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Jun 20, 2017

What is Complicated Grief?



Complicated grief is when the usual responses to the death and loss do not fade over time and can impair or prevent people from leading normal lives. The characteristics of complicated grief can include the symptoms above as well as;

  • Anger, irritation, or episodes of rage

  • An inability to focus on anything but the death of a loved one

  • Focusing intensely on reminders of the deceased or an excessive avoidance of such reminders

  • Intense feelings of sadness, pain, detachment, sorrow, hopelessness, emptiness, low self-esteem, bitterness or longing for the deceased's presence

  • Problems accepting the reality of the death

  • Self-destructive behavior, such as alcohol or drug abuse

  • Suicidal thoughts or actions (If you're experiencing suicidal, call the National Suicide Prevention Lifeline at 800-273-8255 to speak to a professional counselor!)

No specific amount of time defines when normal grief becomes complicated grief. Some impose a threshold of around six months, but it is perfectly normal for grievers to find the first year following a significant loss difficult as survivors experience holidays, birthdays, anniversaries, and other significant milestones for the first time without their loved ones.


If you exhibit some of the characteristics of complicated grief above, then you might consider seeking help from a mental-health professional. You should also consider joining a bereavement support group in your area, particularly if one exists for people who have experienced a similar type of loss. While grief typically causes feelings of isolation, discussing your situation with others mourning similar circumstances can help you gain a different perspective on your specific responses


Cheryl Rumley, RN

Owner, Apex Health Care Services &

Aging in Place Toolkit Advisor

New Posts
  • apexhealth01
    Jun 20, 2017

    Death is an unpleasant and unwelcome inevitability of life, and its presence makes us feel uncomfortable like little else can. Even the most talkative people struggle to find the right words for someone who is mourning the loss of a loved one. Hoping to provide some comfort to grievers, people often resort to the clichés and other trite expressions to avoid an awkward silence. You might recognize these: "I Know How You Feel" No, you don't. Like our personalities, each of us reacts and responds to grief differently. Saying you know how another person feels is condescending. Here’s a better approach: If you experienced the death of someone close and feel the need to reference it, do so in the form of an open-ended question or comment. For example, you might say, "When my daughter died, I blamed myself for letting her use the car that night. If you're feeling that way, please know that I'm here to talk any time you need to.” And if you don't know how someone mourning a death is feeling, it really is okay to simply state, "I don't know what to say, but please know that I'm sorry." Avoid just saying, "I'm sorry for your loss." This phrase is trite and rings hollow to those grieving. "He's in a Better Place Now" Anyone who utters this phrase has clearly not grappled with the loss of someone close, a mother facing the future without her child, a widower first returning to the empty house he shared with his wife for decades, -- these survivors think the best place for their deceased loved ones is right by their side and among the living. Here’s a better approach: Share your favorite memory of the deceased, if appropriate, which can help recall other warm memories about his or her life. "Don't Cry" or "You Need to Be Strong" Commenting on how someone is responding to a difficult situation is condescending and serves no purpose other than to create feelings of guilt and resentment and can contribute to an abnormal or complicated grief process. Here’s a better approach: Switch off your cognitive function temporarily and simply allow yourself to respond emotionally. People will remember how you made them feel, not necessarily what you said: Holding a hand with both of yours, the long hug, the feel of your touch on a shoulder, or tears shared. "She Looks So Natural" Have you ever looked at a living person and said something like this? Of course not, because we don't feel the need to comment on it. Uttering this comment when viewing the casket merely emphasizes that the person is not alive. Here’s a better approach: Obviously, if a mourner expressly asks you, "Doesn't he/she look wonderful?" then you should readily agree. Short of that, avoid any comments on the appearance of the deceased. Instead, share a happy memory that you feel captures/conveys something special about the person who died. "Let Me Know If I Can Help" Telling someone who is grieving and mentally exhausted by the multitude of decisions that have to be made does not need to make yet another decision. More than likely, the person has given little thought to responsibilities of returning to a “normal” life since the death occurred. Asking this question, therefore, merely puts them on the spot to make you feel less helpless. Here’s a better approach: If you want to help the griever at some point, simply state that you’ll call next week once things have settled down. By then, the services will be over and it’s likely the out-of-town guests will likely have headed home, too. When you do call, offer a specific suggestion instead of leaving it up to the bereaved individual. You might offer to help out with chores, doing the laundry, picking up some groceries or offer to bring over a meal and simply spend some time listening and providing quiet companionship. Cheryl Sandberg, the author of Lean In, lost her husband suddenly and has written about her recovery from her devastating loss and what she learned. In a recent interview with AARP, she reflected on her life with her husband, their bond, and her slow but constant recovery to be present today. She talks about the fear she had for her children and how resilient they are when recovery allows them to express their grief. She writes how grief made her think she was always going to feel awful and how she decided to change that sentence to “I will sometimes feel this awful.” Sandberg tried a cognitive therapy, where you write down a belief that’s causing you anguish and then you disprove it. She wrote “I will never feel okay again.” Seeing those words forced her to realize that just that morning someone had told a joke and she laughed. In that moment, she’d proven the sentence false. She reminisced that while she’s only partway through her own journey, the fog of acute grief has lifted, but the sadness and longing for her husband Dave remain. She concluded, “I’m still finding my way, but I’ve learned that when life pulls you under, you can kick against the bottom, break the surface and breathe again.” Her lessons teach us that grief is a process and there are coping skills to learn and practice to bring hope for the future. Cheryl Rumley, RN Owner, Apex Health Care Services & Aging in Place Toolkit Advisor
  • apexhealth01
    Jun 20, 2017

