What is complicated grief?

Feelings of sadness and hopelessness are really common after someone dies. Over time though, most people will start to adapt and feel better again. When this doesn’t happen for many months or even years it is sometimes known as complicated grief or prolonged grief disorder. It is more likely to happen if someone’s death was very tragic, traumatic or unexpected.

Our understanding of complicated grief or prolonged grief disorder is still growing. The terms are often used interchangeably and in the UK people are not usually given them as a diagnosis by a doctor.  Not everyone agrees that grief can be a mental health issue. But we hope the following information will help you get extra help if you need it.

What does complicated grief or prolonged grief disorder feel like?

Complicated grief can be difficult to identify. There is a really wide range of feelings and physical effects that are very common after someone dies and grief is often hard for a very long time. But usually feelings do change over time – slowly becoming more manageable, or coming and going. 

The following signs may mean you are suffering from complicated or prolonged grief.

Feeling stuck

If you feel stuck feeling one way for many months it can be a warning sign. You might still feel flattened by sadness the whole time, or maybe you still feel completely numb after many months have passed.

Not coping with life 

It’s normal to find it very difficult to get on with normal life after somone dies. But if you are struggling to feed yourself, shop for groceries or return to work after several months that can be a warning sign that you need more help.

No enjoyment in life

The pain of a close bereavment may never completely go away. But over time most people are able to take a break from their pain and slowly start to take part in and even enjoy some of their life.

If you find that the following are true for you may be experiencing complicated grief:

• you’ve withdrawn from daily life
• you’re avoiding things that you would normally like
• you can’t find any enjoyment in anything
• this lasts for a long period of time.

Very difficult feelings

There is a really wide range of feelings that are normal in grief but in complicated or prolonged grief these can be very intense and go on for a long time with no lessening or change in strength.

• You may have difficult feelings of guilt or remorse.
• You might spend a lot of time yearning for the person and wishing for the time back.
• You might suffer from thoughts and feelings which feel stuck on a loop, with no respite.
• You may feel like there is no meaning in life and that there is no hope for the future.

Rest and sleep can be very difficult.

When is complicated grief more likely?

There’s still a lot more to learn about complicated grief, but the following things are risk  factors:

• How the person died: If the person died in a sudden or traumatic way this can affect the grieving process.

• Your relationship with the person who died: If you were cut off from the person who died or you had fallen out recently, this might make grieving more difficult.

• Family conflicts: Any existing family conflict can make things difficult. If you had difficult relationships with parents or carers when you were young that can also have an effect.

• Loss of a child: If your child has died you may be more likely to experience complicated or prolonged grief.

• Previous bereavements and other losses: If you’ve experienced other deaths in your past, particularly at an early age, this can make complicated grief more likely. Some people can experience grief overload, from multiple bereavements or from other losses, eg of home or job, or through divorce.

• Mental health conditions: If you have an existing mental health condition then this can make the grieving process more difficult.

What people have found helps them

Grief is very individual and what helps is different for different people too. The following suggestions are what some bereaved people who have struggled with complicated or prolonged grief have found helps.

Keeping a steady routine

Keeping to a routine helps us stay as healthy and balanced as we can be in a difficult period. Try to rest and eat at regular times.

Self-compassion

Try to treat yourself kindly. It’s OK to grieve because someone close has died, but know it’s also OK to experience a bit of happiness. This might be tiny to start with: an old activity or a new one, a nice walk or anything which fills your mind with something that’s not the grief.

Talking to friends, family or your community

Talking about how you’re feeling can really help.  Try to identify those people who you feel safe with and can trust to be able to be share or witness your grief. You might be able to find a support group of others who really understand what you are going through. Or get in touch with Cruse.