While talking with her doctor, the woman reveals that she’s been sleeping on her couch because sleeping in the bed she and her husband shared makes her miss him too much. She still blames herself and her husband’s medical team for his death, and she thinks about him “constantly” — often wishing to die so that she can be with him again. Grief, briefly defined, is the emotional reaction a person has following a loss. During the weeks and months following a loss — such as the death of a spouse or parent — almost any reaction is considered “normal.” But at a certain point, if the grief continues to interfere with a person’s life, it may be considered a diagnosable disorder. RELATED: How 2 Caregivers Are Coping With Losing a Loved One During the COVID-19 Pandemic 2. Since the death, there has been a grief response characterized by one or both of the following nearly every day for at least the last month:
Intense yearning or longing for the deceased personPreoccupation with thoughts or memories of the deceased person (in children and adolescents, preoccupation may focus on the circumstances of the death)
- As a result of the death, at least three of the following eight symptoms have been experienced nearly every day for at least the last month:
Identity disruption (such as feeling as though part of oneself has died)Marked sense of disbelief about the deathAvoidance of reminders that the person is deadIntense emotional pain (such as anger, bitterness, or sorrow) related to the deathDifficulty with reintegration into life after the death (including problems engaging with friends, pursuing interests, or planning for the future)Emotional numbness (for example, an absence or marked reduction in the intensity of emotions, or feeling stunned) as a result of the deathFeeling that life is meaningless as a result of the deathIntense loneliness (such as feeling alone or detached from others) as a result of the death
- The loss causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- The duration and severity of the bereavement reaction clearly exceeds expected social, cultural, or religious norms for the individual’s culture and context.
- The symptoms of grief are not better explained by major depressive disorder, post-traumatic stress disorder, or another mental disorder, or attributable to the physiological effects of a substance (such as medication or alcohol) or another medical condition. Shear adds that complicated grief or prolonged grief disorder is by and large defined by the extent to which grief affects someone’s life. “It’s when grief is continuing to dominate someone’s life, getting other people frustrated, and it feels like they can’t come to terms with the new reality or restore their ability to thrive,” she says. RELATED: The Top Mental Health TikTok Influencers — and Why They’re Important It’s also worth pointing out that many of the criteria for prolonged grief disorder are subjective or based in part on a person’s social or cultural norms. “There is considerable cultural variation in what is regarded as ‘normal’ or ‘typical’ grief,” says Matthew Ratcliffe, PhD, professor of philosophy at the University of York in the United Kingdom, whose current research focuses on grief. He adds, however, that an extended duration of grief and an inability to accept events that have happened are often the hallmark indicators that grief may be considered “prolonged grief disorder.” RELATED: Symptoms of Depression That You Shouldn’t Ignore “Experiences of grief and their course over time are highly diverse,” Dr. Ratcliffe says. Just as the experience of grief is diverse, so are the methods by which people can cope with it. It’s important to emphasize, once again, that experts tend not to talk about grief in terms of “normal” and “abnormal.” The term “complicated grief” doesn’t mean that someone’s method of mourning is somehow wrong. Rather, it’s an acknowledgment that some forms of grief may be especially difficult to overcome and could benefit from an expert’s attention. If you suspect that the grief you are experiencing or the grief that someone you know is experiencing may be prolonged or complicated grief — and that you or that person may benefit from professional help — seek it. Start with your therapist (if you have one) or ask your primary care provider for a recommendation. RELATED: A Psychiatrist’s Guide to Finding a Mental Health Care Provider
