What is Complicated Grief?

Complicated grief is a form of grief in which the bereaved becomes, in a sense, stuck, unable to process the death of a loved one. While grief is an entirely natural and normal response to death and it takes many different forms, complicated grief is a cause for concern because it traps the bereaved in a cycle which she or he cannot break free of. Studies on this form of extreme grief suggest that as many as 10% of people may experience complicated grief after the death of a loved one, and the circumstances of the death can have an impact on whether or not complicated grief will occur. The history of the bereaved can also make a difference.

Someone who experiences complicated grief is thrust into a very intense form of grief which is accompanied by frequent and intrusive thoughts about the dead. This can include hallucinations in which the bereaved thinks that the deceased is still alive. This form of grief can be accompanied by severe depression, including suicidal thoughts, and the bereaved may feel intensely lonely, disinterested in life, and unable to participate in daily activities.

A sense of longing for the dead is often present as well. While people in complicated grief are aware on some level that their loved one has died, the death is difficult to process, and the bereaved may cling closely to reminders of the dead. In fact, in brain imaging studies of people who experienced complicated grief compared with people who experienced more healthy grieving, researchers noted that the reward centers of the brain were activated when people experiencing this form of grief thought about the dead, suggesting that the brain is in part encouraging the bereaved to cling to the dead.

Someone experiencing this form of grief can undergo personality changes, may not be able to return to work, school, and a social life after the death, and can be at risk for maladaptive behaviors. Psychotherapy can help the bereaved explore and process the death, working through it instead of becoming stuck in a holding pattern of grief. Another thing which can help with complicated grief is a bereavement group.

It is important to recognize that people grieve in different ways, and that the emotions of a person in the days immediately following the news of a death do not necessarily predict complicated grief. People also experience lingering sorrow as they process a death over weeks, months, and years, and this is entirely normal and healthy. In complicated grief, however, someone appears to be stranded in the state she or he was in immediately after news of the death, experiencing unusually intense emotions and moods.