Materiały źródłowe

• #1

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3384440/

  Complicated grief is a recently recognized condition that occurs in about 7% of bereaved people. […] People with complicated grief need help, and clinicians need to know how to recognize the symptoms and how to provide help. […] An important minority, currently estimated at about 7% of bereaved people, does not cope effectively with bereavement. Instead, they become entangled in grief, caught up in a futile struggle of silent protest, trying to avoid reminders, and being carried helplessly on endless waves of acutely painful emotion. These people are suffering from complicated grief (CG), a syndrome in which healing is impeded and acute grief is intense and prolonged. […] CG is a chronic impairing form of grief brought about by interference with the healing process. […] The result is delayed healing and increased pain which occurs because aspects of a person’s response to the circumstances or consequences of the death derail the mourning process, interfering with learning, and preventing the natural healing process from progressing.

• #2 Complicated grief | Psychlinks Forum — Archive Only (2004-2022)

  https://forum.psychlinks.ca/threads/complicated-grief.7067/

  Some estimates suggest that as few as 6 percent or as many as 20 percent of bereaved people develop complicated grief. […] Complicated grief treatment hasn’t been standardized because mental health providers are still learning about the condition. […] More study is needed to help determine which treatment options may be best for complicated grief.

• #3 Complicated grief – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/complicated-grief/symptoms-causes/syc-20360374

  For some people, feelings of loss are debilitating and don’t improve even after time passes. This is known as complicated grief, sometimes called persistent complex bereavement disorder. […] It’s not known what causes complicated grief. As with many mental health disorders, it may involve your environment, your personality, inherited traits and your body’s natural chemical makeup.

• #4 Depression vs. Complicated Grief

  https://www.healthline.com/health/depression/complicated-grief

  A history of trauma or abuse can cause your normal grief to develop into CG as your mind and body struggle to accept your sudden loss. […] CG has been shown to activate parts of the brain associated with reward. […] Another study showed that CG can also stimulate your brain’s amygdala, causing avoidance behaviors. […] Complicated grief may occur in response to other meaningful situations that don’t involve death. These are sometimes referred to as non-bereavement losses.

• #5 Persistent Complex Bereavement Disorder: Typical Symptoms, Causes, And Treatments For Prolonged Grief | BetterHelp

  https://www.betterhelp.com/mental-health/disorders-conditions/persistent-complex-bereavement-disorder/

  Grief after death is common, as death is a part of human existence. […] However, 10% to 20% of people have difficulties that persist rather than diminish. This can sometimes be called persistent grief disorder or complicated grief disorder. […] Doctors are unsure what causes PCBD or complex grief, but recent research indicates that the effects of grief on the body are complex. For example, cardiovascular biomarkers show consistent changes between people experiencing acute and chronic grief, which can cause physical symptoms like elevated heart rate and high blood pressure. […] Once these regions were identified, the study compared the response of those with complicated grief to those who were adapting well and identified a single area responding differently. People experiencing complicated grief experienced more activity in a part of the basal ganglia called the nucleus accumbens, which is involved in the brains reward pathway. […] This research indicates that PCBD or complicated grief may be linked to the idea that wanting and yearning for the deceased activates a part of the brains reward center, but more research is needed to understand the intense emotional connections related to this mental illness.

• #6 Depression vs. Complicated Grief

  https://www.healthline.com/health/depression/complicated-grief

  A history of trauma or abuse can cause your normal grief to develop into CG as your mind and body struggle to accept your sudden loss. […] CG has been shown to activate parts of the brain associated with reward. […] Another study showed that CG can also stimulate your brain’s amygdala, causing avoidance behaviors. […] Complicated grief may occur in response to other meaningful situations that don’t involve death. These are sometimes referred to as non-bereavement losses.

• #7 Complicated Grief Symptoms and Treatment | Blog | TalktoAngel

  https://www.talktoangel.com/blog/complicated-grief-symptoms-and-treatment

  Complicated grief can arise from various circumstances and factors that complicate the mourning process beyond what is considered typical. Understanding these causes is crucial for identifying individuals at risk and providing appropriate support: […] Research indicates that individuals with a history of trauma or previous mental health conditions may be more susceptible to developing complicated grief. Studies have shown that the neurobiological underpinnings of complicated grief differ from those of normal grief, involving dysregulation in neural circuits associated with reward, motivation, and emotion processing.

• #8 Complicated Grief: When Grieving Becomes a Long Journey

  https://psychcentral.com/depression/all-about-complicated-grief

  Grief is a natural response to losing someone you love. But for most people, even when challenging and hurtful, grief is a temporary experience. […] The causes of prolonged grief disorder are not yet clear, but many factors may be involved, including: trauma, biology, environmental aspects. […] Some research suggests that those with a history of substance use disorder may be more likely to develop prolonged grief disorder. […] A 2020 study also suggests that those who experience prolonged grief show impairments in their emotional processing ability, as well as increased activity in the amygdala. […] Research from 2015 has suggested that a potential cause of prolonged grief disorder is a lost sense of identity after losing someone so close to you. […] This, however, doesn’t imply causality. More research is needed to understand what leads someone to develop symptoms of complicated grief. […] Complicated grief, on the other hand, is directly caused by a specific stressful circumstance: the death of a loved one. […] Not being able to move on without the person you lost is a specific symptom of prolonged grief disorder and not depression.

