Complicated Grief: Signs, Symptoms, and Treatment

Losing someone you love is never easy; it takes time to heal, accept loss, and adjust. For most people, the feelings of hurt, sadness, and sorrow gradually ease as they go through a normal, healthy grieving process.

But for some, negative feelings can persist or intensify as time goes on, making it hard to recover and resume everyday life. This is known as complicated grief, and it’s what we’ll be talking about today.

Complicated grief is a mental health issue that deserves attention. If you think you may have it or know someone who has, this article will offer guidance on the best steps to take. We’ll explain what to look out for, the symptoms, risk factors, prevention tips, and where to seek help.

Everyone deserves to be able to process their loss, positively remember loved ones, and move forward with their lives. If complicated grief is causing you intense and ongoing suffering, it’s important to know that help is available, and you can overcome it.

What is Complicated Grief?

Complicated grief, or persistent complex bereavement disorder as it’s also known, is a form of acute grief that lingers or worsens with time. It interrupts the normal grieving process, preventing the bereaved from healing and leading a normal life. It effectively traps the griever in a prolonged, intense state of mourning.

It’s thought to be related to adjustment disorder, which can occur when people struggle to cope with stressful life experiences. Complicated grief can also have similar symptoms to other mental illnesses, like depression.

Signs and Symptoms

Complicated grief symptoms can be similar to those of normal grief, especially in the early stages after the loss. This can make it tricky to determine whether someone has it or not.

We’ll provide some tips in a moment to help you assess your situation, so you’ll know when to seek help. But first, here are the most common symptoms of complicated grief to look out for:

  • Intense Rumination: Constantly thinking about and dwelling on the loss of your loved one. You find it hard to focus on anything else.
  • Problems with Acceptance: You cannot accept the death or the new reality of life after the loss.
  • Overwhelming Negative Emotions: Regularly experiencing feelings of intense anger, sadness, sorrow, guilt, bitterness, or depression.
  • Self-blame or Hatred: You believe you could have prevented the loss or did something wrong. You beat yourself up with constant self-criticism.
  • Avoidance and Isolation: You isolate yourself socially, avoid others, and have difficulty with relationships. You may also excessively avoid things that remind you of your loss.
  • Loss of Meaning: You feel numb, detached, and a sense of emptiness. You think you have no purpose in life.
  • Suicidal Thoughts: Thoughts of harming yourself or ending your life. You may wish you had died with or instead of your loved one.

While some of the symptoms above can be a part of a normal grieving experience, such as intense feelings of sadness or sorrow, it’s always best to seek the help of a mental health professional if:

  • You are still experiencing debilitating grief more than six months after the loss.
  • The symptoms have not reduced, or have intensified, months after the loss.
  • The symptoms are preventing you from resuming a normal life.
  • You are having suicidal thoughts or self-harming.
  • You are engaging in self-destructive behaviors or substance abuse.

Who’s Most at Risk?

Anyone can develop complicated grief, and it’s not possible to say for sure what causes it.

That said, it’s believed that certain factors may increase the risk of someone developing it, such as:

  • Women are more likely to develop it than men.
  • It becomes more common with older age.
  • The loss or death is violent, shocking, or unexpected.
  • The griever has a history of mental health disorders.
  • The griever experienced trauma or abuse as a child.
  • The griever experienced multiple losses in a short period.
  • Support is not given to or sought by the griever.

Can You Prevent it?

There is no guaranteed way to prevent complicated grief from developing. However, there are ways to reduce the risk.

Seeing a counselor soon after the loss can help, especially for those who are at higher risk. Likewise, talking about your loss with others, such as family and friends, can provide valuable support

Allowing yourself to feel the pain caused by the loss, as unpleasant as it is, can also help you move through the stages of grief. 

What to Do If You Think You Have It

Okay, so you’ve identified the signs and symptoms and believe you may have complicated grief. What should you do now?

The best advice would be to book an appointment with a trusted and qualified mental health professional. Preferably, you should find a therapist who has experience working with complicated grief and success in treating it. 

A therapist can provide clarity and set you on the path to recovery. If complicated grief is left undiagnosed and untreated, it can continue to cause suffering for many years. Complications can also occur, such as the development of anxiety or depression. This is why it’s always best to seek help if you’re unsure.

How Is it Treated?

Your therapist will perform a psychological and medical exam to diagnose your condition and determine the best treatment. This is important as there are similarities between complicated grief, normal grief, and major depression; each will require a different approach.

Normal grief does not necessarily need treatment, but a therapist can still help you work through your feelings, offer support, and give advice on coping. 

Forms of psychotherapy, such as complicated grief therapy or bereavement therapy, are often used to treat complicated grief. Therapy can:

  • Help you understand complicated grief.
  • Help you identify and overcome harmful thoughts and beliefs.
  • Teach you effective coping skills.
  • Help you redefine your goals and adjust to your loss.
  • Allow you to share your experience with others.
  • Help you process your thoughts and emotions.


Losing a loved one is such a painful and distressing experience, and unfortunately, it’s something that most people face.

Complicated grief makes it difficult to come to terms with the loss, causing long-lasting and unnecessary suffering. After all, the wish of the person you lost would be for you to live well, not in misery.

Thankfully there are ways to treat it, and online support is available as well. If you know someone who has complicated grief, please encourage them to seek help. Online therapists at Calmerry can help sufferers find resolution and acceptance and move on with their lives.

Kate Skurat

Kate Skurat

Licensed Mental Health Counselor | Washington, United States

Kate has a B.S. in Psychology and M.A. in Clinical Psychology from Pepperdine University and has worked in healthcare since 2017. She primarily treated depression, anxiety, eating disorders, trauma, and grief, as well as identity, relationship and adjustment issues. Her clinical experience has focused on individual and group counseling, emergency counseling and outreach. Read more