When Grief Becomes Overwhelming: Identifying and Treating Complicated Grief

Sandra felt life couldn’t get better. She and her husband were planning their retirement, and the future was looking great until the phone call that shattered her world. Sandra’s husband, Tom, was driving home from work when a truck driver crossed the center line and hit his vehicle. The impact killed him instantly. Initially, Sandra experienced normal grief. She would cry, experienced sadness, and longed for Tom, but the days turned to months, and her grief did not subside. Sandra felt as if her life could not go on. Tom’s clothing was untouched in their bedroom, and Sandra spent hours looking at them. She took a leave from her job and was overwhelmed with the idea of returning to work, so she extended her leave of absence. Her sleep was affected, and she began to have frequent headaches that started to affect her physical health. Through all of her sadness, her relationships began to suffer as she pushed everyone away; she could not engage or find joy in anything.

Grief is a normal process or response to loss, but when a person experiences grief marked by persistent, intense sorrow and has difficulty moving on with life, it is called complicated grief; this is the type of grief that Sandra is experiencing. 

What is the Difference between Normal Grief and Complicated Grief?

Most people adapt to the loss of a loved one and begin to move into an acceptance and a new normal of life without their loved one; a slight majority do not. 

Complicated grief is a “recognized condition that occurs in about 7% of bereaved people”. (Shear, 2012)

An individual who experiences acute, persistent grief that does not seem to end and is marked by rumination related to the cause of death or behaviors such as excessive avoidance, difficulties regulating emotions, developing other problems such as addictions, depression, isolation, or other symptoms due to the death can be labeled as experiencing complicated grief or prolonged grief.

What are the Risk Factors for Complicated Grief?

  • A person is more likely to experience complicated grief if the death is sudden and unexpected, like in an accident or suicide. 
  • If the person who died had a close personal relationship with the person, such as with the death of a spouse, parent, sibling, or child, they are more at risk. 
  • If the person experienced trauma during the event of the loss or they have an underlying mental health condition.

How is Complicated Grief Diagnosed?

In the case of Sandra, the family recommended she see her family physician. A physician will diagnose the individual if the grief is affecting their mental, physical, or social health. They will also look at the timeframe, which is if the adult has experienced their grief for more than one year; for children or adolescents, the time frame is six months. 

The physician will also ask questions such as:

  • If you feel intense emotional pain.
  • You don’t want to accept that the death happened and avoid reminders of the death.
  • You don’t experience emotions as you did before or feel emotionally numb.
  • You feel like your life no longer has meaning, avoid social activities, or feel lonely, detached, or depressed. 
  • You have trouble carrying out every day routines.
  • You feel bitter or angry about your loss.
  • You think life isn’t worth living without your loved one, or you wish you had died with them.

The physician will look for three or more symptoms before diagnosing complicated grief.

What are the Treatments for Complicated Grief?

There are various treatments for complicated grief. The physician may recommend bereavement counseling, Cognitive Behavioral Therapy (CBT), or treatment for Post-Traumatic Stress Disorder (PTSD). They may also prescribe medications such as an antidepressant or antianxiety medication. Each person is individualized in their treatment. 

The most important thing is to get the needed help and realize that everyone experiences grief – complicated grief is prolonged, and help is available. Also, know that even with treatment, there will be times, such as the date of death, holidays, or the birthday of your loved one, that will be difficult. During these times, reach out to friends, family, or a professional to help you through these difficult times. 

Works Cited

Cleveland Clinic. “Complicated Grief.” 3 May 2023. Cleveland Clinic. May 2024.

Mayo Clinic Staff. Complicated Grief. 13 December 2022. 27 May 2024.

Shear M. K. (2012). Grief and mourning gone awry: pathway and course of complicated grief. Dialogues in clinical neuroscience14(2), 119–128.