• #9 Persistent Complex Bereavement Disorder: Typical Symptoms, Causes, And Treatments For Prolonged Grief | BetterHelp

  https://www.betterhelp.com/mental-health/disorders-conditions/persistent-complex-bereavement-disorder/

  Grief after death is common, as death is a part of human existence. […] However, 10% to 20% of people have difficulties that persist rather than diminish. This can sometimes be called persistent grief disorder or complicated grief disorder. […] Doctors are unsure what causes PCBD or complex grief, but recent research indicates that the effects of grief on the body are complex. For example, cardiovascular biomarkers show consistent changes between people experiencing acute and chronic grief, which can cause physical symptoms like elevated heart rate and high blood pressure. […] Once these regions were identified, the study compared the response of those with complicated grief to those who were adapting well and identified a single area responding differently. People experiencing complicated grief experienced more activity in a part of the basal ganglia called the nucleus accumbens, which is involved in the brains reward pathway. […] This research indicates that PCBD or complicated grief may be linked to the idea that wanting and yearning for the deceased activates a part of the brains reward center, but more research is needed to understand the intense emotional connections related to this mental illness.

• #10 Complicated Grief | Fact Sheet – ABCT – Association for Behavioral and Cognitive Therapies

  https://www.abct.org/fact-sheets/complicated-grief/

  Complicated grief affects between 2% to 3% of the population worldwide and 7% to 10% of bereaved people. […] While most people who lose a loved one instinctively adapt to the loss, for a substantial minority of the bereaved the adaptation process is slowed or halted by complications, and the symptoms of acute grief persist indefinitely. We call this condition complicated grief. […] Risk factors include a history of mood or anxiety disorders, alcohol or drug abuse, and multiple losses. […] Complicated grief is different from depression and/or posttraumatic stress disorder (PTSD). […] In PTSD, anxiety is focused on the fear of recurrent danger, as opposed to insecurity without the deceased as in complicated grief, and intrusive or distorted thoughts relate to the traumatizing event, as opposed to the deceased individual. […] There are two approaches: one deals with complicated grief; the other gives us strategies for accepting the loss and for restoring a sense of the possibility of future happiness.

• #11 Complicated Grief | Fact Sheet – ABCT – Association for Behavioral and Cognitive Therapies

  https://www.abct.org/fact-sheets/complicated-grief/

  Complicated grief affects between 2% to 3% of the population worldwide and 7% to 10% of bereaved people. […] While most people who lose a loved one instinctively adapt to the loss, for a substantial minority of the bereaved the adaptation process is slowed or halted by complications, and the symptoms of acute grief persist indefinitely. We call this condition complicated grief. […] Risk factors include a history of mood or anxiety disorders, alcohol or drug abuse, and multiple losses. […] Complicated grief is different from depression and/or posttraumatic stress disorder (PTSD). […] In PTSD, anxiety is focused on the fear of recurrent danger, as opposed to insecurity without the deceased as in complicated grief, and intrusive or distorted thoughts relate to the traumatizing event, as opposed to the deceased individual. […] There are two approaches: one deals with complicated grief; the other gives us strategies for accepting the loss and for restoring a sense of the possibility of future happiness.

• #12 What Is Complicated Grief and When Is It a Disorder?

  https://www.everydayhealth.com/emotional-health/grief/what-is-complicated-grief/

  Complicated grief is defined as grief that is unusually severe and prolonged and impairs a person’s ability to live a normal life, according to the article. […] Complicated grief is now called prolonged grief disorder, says M. Katherine Shear, MD, the author of the study in The New England Journal of Medicine and the Marion E. Kenworthy professor of psychiatry at Columbia University in New York, who studies grief and bereavement. […] According to Shear’s work, some risk factors for complicated grief include: a history of mood or anxiety disorders, a history of alcohol or drug abuse, experiencing multiple losses, a difficult childhood or upbringing, poor social support following a loss, serious conflicts with friends or loved ones, and major financial problems following a loss. […] The causes of complicated grief are likely multifactorial. In other words, several of these factors along with others not mentioned here may come together to cause complicated grief. […] 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.

• #13 Persistent Complex Bereavement Disorder DSM-5

  https://www.theravive.com/therapedia/persistent-complex-bereavement-disorder-dsm–5

  A number of risk factors have been identified for the development of pathological grief after bereavement. These include first-degree relationship to the deceased, separation anxiety in childhood, controlling parents, abuse by or death of parents during childhood, a poorly-functioning marriage or insecure attachment style prior to widowhood, emotional dependency on the deceased, lack of preparation for the death and in-hospital death of the loved one. […] A prolonged state of abnormal grief has been associated with elevated rates of suicidal ideation and suicide attempts. […] This has led to the proposal of a separate psychiatric disorder of persistent and complex bereavement, although it was elected in the preparation of DSM-5 to defer the establishment of this diagnosis for further study.

• #14 What is complicated grief? Symptoms and treatment

  https://www.medicalnewstoday.com/articles/complicated-grief

  Complicated grief is grief that lasts longer and is more intense than a culture may consider typical. It may disrupt someones daily life, alter their sense of identity, and cause frequent, strong emotions, such as longing, anger, or loneliness. […] According to the APA, it may cause someone to become preoccupied by their loss in a way that disrupts daily life. […] According to a 2022 article, complicated grief may affect up to 710% of people who experience bereavement. […] Researchers are not sure why some people develop prolonged grief, and others do not. Different studies have identified various risk factors. Some include: a loved one dying in a way that is sudden, painful, violent, or otherwise traumatic; the nature of the relationship with the departed loved one, as closer relationships may inspire more grief; denial or difficulty accepting the death; avoidance of difficult emotions, which may prevent someone from processing what has happened; a negative view of the self and the world.

