Complicated Grief: What is it? Thumbnail

A bereaved individual who suffers from complicated grief is unable to stop crying. Find out more about the condition's signs and symptoms.

Losing a loved one is one of the most devastating experiences in a person's life. Those who go through grief and bereavement often experience sadness, anxiety, numbness, anger, and even guilt. With time, these feelings fade, making it possible to move forward and accept the loss.

For others, the pain of loss becomes debilitating and doesn't go away over time. When this continues for at least six months after the loss, it is called complicated grief. A person experiencing complicated grief may have difficulty recovering, affecting their work, school, relationships, and ability to function.

When feelings of sorrow persist and become overwhelming, treatment can help you accept the loss and regain a sense of peace.

Symptoms of Complicated Grief

Complicated grief exhibits similar signs and symptoms to normal grief. While symptoms of normal grief fade with time, people suffering from complicated grief have persistent symptoms that can be intense.

Symptoms of complicated grief can include:

  • Experiencing intense sadness and pain
  • Frequently ruminating about a loved one's death
  • Avoiding places, things, or circumstances that remind you of your loved one's death
  • Intense longing for the deceased
  • Death is difficult to accept
  • Feeling numb
  • Losing your sense of purpose in life
  • Feeling angry about the loss
  • Loss of interest in previously enjoyed activities
  • Having trouble carrying out everyday routines
  • Withdraw from people and social activities
  • Intense feelings of guilt
  • Thinking you could have prevented the death
  • Believing that life isn't worth living without your loved one
  • Wishing you had died instead
  • Suicidal thinking or attempts

Complicated grief can also manifest physically. Symptoms may include:

  • Changes in appetite
  • Sleeping problems
  • Muscle tension
  • Suppressed immune function

Causes of Complicated Grief

While the cause of complicated grief is not fully known, certain risk factors may contribute to its development. These include:

  • A sudden or violent death, such as a car accident, murder, or suicide
  • Witnessing the loss in person
  • Experiencing multiple deaths in a short period
  • Death of a child
  • Lack of a support system
  • History of mental illness, such as depression, anxiety disorders, or post-traumatic stress disorder (PTSD)
  • Close relationship or dependence on the deceased person
  • Self-isolation
  • Childhood abuse or neglect
  • Experiencing significant stress, such as divorce or financial hardships
  • History of substance abuse


Left untreated, complicated grief can have several effects on a person's overall well-being, leading to depression, anxiety, physical illness, and suicidal thoughts.


It is quite common for people who are grieving to develop depression. While grief often comes in waves, people with depression feel low most of the time. Depression can make people feel sad, empty, or hopeless. People with depression may also develop feelings of self-loathing or low self-esteem. Left untreated, depression can negatively affect a person's work, school, relationships, and even their ability to care for themselves.

Anxiety Disorders

While it's common to experience anxiety after loss, anxiety that persists or becomes intense may indicate an anxiety disorder. Anxiety disorders can cause overwhelming feelings of fear, worry, and irritability. Left untreated, they can lead to fatigue, insomnia, or unexplained physical pain. In severe cases, people can even feel like they are having a heart attack or about to die.

Post-Traumatic Stress Disorder

After experiencing a traumatic loss, individuals are more likely to develop post-traumatic stress disorder (PTSD). PTSD is an intense emotional and psychological reaction to a distressing or traumatic event, such as suddenly losing a loved one. People who have PTSD often have frequent flashbacks or nightmares of the event. They can often feel on edge and avoid things that remind them of the event. Symptoms of PTSD can develop right after an event or take months or even years to appear.

Physical Illness

The grieving process stresses the body and can weaken your immune systems, making you more susceptible to illness, fatigue, and aches. Prolonged grieving can also trigger recurrent medical conditions or worsen their symptoms. It's not uncommon for people to develop new health problems after losing a loved one. Even small children, despite their resilience and youthfulness, can suffer stress-induced health issues while grieving.

