During the first few months after a loss, many signs and symptoms of normal grief are the same as those of complicated grief. However, while normal grief symptoms gradually start to fade over time, those of complicated grief linger or get worse. Complicated grief is like being in an ongoing, heightened state of mourning that does not lessen, or even gets worse with time. People ask “how long should grief last, and the truth is that the “trajectory” of grief varies a lot between different mourners, even among people in the same family.
Rather than focusing on “how long will this take”, a better question might be “what is the trend of someone’s grief?” Even with expectable setbacks, if the overall trend of the intensity of someone’s grief is for it to slowly lessen, which is probably normal. If the trend is “flat” and simply showing no signs of gradually lessening and “softening” over time, that is a concern that bears watching. And if the trend is clearly deteriorating over time, that is a “red flag” that some professional help is likely warranted.
Signs that someone's grieving process is deteriorating include:
- Development of a full blown depression, including persistent sleep disturbance, significant weight loss (or gain), an inability to take pleasure in any activities that were previously enjoyable, and growing thoughts of wanting to end one’s own life.
- Growing bitterness and anger that is interfering with important relationships.
- Increasing use of drugs (including alcohol, prescription medications, and “street drugs”) to numb the emotional pain of the loss.
- Increasing hopelessness about one’s ability to recover and feel better.
- Loss of the ability to plan for or care about one’s future, and about having a better, happier life.
- Loss of a sense of meaning and purpose to one’s life, or of trust in other people.
- Increasing thoughts of ending one’s own life, and of seeing suicide as the only solution to the problems and pain caused by the suicide of the deceased.
The development of these signs of complicated grief are indications that the mourner should seek help from a qualified mental health clinician as soon as possible.
Signs and symptoms of complicated grief may include:
- Intense sorrow, pain and rumination over the loss of your loved one.
- Focus on little else but your loved one's death.
- Extreme focus on reminders of the loved one or excessive avoidance of reminders.
- Intense and persistent longing or pining for the deceased.
- Problems accepting the death.
- Numbness or detachment.
- Bitterness about your loss.
- Feeling that life holds no meaning or purpose.
- Lack of trust in others.
- Inability to enjoy life or think back on positive experiences with your loved one.
Complicated grief also may be indicated if you continue to:
- Have trouble carrying out normal routines.
- Isolate from others and withdraw from social activities.
- Experience depression, deep sadness, guilt or self-blame.
- Believe that you did something wrong or could have prevented the death.
- Feel life isn't worth living without your loved one.
- Wish you had died along with your loved one.
If you're unable to move through these stages or continue to experience the symptoms more than a year after the death of a loved one, you may have complicated grief. If so, seek professional help. It can help you come to terms with your loss and reclaim a sense of acceptance and peace.