Finding clarity in complicated grief

Before prolonged grief disorder was a recognized mental health condition, some experts called this experience complicated grief. This term is used to describe grief that lasts longer and is more intense than “typical” grief. Complicated grief is believed to affect about 7% of bereaved adults in the U.S. each year. If you’re experiencing challenges in the aftermath of a loss, know that you’re not alone and it’s OK to seek support.

How complicated grief can feel

After someone you love dies, you might not want to be around other people, go to work or school, or even get out of bed. You might lose your appetite, have trouble controlling your emotions, and have difficulty accepting this new reality. No two people will grieve in the same way, and there’s no right or wrong way to move through this experience. But with “typical” grief, most people will be able to move on and resume activities in time. This doesn’t mean that you no longer love or miss the person you lost or that you won’t have some hard days.  

Complicated grief can feel similar to “typical” grief. But the difference is that it may linger for longer than what’s considered typical for a person’s culture. It may also keep a person from doing daily activities for extended periods of time.

Putting a name to your experience of grief

The challenge in defining complicated grief is that, for many people, loss is inherently complex. It’s important to recognize that even “normal” grief can be deeply painful and may make daily life more difficult for a long time.  

Experts have guidelines they use to determine whether someone’s grief may rise to the level of “complicated.” But it isn’t an exact science. So many factors can affect the grieving process. What seems typical for one person or culture can be vastly different from the next. If you’re experiencing any of the following, it could be a sign that you’re living with complicated grief or prolonged grief disorder and may benefit from professional help:

• You’re having a hard time accepting the reality of your loss.

• You’re actively avoiding any person, place, or thing that could remind you of the person who died.

• You’re experiencing strong negative emotions about your loss (like sadness, bitterness, anger).

• You’ve stopped spending time with friends, pursuing hobbies or activities, or thinking about the future.

• You’re questioning the point of life without your loved one.

• You feel isolated and alone in your grief.

Circumstances that can make grief more complex

We can’t always predict when someone will experience complex grief. But experts have discovered a few factors that may increase the odds. You might be more likely to experience prolonged grief if:

• Your loss was sudden and/or violent (like due to an accident or natural disaster).

• You witnessed your loved one die in a slow, painful way.

• You lack a strong support system.

• You were assigned female at birth (AFAB).

• You have an anxious attachment style.

• You don’t have adequate access to basic resources (like food, housing, finances).

• You have pre-existing mental health challenges like depression or suicidal ideation.*

• You lost someone you had a very strong bond with, like a parent, spouse, or child.

The 988 Suicide and Crisis Lifeline provides 24/7, confidential support with trained crisis counselors. If you or a loved one is in emotional distress or a suicidal crisis, please call or text 988. 

If experiencing a life-threatening emergency or you need immediate help, please call 911.

Finding your way through complicated grief

If you’re having a hard time navigating life after a significant loss, you’re not alone. Grief is one of the most difficult human experiences, but healing is possible. Research shows that about 70% of people overcome complicated or prolonged grief with the right support. This often means working with a therapist or attending a bereavement support group. But it can also include:

• Taking care of your body: Grief can be exhausting both emotionally and physically. So during this time, do your best to rest, eat nutritious meals or snacks, and move your body in ways that feel good to you.

• Talking about it: If your grief stays bottled up, it can be harder to manage. Talk about what you’re experiencing with someone you trust. This can mean opening up about the difficult feelings or challenges you’re facing. But it can also mean sharing stories of your loved one, including happy memories.

• Sticking to a routine: You might not be feeling very motivated right now, and that’s OK. But try to create a basic schedule and stick to it. Doing things like going to bed at the same time or scheduling regular check-ins with friends can provide a sense of structure in what may feel like a chaotic time.

• Creating rituals: Look for small ways to help you feel more connected to the person you lost. For example, take a walk in a place you used to visit together, make a donation in their name, or watch a movie you both loved.

Clinician’s take

Grief often becomes more complex when there’s guilt, trauma, or an unclear sense of closure. People who tie their identity or safety to the person they lost may have difficulty adjusting. Fortunately, a therapist can help guide you through the pain toward healing.

Brandy Chalmers, LPC

Clinical reviewer