• #15 Complicated grief | Cruse Bereavement Support

  https://www.cruse.org.uk/understanding-grief/effects-of-grief/complicated-grief/

  If you were cut off from the person who died or you had fallen out recently, this might make grieving more difficult. […] If your child has died you may be more likely to experience complicated or prolonged grief. […] If you’ve experienced other deaths in your past, particularly at an early age, this can make complicated grief more likely. Some people can experience grief overload, from multiple bereavements or from other losses, eg of home or job, or through divorce. […] If you have an existing mental health condition then this can make the grieving process more difficult.

• #16 What is complicated grief? Symptoms and treatment

  https://www.medicalnewstoday.com/articles/complicated-grief

  Complicated grief is grief that lasts longer and is more intense than a culture may consider typical. It may disrupt someones daily life, alter their sense of identity, and cause frequent, strong emotions, such as longing, anger, or loneliness. […] According to the APA, it may cause someone to become preoccupied by their loss in a way that disrupts daily life. […] According to a 2022 article, complicated grief may affect up to 710% of people who experience bereavement. […] Researchers are not sure why some people develop prolonged grief, and others do not. Different studies have identified various risk factors. Some include: a loved one dying in a way that is sudden, painful, violent, or otherwise traumatic; the nature of the relationship with the departed loved one, as closer relationships may inspire more grief; denial or difficulty accepting the death; avoidance of difficult emotions, which may prevent someone from processing what has happened; a negative view of the self and the world.

• #17 Complicated Grief: When Grieving Becomes a Long Journey

  https://psychcentral.com/depression/all-about-complicated-grief

  Grief is a natural response to losing someone you love. But for most people, even when challenging and hurtful, grief is a temporary experience. […] The causes of prolonged grief disorder are not yet clear, but many factors may be involved, including: trauma, biology, environmental aspects. […] Some research suggests that those with a history of substance use disorder may be more likely to develop prolonged grief disorder. […] A 2020 study also suggests that those who experience prolonged grief show impairments in their emotional processing ability, as well as increased activity in the amygdala. […] Research from 2015 has suggested that a potential cause of prolonged grief disorder is a lost sense of identity after losing someone so close to you. […] This, however, doesn’t imply causality. More research is needed to understand what leads someone to develop symptoms of complicated grief. […] Complicated grief, on the other hand, is directly caused by a specific stressful circumstance: the death of a loved one. […] Not being able to move on without the person you lost is a specific symptom of prolonged grief disorder and not depression.

• #18 Persistent Complex Bereavement Disorder DSM-5

  https://www.theravive.com/therapedia/persistent-complex-bereavement-disorder-dsm–5

  There is no single common denominator to identify who will suffer from persistent complex bereavement disorder but there are various potential contributing/risk factors. […] Personality traits such as a negative outlook and specific factors like a violent causes of death (such as suicide) may be associated with the onset of complicated grief, along with insecure attachment style or a history of trauma. […] Individuals suffering from persistent complex bereavement disorder may find that the symptoms of their condition have a host of adverse effects on their mood, functioning and relationships. […] Complicated grief manifests in different ways from person to person; some individuals may become preoccupied with the deceased to the point that they display symptoms of an illness their loved one had, or attempt to feel closer to the departed by surrounding themselves with their possessions.

• #19 Grief and Prolonged Grief Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507832/

  Prolonged grief disorder is a complex condition that can emerge when an individual is unable to transition from acute grief to a more integrated form of mourning following the death of a loved one. […] This condition, identified as prolonged grief disorder, results from a failure to transition from acute to integrated grief. Symptoms of acute grief include sadness, tearfulness, and possibly insomnia, and typically require no treatment. Prolonged grief disorder involves intense, painful emotions associated with a lack of adaptation to the loss of a loved one that persists for more than 1 year in adults and more than 6 months in adolescents or children. This condition is estimated to affect as many as 7% of bereaved individuals. […] There are identifiable risk factors that can increase a person’s likelihood of developing prolonged grief disorder. Traumatic circumstances such as the death of a spouse or a child, the death of a parent in early childhood or adolescence, sudden, unexpected, and untimely deaths (particularly if associated with horrific circumstances), multiple deaths (particularly disasters), and deaths by murder or manslaughter can prolong grief. Vulnerable people such as those with low self-esteem, low trust in others, previous psychiatric disorders, previous suicidal threats or attempts, young age of the deceased, lower perceived social supports, an ambivalent attachment to the deceased person, dependent or interdependent attachment to the deceased person, and insecure attachment to parents in childhood (mainly learned fear or learned helplessness) can also increase risk for prolonged grief.

• #20 What Is Prolonged Grief Disorder?

  https://www.webmd.com/mental-health/prolonged-grief-disorder

  Prolonged grief disorder (PGD), or complicated grief, can happen after a person close to you has died within at least 6 months (12 months for children and teens). […] PGD is common in those whove lost a child or romantic partner. Its more likely to happen after a violent or abrupt death, such as murder, suicide, or an accident. […] Loss from ongoing disasters, like the COVID-19 pandemic, can also lead to PGD. […] The DSM-5 criteria for PGD are a persistent grief response, including constant yearning for a person who died and/or fixation with the death of a loved one. And at least three of eight symptoms listed above. […] In 2018, the World Health Organization (WHO) approved another trait. They state that PGD symptoms also cause significant trouble in important areas, such as ones personal, educational, or work life. If the person is still able to function in these areas, its only through intense additional effort.

