Complicated Grief: What Happens When You Can’t Go On

Complicated grief is more than the intense, acute grief almost everyone experiences after someone dear to them dies. Complicated grief is prolonged and all-consuming.

When a loved one dies, the strong feelings of loss can be debilitating. Most people experience a period of intense sorrow and yearning for the departed, along with anxiety, numbness, anger, guilt, remorse, or shame that interferes with their life.

In time, the healing process begins, strong feelings and painful emotions begin to fade, and we adapt to the absence of our loved one. The typical process is about accepting and integrating grief into our lives in ways that allow us to naturally move forward while also remembering and honoring the person who died.

In other words, grief never goes away—but it finds an appropriate place in your life.

For some, this never happens, and they remain in a heightened state of mourning that interferes with every aspect of life, making it nearly impossible to accept and adapt to the new reality without their loved one. This is known as complicated grief, which now falls under the official diagnosis of Prolonged Grief Disorder.

When Grief Becomes Complicated

According to the Center for Complicated Grief at the Colombia University School of Social Work, complicated grief occurs when something interferes with the process of adapting to the loss. Persistent troubling thoughts, like thinking you somehow failed your loved one; dysfunctional behaviors, such as avoiding all reminders of the person who’s died; and difficulty regulating intense emotions complicate, or get in the way of, accepting and adapting to the loss of someone meaningful.

When this happens, intense feelings of grief can become prolonged and pervasive, taking a hold of a person’s mind and dominating their life. The severe emotional pain, yearning for the deceased, and obsessive thoughts that generally dominate the initial period of loss persist for a long period of time (at least six months or more).

Manifestations of Complicated Grief

People with complicated grief can’t begin to imagine life without their loved one. They don’t see a path forward and feel like nothing matters. They can’t figure out what’s wrong and assume they’ll be like this forever. Simultaneously, they feel guilty for trying to move on. They may think it’s depression, but complicated grief is its own disorder with its own protocol for treatment.

It’s also more than the intense, acute grief almost everyone experiences after someone dear to them dies. Complicated grief is prolonged, pervasive, and impairing. It completely consumes a person.

Healing or Integrating Grief

The process for healing grief isn’t orderly, according to Katherine Shear, MD, psychiatrist, and founder of the Center for Complicated Grief. Nor does it occur in a particular way. Everyone goes through their own process of grieving and adapting to the loss of a loved one. Most people rely on the support of friends and families to help them through the incredibly painful moments.

They also share stories of the person who passed, which helps them begin to accept the reality of life without them. They learn how to live with the expected and unexpected reminders of the person who died and soothe themselves when uncomfortable emotions arise.

However, people with complicated grief often isolate themselves or try to hide their emotions from others. They may become trapped thinking of all the ways things could have been different. They may daydream of still living a life with the person who's passed or escape reality in more self-destructive ways. Rather than lessening over time, their grief becomes increasingly more intense and debilitating.

Right now there’s a spotlight on grief—further complicated by the pandemic. According to the American Psychological Association, psychologists and mental health experts are researching and developing evidence-based therapies for treating complicated grief. And they’re having success.

If you’re struggling with grief or know someone who is, the Center for Complicated Grief is dedicated to helping. It developed an evidence-based treatment for complicated grief and trains therapists worldwide. You can find a complete list of therapists specializing in complicated grief on its site.

For further consideration: “A Letter-Writing Burn Ritual for Healing.”