What Is Complicated Grief and What Are Its Symptoms?

Most of our clients have experienced a certain amount of grief; it is a natural and expected response to a painful and traumatic event. However, the severity, symptoms and duration may differ.

Typically people will react strongly to a loved one’s death and offer support through a series of rituals and acts of compassion. Nevertheless, despite the shared experience and the social connection, losing a loved one is one of the most isolating experiences of a person’s life.

Researchers have highlighted the intensity of this experience; thus, mental health professionals offer many treatment options to help with the loss of a loved one, whether you are struggling with normal grief or complicated grief. This blog will explore grief, complicated grief disorder, how this differs from other forms of grief, and explore the signs and symptoms and potential causes.

What Is Grief?

There are over 60 million deaths worldwide every year, and each one leaves behind many close connections who are left to deal with the intense loss. Losing a loved one is an extremely stressful experience resulting in an uncontrollable, disruptive, emotional period of mourning.

Grief is not one single emotion; it is an experience that you feel emotionally, mentally and physically when you go through something traumatic. Typically grief is associated with bereavement; however, grief can be triggered by other losses, including:

  • Losing your job
  • A drastic change in financial status or lifestyle
  • Miscarriage or stillbirth
  • Divorce or the end of a serious relationship
  • Serious illness for yourself or someone you love
  • Assault or robbery
  • A ‘near-death’ experience

Due to our individual differences, everyone all experiences grief differently. Even if two people experience the same loss, they are likely to grieve in different ways. Despite our differences, there are a set of common emotions and experiences that people tend to feel. This is called normal grief disorder.

What Is Normal Grief?

Normal grief is the typical experience of mourning that people feel in the first days, weeks or maybe months after an intense loss. Although there is no set time period for the grieving process, people with normal grief are able to slowly get over their loss. They are said to establish a ‘new normal’ after their experience of grief. Although they may never forget the loss, they learn to live with it and are able to get on with life. Some symptoms of normal grief include:

  • Crying
  • Sleeping difficulties
  • Decrease in energy
  • Feeling apathetic or lethargic
  • Changes in appetite
  • Withdrawing from relationships or social situations
  • Concentration issues
  • Feelings of loneliness, depression, anxiety, sadness or emptiness

What Is Complicated Grief (Persistent Complex Bereavement Disorder)?

While normal grief is temporary and tends to dissipate, those experiencing complicated grief feel trapped in their intense feelings of sadness and loss. These intense feelings typically disrupt an individual’s daily life as grief gradually becomes a constant and heavy companion.

Complicated grief, also known as complicated bereavement disorder, prolonged grief disorder, chronic grief or exaggerated grief, affects around 7% of all bereaved people, and leaves them unable to cope with a particular loss, causing undue distress and disability.

With complicated grief, the acute grief experienced by the majority of us is prolonged and the response to loss never seems to go away. As discussed, there is obviously no set time period for the healing process, however, mental health professionals have said that if grief is persistent for over six months, you may be experiencing complicated grief. There is a range of symptoms to look out for to help identify the form of grief you may be experiencing. Recognising these can help you find the right help and support.

Signs and Symptoms

Acute grief is recognised through an intense yearning and sadness that tends to fade as time passes. In contrast, an individual living with complicated grief disorder feels trapped within the grief, with symptoms worsening over time.

Some of the symptoms of complicated grief are the same as normal grief; however, complicated grief symptoms are much more persistent and intense. Other symptoms can include:

  • A constant intense sorrow and deep sadness
  • Sleeping problems
  • Obsession with the loss
  • Excessive avoidance of reminders of the loss
  • Unable to accept the loss
  • Feeling a loss of purpose
  • Suicidal thoughts
  • Strong feelings of anger towards the world
  • Intensified pre-existing mental health conditions (anxiety disorder, major depression, substance abuse, etc.)
  • Significant impairment to everyday life

If you recognise any of these symptoms in your or a loved one it is important to seek professional medical advice. Working with a mental health professional can help you work through your experience of grief and can aid you in coping with your symptoms in order for you to live a fulfilling life.


The sadness felt throughout grief is a universal experience that affects us all. But if this feeling persists and you are unable to move on, it is likely you have developed a complicated grief disorder. Although there is no one set cause for the risk of developing complicated grief, there are a number of risk factors that increase the chances of a person developing the disorder.

The most common cause of complicated grief (CG) is the unexpected or shocking death of a loved one or family member. Studies have suggested that you are more likely to experience the disorder if you have lost a child or a partner. In general, the death of a child is noted to be the most difficult kind of loss, with bereaved family members at risk of experiencing depression or anxiety disorders for up to 10 years after the death.

Traumatic grief can result in very intense reactions which can develop into complicated grief. Traumatic grief is when a deceased person has passed in an unexpected or violent way. For example, bereaved family members may be experiencing the death of a child, someone who has been murdered or someone who died in a violent accident. Traumatic grief can cause people to develop post-traumatic stress disorder (PTSD) in which specific treatment is required to help a person overcome the condition.

Other causes of CG symptoms include:

  • Suffering from a substance abuse disorder
  • Pre-existing mental disorder e.g. separation anxiety, post-traumatic stress disorder (PTSD), or depression
  • Experiencing more than one death at one given time

Diagnosing Complicated Grief

Experiencing grief is a completely normal reaction to a sudden loss, however, when this grief is persistent and intense, it may become complicated. Although complicated grief is not officially listed in the diagnostic and statistical manual as a clinical disorder by the American Psychiatric Association, it is a real condition with a range of effective treatment options.

Mental health experts agree that if an individual has lived with persisting grief for over six months, then it can be recognised as complicated grief. The symptoms listed above are also indications that normal grief has developed into a complicated disorder.


As an intensely painful and difficult process, complicated grief disorder requires treatment from a mental health professional. Fortunately, research has found that there is a range of effective options that can be utilised to treat complicated grief. If you have recently suffered an immense loss, the first step is to speak to your doctor who will be able to offer support and guidance for your next steps

Treatment for complicated grief focuses on teaching individuals to accept and live with the condition to ensure that the healing process can begin. Therapists will ensure that you are able to effectively manage your feelings in order to move on with your life, while not forgetting the deceased loved one.

If another mental illness is present, such as co-occurring depression, it is important that this is also treated to ensure a successful recovery. For example, mental health experts may prescribe antidepressants to help relieve symptoms if complicated grief is accompanied by depression. 

Traumatic grief therapy is also a proven effective treatment option for complicated grief. This treatment option consists of a therapist using behavioural and interpersonal techniques to guide you in dealing with your loss.

Treatment at Addcounsel

Although experiencing grief can seem like an extremely isolating experience, you are never alone and help is always available to help you through these difficult times.

Addcounsel offers an outstanding and exceptional one-to-one treatment option for outpatient mental and behavioural care treating a range of mental disorders. Our evidence-based services are delivered by a team of mental health professionals who ensure each of our clients receives the utmost compassion and care as they work towards a healthy recovery.

Addcounsel understands the importance of complete privacy for our clients while they heal. The one-to-one treatment for our clients ensures that they are able to practise new coping mechanisms throughout their daily routine. Addcounsel offers a range of modalities such as:

  • One-to-one sessions
  • Counselling
  • Cognitive behavioural therapy (CBT)
  • Dual diagnosis
  • Targeted trauma treatment
  • EMDR
  • Ongoing aftercare

It can seem overwhelming to ask for help, but we are here to ensure that the start of your recovery journey is as easy as possible. The first step is reaching out for support. If you believe that you or a loved one is living with complicated grief then please contact us today to find out more about Addcounsel.

We are here to help

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