• #21 What Is Prolonged Grief Disorder?

  https://www.webmd.com/mental-health/prolonged-grief-disorder

  Prolonged grief disorder (PGD), or complicated grief, can happen after a person close to you has died within at least 6 months (12 months for children and teens). […] PGD is common in those whove lost a child or romantic partner. Its more likely to happen after a violent or abrupt death, such as murder, suicide, or an accident. […] Loss from ongoing disasters, like the COVID-19 pandemic, can also lead to PGD. […] The DSM-5 criteria for PGD are a persistent grief response, including constant yearning for a person who died and/or fixation with the death of a loved one. And at least three of eight symptoms listed above. […] In 2018, the World Health Organization (WHO) approved another trait. They state that PGD symptoms also cause significant trouble in important areas, such as ones personal, educational, or work life. If the person is still able to function in these areas, its only through intense additional effort.

• #22 Complicated grief | Cruse Bereavement Support

  https://www.cruse.org.uk/understanding-grief/effects-of-grief/complicated-grief/

  If you were cut off from the person who died or you had fallen out recently, this might make grieving more difficult. […] If your child has died you may be more likely to experience complicated or prolonged grief. […] If you’ve experienced other deaths in your past, particularly at an early age, this can make complicated grief more likely. Some people can experience grief overload, from multiple bereavements or from other losses, eg of home or job, or through divorce. […] If you have an existing mental health condition then this can make the grieving process more difficult.

• #23 Grief and Prolonged Grief Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507832/

  Prolonged grief disorder is a complex condition that can emerge when an individual is unable to transition from acute grief to a more integrated form of mourning following the death of a loved one. […] This condition, identified as prolonged grief disorder, results from a failure to transition from acute to integrated grief. Symptoms of acute grief include sadness, tearfulness, and possibly insomnia, and typically require no treatment. Prolonged grief disorder involves intense, painful emotions associated with a lack of adaptation to the loss of a loved one that persists for more than 1 year in adults and more than 6 months in adolescents or children. This condition is estimated to affect as many as 7% of bereaved individuals. […] There are identifiable risk factors that can increase a person’s likelihood of developing prolonged grief disorder. Traumatic circumstances such as the death of a spouse or a child, the death of a parent in early childhood or adolescence, sudden, unexpected, and untimely deaths (particularly if associated with horrific circumstances), multiple deaths (particularly disasters), and deaths by murder or manslaughter can prolong grief. Vulnerable people such as those with low self-esteem, low trust in others, previous psychiatric disorders, previous suicidal threats or attempts, young age of the deceased, lower perceived social supports, an ambivalent attachment to the deceased person, dependent or interdependent attachment to the deceased person, and insecure attachment to parents in childhood (mainly learned fear or learned helplessness) can also increase risk for prolonged grief.

• #24 Grief and Prolonged Grief Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507832/

  Prolonged grief disorder is a complex condition that can emerge when an individual is unable to transition from acute grief to a more integrated form of mourning following the death of a loved one. […] This condition, identified as prolonged grief disorder, results from a failure to transition from acute to integrated grief. Symptoms of acute grief include sadness, tearfulness, and possibly insomnia, and typically require no treatment. Prolonged grief disorder involves intense, painful emotions associated with a lack of adaptation to the loss of a loved one that persists for more than 1 year in adults and more than 6 months in adolescents or children. This condition is estimated to affect as many as 7% of bereaved individuals. […] There are identifiable risk factors that can increase a person’s likelihood of developing prolonged grief disorder. Traumatic circumstances such as the death of a spouse or a child, the death of a parent in early childhood or adolescence, sudden, unexpected, and untimely deaths (particularly if associated with horrific circumstances), multiple deaths (particularly disasters), and deaths by murder or manslaughter can prolong grief. Vulnerable people such as those with low self-esteem, low trust in others, previous psychiatric disorders, previous suicidal threats or attempts, young age of the deceased, lower perceived social supports, an ambivalent attachment to the deceased person, dependent or interdependent attachment to the deceased person, and insecure attachment to parents in childhood (mainly learned fear or learned helplessness) can also increase risk for prolonged grief.

• #25 Understanding Complicated Grief: Causes, Symptoms & Treatment

  https://thriveworks.com/help-with/grief-loss/complicated-grief/

  Complicated grief is characterized by the overwhelming and persistent feelings of intense grief that extend beyond what is considered normal grieving. […] Understanding the potential causes and triggers of complicated grief is essential in addressing this challenging condition effectively. Common factors that can lead to complicated grief include: The sudden and unexpected death of a loved one, The loss of a child, A lack of coping skills, Insufficient support from friends and family, Unresolved conflicts before the loved ones passing, Coexisting mental health issues such as depression and anxiety. […] Complicated grief occurs when the individual is unable to adapt to the loss of a loved one. This inability to adapt can be influenced by a variety of factors, including the circumstances of the loss, the individuals coping mechanisms, and their support network.