    Normal grief is the natural and necessary way people respond to personally painful or traumatic events. As we follow Holly in the movie P.S. I Love You we watch her cry, memorialize her husband and become a recluse. Her close friends and mother keep calling and showing up. They encourage her to socialize, travel, and reflect on the good times to pull her along her journey while they live their own lives. Holly’s friends are getting married and having babies but she is too consumed with sorrow to share their joy. Her grief is prolonged. Most survivors normally exhibit some/all of the following characteristics temporarily when responding to a loss in the days, weeks, or months after the death of a loved one: Tears, crying, or sobbing Sleep pattern changes, such as difficulty falling asleep or too little/too much sleep An overall lack of energy Feeling lethargic or apathetic about the day's necessary tasks or life in general Changes in appetite, such as not wanting to eat or consuming too much, particularly junk food Withdrawing from normal/usual social interactions and relationships Difficulty concentrating or focusing on a task, whether at work, personally, a hobby, etc. Questioning spiritual or religious beliefs, job/career choices or life goals Feelings of anger, guilt, loneliness, depression, emptiness, sadness, etc. -- but still occasionally experiencing moments of joy/happiness While there is no timetable for grief, most grievers experience some/all of the above reactions most profoundly in the immediate days/weeks following a loss, but then gradually return to a “new normal” in the months afterward. You won't entirely forget your loved one, but in time, you’ll learn how to cope with the absence and the scar on your heart and in your soul. It’s almost like you wake up one day and still feel pain and loss but you realize for the past week or two you’re no longer crying every day and you’re able to reach out a little and give of yourself. You’re starting to live without that person, or major life loss, at forefront of your thoughts and day. Cheryl Rumley, RN Owner, Apex Health Care Services & Aging in Place Toolkit Advisor
  • apexhealth01
    Jun 20, 2017

    Grief is the powerful, multifaceted, and often uncontrollable response that human beings experience following a personally painful or traumatic event. The movie P.S. I Love You depicted a realistic example of how grief strikes unexpectedly, and how people slowly accept life alongside a loss. The main character Holly, a widow in her 30’s, grieves for her husband Gerry, who died of a brain tumor. At first, she cannot stand to be around anyone. She stays in her apartment for months, sleeps in his clothes, doesn’t eat, bathe or socialize. Her family and friends are perplexed by her absence from every day life. The movie comedically moves Holly thru all the stages of grief, as she learns to live without Gerry. Like Holly’s loss, many other types of events can also trigger grief to varying degrees, such as: Losing a job A significant change in lifestyle or financial status Ending a friendship, romantic relationship, or a marriage Serious illness or disease, whether personal or affecting someone you love Losing your physical mobility or independence A robbery or burglary that violates your feeling of security/safety An automobile accident or other significant "near-death" event It’s important to understand that grief is not a single emotion; it's an experience or state-of-being that manifests itself physically, emotionally, mentally, and spiritually. Moreover, like our fingerprints, each of us experience grief uniquely –whether it’s how long we grieve or how we grieve, even when situations are similar, such as the death of a parent, spouse/partner, child, pet, etc. Cheryl Rumley, RN Owner, Apex Health Care Services & Aging in Place Toolkit Advisor

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