal support system of family and friends, when the individual had a close or dependent relationship with the deceased person.  In addition there are some characteristics that the individual possess that may predispose them to complicated grief, some of these characteristics include, trauma at a child including abuse or neglect, history of separation anxiety in childhood, difficulty adapting to life’s changes and lack of resiliency, and prior psychological problems.
Lobb, E. A., Kristjanson, L. J., Aoun, S. M., Monterosso, L., Halkett, G. B., & Davies, A. (2010). Predictors of complicated grief: A systematic review of empirical studies. Death Studies, 34(8), 673-698. doi:10.1080/07481187.2010.496686
Next –Part Two--7 Signs of Complicated Grief

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