• #26 The Profound Sadness of Prolonged Grief | Harvard Medicine Magazine

  https://magazine.hms.harvard.edu/articles/profound-sadness-prolonged-grief

  Prolonged grief generally presents with an inability to adapt to the loss, Simon says. You wake up and feel like your loss is brand new, over and over again. […] It explained that grief can be complicated, much as wound-healing can be complicated, with the intensity and duration of symptoms heightened and prolonged. […] While there arent rigid rules as to who is more likely to experience such grief, Shear says that, in general, people who lose an identifying relationship a parent, a child, a spouse are more susceptible to the condition. […] In older adults, prolonged grief can affect as many as a quarter of those suffering a loss, according to a 2011 study, while a 2014 study in JAMA Psychiatry stated that about 9 percent of bereaved older women, defined as women over the age of 65, experience prolonged grief.

• #27 Complicated Grief: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24951-complicated-grief

  Complicated grief is experiencing symptoms of grief that continue for a year after a loss. Complicated grief can affect your physical health, interpersonal relationships and daily responsibilities. […] Complicated grief is long-lasting grief that occurs after a loss. It causes intense emotions and consuming thoughts that dont fade over time and can affect your daily life. […] But complicated grief doesnt go away on its own. It can wear on you physically and emotionally, more than whats usually expected after a loss. […] Loss causes complicated grief. It could happen after the death of a loved one, a divorce or moving, for example. Loss affects people in different ways and it can have a prolonged effect on a person. […] You may be more at risk of developing complicated grief if you experienced unexpected loss (suicide or accident).

• #28 Complicated grief

  https://www.mymlc.com/health-information/diseases-and-conditions/c/complicated-grief2/?section=Causes

  Losing a loved one is one of the most distressing and, unfortunately, common experiences people face. For some people, feelings of loss are debilitating and don’t improve even after time passes. This is known as complicated grief, sometimes called persistent complex bereavement disorder. In complicated grief, painful emotions are so long lasting and severe that you have trouble recovering from the loss and resuming your own life. […] It’s not known what causes complicated grief. As with many mental health disorders, it may involve your environment, your personality, inherited traits and your body’s natural chemical makeup. […] Complicated grief occurs more often in females and with older age. Factors that may increase the risk of developing complicated grief include: An unexpected or violent death, such as death from a car accident, or the murder or suicide of a loved one.

• #29 Psychiatry.org – Prolonged Grief Disorder

  https://www.psychiatry.org/patients-families/prolonged-grief-disorder

  Grief is a natural response to the loss of a loved one. For most people, the symptoms of grief begin to decrease over time. However, for a small group of people, the feeling of intense grief persists, and the symptoms are severe enough to cause problems and stop them from continuing with their lives. Prolonged grief disorder is characterized by this intense and persistent grief that causes problems and interferes with daily life. […] Some individuals may be at greater risk of developing prolonged grief disorder, including older adults and people with a history of depression or bipolar disorder. Caregivers, especially if they were caring for a partner or had experienced depression before the loss, are also at greater risk. The risk for prolonged grief is also greater when the death of the loved one happens very suddenly or under traumatic circumstances.

• #30 Grief and Prolonged Grief Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507832/

  Prolonged grief disorder is a complex condition that can emerge when an individual is unable to transition from acute grief to a more integrated form of mourning following the death of a loved one. […] This condition, identified as prolonged grief disorder, results from a failure to transition from acute to integrated grief. Symptoms of acute grief include sadness, tearfulness, and possibly insomnia, and typically require no treatment. Prolonged grief disorder involves intense, painful emotions associated with a lack of adaptation to the loss of a loved one that persists for more than 1 year in adults and more than 6 months in adolescents or children. This condition is estimated to affect as many as 7% of bereaved individuals. […] There are identifiable risk factors that can increase a person’s likelihood of developing prolonged grief disorder. Traumatic circumstances such as the death of a spouse or a child, the death of a parent in early childhood or adolescence, sudden, unexpected, and untimely deaths (particularly if associated with horrific circumstances), multiple deaths (particularly disasters), and deaths by murder or manslaughter can prolong grief. Vulnerable people such as those with low self-esteem, low trust in others, previous psychiatric disorders, previous suicidal threats or attempts, young age of the deceased, lower perceived social supports, an ambivalent attachment to the deceased person, dependent or interdependent attachment to the deceased person, and insecure attachment to parents in childhood (mainly learned fear or learned helplessness) can also increase risk for prolonged grief.

• #31 What Is Prolonged Grief Disorder?

  https://www.webmd.com/mental-health/prolonged-grief-disorder

  Prolonged grief disorder (PGD), or complicated grief, can happen after a person close to you has died within at least 6 months (12 months for children and teens). […] PGD is common in those whove lost a child or romantic partner. Its more likely to happen after a violent or abrupt death, such as murder, suicide, or an accident. […] Loss from ongoing disasters, like the COVID-19 pandemic, can also lead to PGD. […] The DSM-5 criteria for PGD are a persistent grief response, including constant yearning for a person who died and/or fixation with the death of a loved one. And at least three of eight symptoms listed above. […] In 2018, the World Health Organization (WHO) approved another trait. They state that PGD symptoms also cause significant trouble in important areas, such as ones personal, educational, or work life. If the person is still able to function in these areas, its only through intense additional effort.

• #32 How to Identify and Address Complicated Grief | Online Counseling Programs

  https://onlinecounselingprograms.com/resources/what-is-complicated-grief/

  Events […] Natural versus traumatic violent death suicide, homicide, accident, finding the loved ones body after a violent death […] Death in a hospital versus home, or not being present when the loved one dies […] Preventable death (perceived negligence of treatment where it seems that the death could have been prevented) […] Multiple deaths around the same time […] Witnessing the death […] Relationships […] High marital dependency (if spouse has died) […] Close relationship to a dying patient […] Personal History […] History of trauma and losses […] Attachment issues.