Suicidal Thoughts

A grieving person may feel as if there is no point in living and may think about taking their own life. All thoughts of suicide should be taken very seriously. A person planning suicide may talk or write about it. They may begin to put their personal affairs in order, such as giving away personal items, creating a will, or closing accounts. If you or a loved one are having thoughts of self-harm or suicide, please seek help immediately.

When to Seek Professional Help

Losing someone you love can impact your life forever and leave you feeling empty. If you experience any of the following symptoms after a loss, it is recommended that you consult a mental health professional.

  • Sadness, anger, or anxiety consume you
  • Inability to perform everyday tasks
  • Feeling hopeless
  • Your eating habits change
  • You can't stop thinking about the death of your loved one
  • Your performance at work or school is suffering
  • You're not taking care of yourself
  • Having no sense of purpose in life
  • Loss of interest in social activities
  • Wishing you had also died
  • You are not sleeping or are oversleeping
  • You are having suicidal thoughts


Left untreated, persistent grief can impair a person's ability to function and lead an everyday life. If you or someone you love is experiencing complicated grief, it is recommended that you seek mental health treatment. Mental health providers can help people overcome their symptoms related to grief and start the healing process. The two most common treatment methods are psychotherapy and medication.


During psychotherapy, patients will meet one-on-one with a licensed mental health provider. There are a variety of techniques a mental health provider can use. However, complicated grief therapy (CGT) is the most common treatment method.

Complicated grief therapy (CGT) can help people:

  • Understand complicated grief
  • Learn how complicated grief is treated
  • Identify grief reactions and learn how to modify them
  • Adjust to life after losing a loved one
  • Redefine life goals
  • Process difficult thoughts and emotions
  • Develop coping skills
  • Reduce feelings of guilt and blame
  • Strengthen relationships

When other conditions, such as depression, occur with grief, a mental health provider may also incorporate other forms of psychotherapy.


Psychotherapy alone is usually sufficient to treat milder forms of complicated grief. However, when complicated grief is severe, antidepressants may be prescribed along with psychotherapy to reduce symptoms.

Coping with Grief

While professional treatment is critical for moving past complicated grief, the following strategies may also help you cope with grief:

  • Connect with others. The ability to laugh or cry with someone can be incredibly healing. Spend time with people you enjoy and who help you feel supported.
  • Manage your stress. Additional stress can often exacerbate grief symptoms and result in depression, anxiety, and other problems. Learn how to manage your stress and ways to help you relax.
  • Plan ahead for the holidays and special occasions. Specific dates and holidays can bring back painful memories of a loved one. Celebrate, reminisce, or honor your loved one in new ways that provide comfort and optimism.
  • Be gentle with yourself. Try not to judge yourself on where you are with your thoughts and feelings. Give yourself time and trust in the healing process.
  • Get plenty of sleep. Grief can be physically and mentally exhausting. Listen to your body and make sure you get plenty of rest.
  • Get physical activity. Exercise and movement are crucial to releasing "feel-good" chemicals in the brain. If possible, go for a walk, spend time outside, or do an activity you love.
  • Stick to a regular routine. When dealing with grief, you may want to isolate yourself and forget everything, but doing so can interfere with the healing process. Keep a regular schedule, eat regular meals, and get out of the house as much as possible.
  • Join a support group. Support groups can help you connect with others going through similar experiences. Talking with others can be comforting and may even help you form new meaningful relationships.
  • Set goals. Life after loss can be overwhelming. Take it day by day and set small, attainable goals to help you move forward.
  • Know when to ask for help. If symptoms worsen or do not lessen with time, it's important to seek professional help. When grief leads to thoughts of self-harm or suicide, call 911 immediately.

Grief Therapy at CHE

Grief is one of life's most challenging experiences. The effects of grief can be profound, and trying to cope with it alone can prolong a person's suffering. If you or a loved one is struggling with unresolved grief, support is available.

CHE Behavioral Health Services provides comprehensive treatment options for people with grief and co-occurring conditions. With a network of over 900 experienced mental health providers, we provide individualized treatment programs designed to meet your needs.

For more information about grief and treatment options offered by CHE Behavioral Health Services, please call 888-515-3834. We are ready to talk, and ready to listen.