7 Signs of Complicated Grief

Part 2 of Could It Be Complicated Grief?

Now to the 7 signs of Complicated Grief.  This is just a brief list of what I consider the most serious signs that should warrant at least a consult with a professional.  There are more signs (symptoms) that you can read about on the Mayo Clinic site.

1) Suicidal thoughts or actions

One of the most alarming signs of complicated grief can be suicidal thoughts or actions.  This is different from the thoughts in uncomplicated grief of wanting to join the deceased love one or wishing to change places with the deceased in order for them to live.  This is not a sign that should be taken lightly. If there are ANY concerns regarding suicide ideas, plans, or attempts—DO NOT WAIT—contact someone immediately.  Suicide is one of the top causes of death in the U.S. and most people will tell someone about his or her plans within days of the event.  It is better to err on the side of caution and save a life.  NationalSuicide Prevention Lifeline 1-800-273-TALK (8255)

2) Depression or unrelenting sadness

This is not the initial sadness when thinking about the deceased loved one.  This is a deep sadness that you can’t shake after many months that affects every part of your life and isn’t getting better.  Depression is often a complication of complicated grief and may require professional support and treatment.  Often in our society we say we are “depressed” when what we mean is that we are sad or upset about a singular event—this is not the same thing as a true depressive disorder.  If you aren’t sure what you are feeling is depression you can consult a professional who can do an assessment with you to help you to understand what you are feeling.  Depression is treatable with either talk therapy or behavioral therapy to change the negative or faulty thinking that lead you to be depressed and keeps you there.  In addition there are medications that have been found to be effective in treating some forms of depression.  The National Institute of Mental Health has a website with a great deal of helpful information about depression and where to seek help.

3) Life is No Longer Enjoyable

This sign is often associated with depression as many of the signs/symptoms of complicated grief do overlap with depression symptoms.  For this sign the person suffering from complicated grief may feel like they will never feel like they did before and are merely putting one foot in front of the other as they trod through each day.  Activities and people that they use to enjoy no longer have that same feeling.  If asked, the individual would find it practically impossible to name anything they would want to do that would bring them joy.

4) Withdrawing from Social Activities

As the time goes by after the death of the loved one and other people continue on with their lives, the person with complicated grief may feel like they are alone in their grief and that they are the only one who still cares about the loved one.  This also makes the person feel like the world around them is foreign to them because they no longer no how to act/react in public situations.  These feelings along with the feelings of depression will keep the person from wanting to participate in social activities and lead to isolation.  This becomes a dangerous loop because isolation makes it more difficult to move beyond the constant thoughts about the loss and therefore keep the person from venturing out into the world.

5) Bitterness, Anger, Irritability, Agitation

There is often guilt and anger surrounding the death of the loved one, especially if this was a violent death.  These negative feelings are not assuaged by positive feelings and just feed upon each other and this leads to the irritability and agitation that the person with complicated grief experiences. 

6) No Hope in the Future

The person with complicated grief cannot imagine a future without the loved one in it.  Trying to think about a future like that can bring on feelings of guilt and anger.  This can further exacerbate the depressive feelings and make the individual feel hopeless and helpless.  Without meaning or purpose for life the individual can see no future and is incapable of hoping for a different future without the loved one.

7) Difficulty handling normal activities and routines

When there is no hope or meaning, the individual has trouble accomplishing even the most routine activity.  It can be rough for the person with complicated grief to take care of their needs, to handle daily chores, or to concentrate enough to hold down a job.  Some people will look from the outside as if they are coping and handling their responsibilities adequately but enternally the person is struggling to just keep up.

Once again I would like to mention how important it is to know the signs of complicated grief in order to seek out treatment to prevent more serious psychological or physical disorders.  In addition I want to reiterate this post and the previous post were strictly informational and that I am neither a psychiatrist nor a medical doctor.  I have provided links to well-known and respected sites if you would like more information on the subject. Whenever there is any question about an individual’s well-being a trusted member of the medical community should be consulted.

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.

References:

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