• #33 How to Identify and Address Complicated Grief | Online Counseling Programs

  https://onlinecounselingprograms.com/resources/what-is-complicated-grief/

  Events […] Natural versus traumatic violent death suicide, homicide, accident, finding the loved ones body after a violent death […] Death in a hospital versus home, or not being present when the loved one dies […] Preventable death (perceived negligence of treatment where it seems that the death could have been prevented) […] Multiple deaths around the same time […] Witnessing the death […] Relationships […] High marital dependency (if spouse has died) […] Close relationship to a dying patient […] Personal History […] History of trauma and losses […] Attachment issues.

• #34 How to Identify and Address Complicated Grief | Online Counseling Programs

  https://onlinecounselingprograms.com/resources/what-is-complicated-grief/

  Events […] Natural versus traumatic violent death suicide, homicide, accident, finding the loved ones body after a violent death […] Death in a hospital versus home, or not being present when the loved one dies […] Preventable death (perceived negligence of treatment where it seems that the death could have been prevented) […] Multiple deaths around the same time […] Witnessing the death […] Relationships […] High marital dependency (if spouse has died) […] Close relationship to a dying patient […] Personal History […] History of trauma and losses […] Attachment issues.

• #35 How to Identify and Address Complicated Grief | Online Counseling Programs

  https://onlinecounselingprograms.com/resources/what-is-complicated-grief/

  Events […] Natural versus traumatic violent death suicide, homicide, accident, finding the loved ones body after a violent death […] Death in a hospital versus home, or not being present when the loved one dies […] Preventable death (perceived negligence of treatment where it seems that the death could have been prevented) […] Multiple deaths around the same time […] Witnessing the death […] Relationships […] High marital dependency (if spouse has died) […] Close relationship to a dying patient […] Personal History […] History of trauma and losses […] Attachment issues.

• #36 How to Identify and Address Complicated Grief | Online Counseling Programs

  https://onlinecounselingprograms.com/resources/what-is-complicated-grief/

  Events […] Natural versus traumatic violent death suicide, homicide, accident, finding the loved ones body after a violent death […] Death in a hospital versus home, or not being present when the loved one dies […] Preventable death (perceived negligence of treatment where it seems that the death could have been prevented) […] Multiple deaths around the same time […] Witnessing the death […] Relationships […] High marital dependency (if spouse has died) […] Close relationship to a dying patient […] Personal History […] History of trauma and losses […] Attachment issues.

• #37 Complicated Grief: Symptoms, Causes & Treatment

  https://laopcenter.com/mental-health/disorder/complicated-grief/

  Environmental factors, including social isolation and lack of support networks, exacerbate grief responses. Individuals who are alone or lack close relationships struggle more significantly with their grief, as they have fewer resources to process their emotions and seek help. […] The risk factors for complicated grief include mental health, unexpected loss, miscarriage, divorce, traumatic childhood experiences, and a history of depression, according to Zisook, S et al.s 2009 study entitled Grief and bereavement, published in the World Psychiatry Journal. […] The complications of complicated grief include mental health, unexpected loss, miscarriage, divorce, traumatic childhood experiences, and a history of depression, according to Zisook, S., Shear, K. (2009). In Grief and bereavement: What psychiatrists need to know. published by World Psychiatry.

• #38 Complicated Grief: Symptoms, Causes & Treatment

  https://laopcenter.com/mental-health/disorder/complicated-grief/

  Environmental factors, including social isolation and lack of support networks, exacerbate grief responses. Individuals who are alone or lack close relationships struggle more significantly with their grief, as they have fewer resources to process their emotions and seek help. […] The risk factors for complicated grief include mental health, unexpected loss, miscarriage, divorce, traumatic childhood experiences, and a history of depression, according to Zisook, S et al.s 2009 study entitled Grief and bereavement, published in the World Psychiatry Journal. […] The complications of complicated grief include mental health, unexpected loss, miscarriage, divorce, traumatic childhood experiences, and a history of depression, according to Zisook, S., Shear, K. (2009). In Grief and bereavement: What psychiatrists need to know. published by World Psychiatry.

• #39 What Is Complicated Grief and When Is It a Disorder?

  https://www.everydayhealth.com/emotional-health/grief/what-is-complicated-grief/

  Complicated grief is defined as grief that is unusually severe and prolonged and impairs a person’s ability to live a normal life, according to the article. […] Complicated grief is now called prolonged grief disorder, says M. Katherine Shear, MD, the author of the study in The New England Journal of Medicine and the Marion E. Kenworthy professor of psychiatry at Columbia University in New York, who studies grief and bereavement. […] According to Shear’s work, some risk factors for complicated grief include: a history of mood or anxiety disorders, a history of alcohol or drug abuse, experiencing multiple losses, a difficult childhood or upbringing, poor social support following a loss, serious conflicts with friends or loved ones, and major financial problems following a loss. […] The causes of complicated grief are likely multifactorial. In other words, several of these factors along with others not mentioned here may come together to cause complicated grief. […] 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.

