Grief Can Get Complicated

Grief is a normal and natural human experience. Some bereaved families deal with it beautifully. However, for many, it isn’t easy to lose a loved one. For them, the grief process can be loaded with problems that prevent them from grieving naturally. In this article, I hope to show the 95% of bereaved people that they are grieving normally while helping the 5% learn how to improve their quality of life. 

For years, the term used to describe this experience was “Complicated Grief.” Now the emerging term is “Prolonged Grief” which is more accurate. With Prolonged Grief, the intensity of the grief reaction is either too much or too little, and the duration is too long or too brief. I sometimes find people have unresolved earlier losses, which can be complicated, but can still be resolved. Personality factors also play a role. As a grief coach, I am always ready to help anyone who asks me, “How can I understand myself better?” 

Everyone should know what prolonged grief looks like. The symptoms of psychological grief distress are less intense after one year. If the distress continues over one year, a bereaved person is at a higher risk of natural death. One cause is “Broken Heart Syndrome.” Is Broken Heart Syndrome a real diagnosis? Yes, it is, but the good news is that it is treatable by seeing your physician for a medical evaluation.

Another contributor to Prolonged Grief is a history of drug and alcohol abuse, poor coping skills, history of mental illness, and a second or third significant crisis that is happening at the same time. All of these conditions can contribute to a diagnosis of depression, as well as Prolonged Grief Disorder. Just know that sadness is a normal human emotion. It is not clinical depression. With Prolonged Grief Disorder, see a psychiatrist or psychotherapist for an evaluation. Treatment is possible.

When you are experiencing bereavement, it might seem like you are going crazy. Many of the bereaved people I talk with ask me if they are going crazy. If you have any break in your grief, such as laughter or a time of enjoying yourself with family and friends, you are not clinically depressed. People who are clinically depressed are not only just sad or going through a period of feeling unhappy, but they are persistently sad for weeks, months, or even years! You may have a high level of distress and sadness but if you focus on the gratitude of your loved one instead of your loss you will get better in time. 

Post-traumatic stress disorder (PTSD) can also prolong your grief. If you had a traumatic experience with the death of your loved one, you might feel personally defective or unworthy. A group of VA hospice nurses, who cared for thousands of dying veterans, identified what they called “Soul Injury”. Just being with your loved one as you watch them die can lead to traumatic grief or Soul Injury. You do not have to be a veteran to experience it. Just don’t ignore it! PTSD and Soul Injury can contribute to Prolonged Grief, but it is treatable. 

Prolonged loneliness or isolation is a contributor to prolonged grief. Without social support, grief can go on for years. Family, best friends, involvement in church, synagogue, temple, or mosque are all help to prevent prolonged grief. Support groups, referrals to self-help groups and even our one-to-one grief coaching can prevent the isolation that leads to prolonged grief. If you ask for help, we can find the best fit for you.

Treatment for Prolonged Grief should consist of a combination of education, psychotherapy, and pharmacotherapy. The best type and duration of treatment is based on each bereaved person’s unique needs. Contact Dr. Katherine Shear’s team at the Center for Prolonged Grief at  www.prolongedgrief.columbia.edu. They offer very effective treatment options.

So, what is the bottom line? If you have loving family and friends, have the skills to bounce back after loss of a loved one and have spiritual beliefs that give you hope, you can prevent Prolonged Grief Disorder. Without these supports, you may be at risk. In this case, consider an assessment and recommendations for treatment. You do not have to live with it!

For more information on grief and bereavement services at Transitions, contact Joe Agnello at jagnello@transitionscare.com or 224-575-0545.