Complicated grief must be diagnosed carefully. Each person’s grieving experience will be unique, and there is no “right way” to grieve. Most of us have intense reactions and feelings after a loss, and there is no timetable for grieving. Acute sadness and life disruption does not mean that we have complicated grief.
In a more typical grieving process we often experience acute grief after a loss; we are in deep pain, and we may have extreme difficulty in coping in our day to day life. In most cases, we very gradually begin to integrate our loss into our ongoing life and our life story. We may struggle and this may take a lot of time. We slowly begin to reengage with the world and with our social connections. The intensity of of our feelings and thoughts of loss, while perhaps still very high at times, will gradually become a bit less dominant and all encompassing. It is important to note that there is often a great deal of pain and upheaval for those who are grieving, and that the path is rarely linear; the road is often bumpy, with many ups and downs.
Complicated grief occurs when there are obstacles which do not allow us to adapt. Those with complicated grief may struggle to accept the reality of their loss, or be unable to adapt to a changed relationship with the deceased. They may also feel unable to imagine a future for themselves which could bring some possibilities for happiness or fulfillment. At least six months must have passed after the loss for a complicated grief diagnosis to be considered.
Complex losses may make us more prone to complicated grief. For example, it is difficult to accept the reality of a loss if our loved one is missing; when the loss is ambiguous or uncertain it is especially challenging to adapt, and we might continue to ruminate about our loved one and cling to hopes of a reunion. When experiencing a disenfranchised loss our lack of societal support might make us more likely to turn inwards, to bitter or angry feelings, and to a struggle to accept and integrate the loss.
If you suspect that you or someone you love may be experiencing complicated grief please visit the resources pages for possible sources of support.