• #40 What Is Complicated Grief and When Is It a Disorder?

  https://www.everydayhealth.com/emotional-health/grief/what-is-complicated-grief/

  Complicated grief is defined as grief that is unusually severe and prolonged and impairs a person’s ability to live a normal life, according to the article. […] Complicated grief is now called prolonged grief disorder, says M. Katherine Shear, MD, the author of the study in The New England Journal of Medicine and the Marion E. Kenworthy professor of psychiatry at Columbia University in New York, who studies grief and bereavement. […] According to Shear’s work, some risk factors for complicated grief include: a history of mood or anxiety disorders, a history of alcohol or drug abuse, experiencing multiple losses, a difficult childhood or upbringing, poor social support following a loss, serious conflicts with friends or loved ones, and major financial problems following a loss. […] The causes of complicated grief are likely multifactorial. In other words, several of these factors along with others not mentioned here may come together to cause complicated grief. […] 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.

• #41 Complicated grief | Cruse Bereavement Support

  https://www.cruse.org.uk/understanding-grief/effects-of-grief/complicated-grief/

  If you were cut off from the person who died or you had fallen out recently, this might make grieving more difficult. […] If your child has died you may be more likely to experience complicated or prolonged grief. […] If you’ve experienced other deaths in your past, particularly at an early age, this can make complicated grief more likely. Some people can experience grief overload, from multiple bereavements or from other losses, eg of home or job, or through divorce. […] If you have an existing mental health condition then this can make the grieving process more difficult.

• #42 What Is Complicated Grief and When Is It a Disorder?

  https://www.everydayhealth.com/emotional-health/grief/what-is-complicated-grief/

  Complicated grief is defined as grief that is unusually severe and prolonged and impairs a person’s ability to live a normal life, according to the article. […] Complicated grief is now called prolonged grief disorder, says M. Katherine Shear, MD, the author of the study in The New England Journal of Medicine and the Marion E. Kenworthy professor of psychiatry at Columbia University in New York, who studies grief and bereavement. […] According to Shear’s work, some risk factors for complicated grief include: a history of mood or anxiety disorders, a history of alcohol or drug abuse, experiencing multiple losses, a difficult childhood or upbringing, poor social support following a loss, serious conflicts with friends or loved ones, and major financial problems following a loss. […] The causes of complicated grief are likely multifactorial. In other words, several of these factors along with others not mentioned here may come together to cause complicated grief. […] 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.

• #43 What Is Complicated Grief and When Is It a Disorder?

  https://www.everydayhealth.com/emotional-health/grief/what-is-complicated-grief/

  Complicated grief is defined as grief that is unusually severe and prolonged and impairs a person’s ability to live a normal life, according to the article. […] Complicated grief is now called prolonged grief disorder, says M. Katherine Shear, MD, the author of the study in The New England Journal of Medicine and the Marion E. Kenworthy professor of psychiatry at Columbia University in New York, who studies grief and bereavement. […] According to Shear’s work, some risk factors for complicated grief include: a history of mood or anxiety disorders, a history of alcohol or drug abuse, experiencing multiple losses, a difficult childhood or upbringing, poor social support following a loss, serious conflicts with friends or loved ones, and major financial problems following a loss. […] The causes of complicated grief are likely multifactorial. In other words, several of these factors along with others not mentioned here may come together to cause complicated grief. […] 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.

• #44 Prolonged Grief: Etiology and Management

  https://www.psychiatrist.com/pcc/prolonged-grief-etiology-management/

  PGD is thought to result from the derailment of the natural grief process. Typically, a bereaved individual adapts to the reality of death, painful as that reality might be. […] In the early phases of the COVID-19 pandemic, many experts predicted that there would be more intense and prevalent grief symptoms among the bereaved due to the traumatic nature of COVID-related deaths, disrupted rituals of mourning due to distancing requirements, and heightened stress throughout the population. […] Although PGD following a loss is a condition recently added to the DSM-5-TR, given that it is relatively common and highly treatable, it should be familiar to all clinicians. […] PGD has several features that overlap with MDD and PTSD (when the death was accompanied by trauma) but is a distinct entity for which a well validated, targeted treatment is available (ie, PGDT).

• #45 Disenfranchised Grief: Causes and How to Manage and Validate It

  https://psychcentral.com/health/disenfranchised-grief

  Disenfranchised grief can occur when other people dont recognize or validate your grief or if you think they may not feel comfortable sharing your grief. A feeling of no one understands can overwhelm you. […] Here are a few examples of situations that might cause disenfranchised grief: loss of a person that others dont recognize as painful for you, such as an ex-spouse, abusive partner, person you were having an extramarital affair with, co-worker, teacher, or classmate […] loss related to a loved one who is or was suspected to have committed a crime and died after police contact […] grievance over a loved one dealing with mental health conditions, including addiction […] loss due to stigmatized death, such as suicide, substance overdose, or abortion. […] Complicated grief has to do with a persons response to a loss, whereas disenfranchised and anticipatory grief have to do with the nature of the loss, she says. […] Because complicated grief is a sign that something is interfering with a persons ability to adapt to the loss and integrate their grief into their lives, it can be experienced regardless of the nature of the loss (disenfranchised, anticipatory, traumatic, etc.), explains St-Germain.

• #46 Complicated grief

  https://www.mymlc.com/health-information/diseases-and-conditions/c/complicated-grief2/?section=Causes

  Losing a loved one is one of the most distressing and, unfortunately, common experiences people face. For some people, feelings of loss are debilitating and don’t improve even after time passes. This is known as complicated grief, sometimes called persistent complex bereavement disorder. In complicated grief, painful emotions are so long lasting and severe that you have trouble recovering from the loss and resuming your own life. […] It’s not known what causes complicated grief. As with many mental health disorders, it may involve your environment, your personality, inherited traits and your body’s natural chemical makeup. […] Complicated grief occurs more often in females and with older age. Factors that may increase the risk of developing complicated grief include: An unexpected or violent death, such as death from a car accident, or the murder or suicide of a loved one.

