Understanding complicated grief

Grief is an intensely personal experience, and what might be the hardest type of grief for one person may not be the same for another. However, many mental health professionals agree that complicated grief, also known as prolonged grief disorder, is one of the most challenging types to cope with. 

Complicated grief is characterised by an intense, prolonged period of mourning that significantly impairs daily functioning. Unlike normal grief, which gradually eases over time, complicated grief persists, often lasting for years without significant improvement.

Common symptoms of grief

Grief is a complex emotional response to loss, often associated with the death of a loved one, but it can also result from other significant changes, such as the end of a relationship, the loss of a job, or a major life transition. The symptoms of grief can vary widely among individuals, but there are common patterns and reactions that many people experience. Understanding these symptoms can help individuals recognise and cope with their grief more effectively.

Emotional symptoms

Profound feelings of sadness and despair are perhaps the most recognisable symptoms of grief. These emotions can manifest as persistent crying, a sense of hopelessness, and a deep longing for the deceased or the lost situation.

Anger is a common reaction to loss. Individuals may feel angry at themselves, the deceased others involved in the situation, or even the perceived injustice or unfairness of the loss. Many people experience guilt or regret during grief. They might dwell on things they wish they had done differently, unresolved conflicts, or unexpressed feelings toward the deceased.

Anxiety and fear

Loss can trigger anxiety and fear, including worries about the future, concerns about one's mortality, or fears about living without the person or situation that was lost.

Initially, grief can lead to feelings of numbness or shock, where the individual feels disconnected from reality or unable to process the loss fully. A deep longing or yearning for the person who has died is a common symptom, often accompanied by vivid memories and a desire to be reunited with the deceased.

Physical symptoms

Grieving individuals often feel physically drained and exhausted, even with adequate rest. This fatigue can result from the emotional toll of grief. Difficulty sleeping, insomnia, or sleeping too much are also common during grief. Sleep disturbances can exacerbate other symptoms of grief and contribute to overall fatigue.

Grief can lead to changes in appetite, resulting in weight loss or gain. Some individuals may lose interest in food, while others may use food as a coping mechanism. Physical manifestations of grief can include headaches, stomachaches, and generalised body pain. These symptoms can be stress-related and indicative of the body's response to emotional distress. Grief can weaken the immune system, making individuals more susceptible to illnesses and infections.

Cognitive symptoms

Grief can cause cognitive disruptions, leading to confusion, difficulty concentrating, and a sense of disorientation. Individuals might find it hard to focus on tasks or make decisions. Memory problems and forgetfulness are common. Grieving individuals might struggle to remember simple tasks, appointments, or conversations.

Persistent thoughts about the deceased or the circumstances of the loss can intrude on daily life. These thoughts can be distressing and difficult to control.

Behavioural symptoms

Many people experiencing grief withdraw from social activities and isolate themselves from friends and family. They might feel that others do not understand their pain or prefer to grieve privately. Grieving individuals might abandon their usual routines or hobbies, either because they no longer find joy in them or because they are overwhelmed by their emotions.

Some individuals might avoid places, people, or activities that remind them of their loss. This avoidance can be a way to cope with the pain but might also hinder the grieving process.

Spiritual symptoms

Grief can lead to spiritual questioning or a crisis of faith. Individuals might grapple with existential questions, search for meaning in their loss, or feel disconnected from their spiritual or religious beliefs. Conversely, some individuals may find comfort in their spiritual or religious practices, seeking solace, and connection through prayer, meditation, or community support.

Here are some effective coping mechanisms:

Grief counselling and therapy: Engaging with a therapist who specialises in grief can provide a safe space to explore and process emotions. Therapies such as Cognitive Behavioural Therapy (CBT) and Complicated

Grief Treatment (CGT) is particularly effective.

Support groups: Joining a support group can provide connection and understanding from others who are experiencing similar loss. Sharing experiences and listening to others can offer comfort and reduce feelings of isolation.

Medication: In some cases, medication may be prescribed to help manage symptoms of depression or anxiety that often accompany complicated grief. This should be discussed with a healthcare provider.

Personal coping strategies

Express emotions: Finding ways to express emotions, whether through talking, writing, art, journaling or other creative outlets, can help in processing grief.

Maintain a routine: Establishing and maintaining a daily routine can provide structure and a sense of normalcy. This can help counter feelings of chaos and purposelessness.

Take care of physical health: Grief takes a toll on the body as well as the mind. Prioritising physical health through regular exercise, a balanced diet, and sufficient sleep is crucial.

Social support: Lean on friends and family for support. While it can be tempting to isolate oneself, staying connected with loved ones can provide emotional support and reduce feelings of loneliness.

Set small goals: Setting small, manageable goals can help provide a sense of achievement and forward movement. These goals can be as simple as going for a walk, cooking a meal, or engaging in a hobby.

Mindfulness and relaxation: Practices such as mindfulness meditation, yoga, and deep breathing exercises can help manage stress and provide moments of peace in the turmoil of grief.