• #47 Complicated grief

  https://www.mymlc.com/health-information/diseases-and-conditions/c/complicated-grief2/?section=Causes

  Losing a loved one is one of the most distressing and, unfortunately, common experiences people face. For some people, feelings of loss are debilitating and don’t improve even after time passes. This is known as complicated grief, sometimes called persistent complex bereavement disorder. In complicated grief, painful emotions are so long lasting and severe that you have trouble recovering from the loss and resuming your own life. […] It’s not known what causes complicated grief. As with many mental health disorders, it may involve your environment, your personality, inherited traits and your body’s natural chemical makeup. […] Complicated grief occurs more often in females and with older age. Factors that may increase the risk of developing complicated grief include: An unexpected or violent death, such as death from a car accident, or the murder or suicide of a loved one.

• #48 Complicated grief | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/complicated-grief?content_id=CON-20319259

  In complicated grief, painful emotions of loss don’t improve with time and are so severe that you have trouble recovering and resuming your own life. […] For some people, feelings of loss are debilitating and don’t improve even after time passes. This is known as complicated grief, sometimes called persistent complex bereavement disorder. […] It’s not known what causes complicated grief. As with many mental health disorders, it may involve your environment, your personality, inherited traits and your body’s natural chemical makeup. […] Complicated grief occurs more often in females and with older age. Factors that may increase the risk of developing complicated grief include: An unexpected or violent death, such as death from a car accident, or the murder or suicide of a loved one. […] Complicated grief can affect you physically, mentally and socially. Without appropriate treatment, complications may include: Depression, suicidal thoughts or behaviors, anxiety, including PTSD. […] It’s not clear how to prevent complicated grief. Getting counseling soon after a loss may help, especially for people at increased risk of developing complicated grief.

• #49 The Profound Sadness of Prolonged Grief | Harvard Medicine Magazine

  https://magazine.hms.harvard.edu/articles/profound-sadness-prolonged-grief

  Prolonged grief generally presents with an inability to adapt to the loss, Simon says. You wake up and feel like your loss is brand new, over and over again. […] It explained that grief can be complicated, much as wound-healing can be complicated, with the intensity and duration of symptoms heightened and prolonged. […] While there arent rigid rules as to who is more likely to experience such grief, Shear says that, in general, people who lose an identifying relationship a parent, a child, a spouse are more susceptible to the condition. […] In older adults, prolonged grief can affect as many as a quarter of those suffering a loss, according to a 2011 study, while a 2014 study in JAMA Psychiatry stated that about 9 percent of bereaved older women, defined as women over the age of 65, experience prolonged grief.

• #50 Complicated Grief: Symptoms, Diagnosis, Treatment

  https://www.verywellmind.com/complicated-grief-symptoms-diagnosis-and-treatment-5089396

  Complicated grief, also known as prolonged grief disorder, is a condition that can occur in some people who have just lost a loved one or are experiencing grief for another reason. […] There is no identifiable cause of complicated grief, but some people might be more at risk of developing the condition than others. Certain risk factors might make a person more susceptible to experiencing the condition, including: […] Interference with the healing process of normal grief could also cause complicated grief. Some types of loss might also cause complicated grief—for instance, loss of a child or a person’s significant other. […] Complicated grief has also proven to be more prevalent in older individuals. One study found that around 9% of older women experience complicated grief.

• #51 Complicated grief | Cruse Bereavement Support

  https://www.cruse.org.uk/understanding-grief/effects-of-grief/complicated-grief/

  If you were cut off from the person who died or you had fallen out recently, this might make grieving more difficult. […] If your child has died you may be more likely to experience complicated or prolonged grief. […] If you’ve experienced other deaths in your past, particularly at an early age, this can make complicated grief more likely. Some people can experience grief overload, from multiple bereavements or from other losses, eg of home or job, or through divorce. […] If you have an existing mental health condition then this can make the grieving process more difficult.

• #52 Complicated Grief: Symptoms, Causes, Treatment, and More

  https://resources.healthgrades.com/right-care/mental-health-and-behavior/complicated-grief

  Complicated grief is another term for prolonged grief disorder (PGD) or complicated bereavement disorder. It is the type of grief that persists after losing a loved one, making it difficult for a person to function as they typically would. […] Researchers have not identified the exact cause of complicated grief. However, some studies have identified risk factors that may contribute to its development. […] Risk factors for complicated grief include: age, sex assigned at birth, as females are more likely to experience complicated grief, nature of the relationship to the deceased, history of anxiety, pessimism, and neuroticism, history of mental health conditions, such as depression and PTSD, an individual’s sense of resilience, level of social and emotional support available, family functioning. […] Complicated grief may lead to further physical and mental health issues. A 2013 study indicates that people with complicated grief may have a higher risk of developing adverse health outcomes, such as depression and PTSD.

• #53 Grief and Prolonged Grief Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507832/

  Prolonged grief disorder is a complex condition that can emerge when an individual is unable to transition from acute grief to a more integrated form of mourning following the death of a loved one. […] This condition, identified as prolonged grief disorder, results from a failure to transition from acute to integrated grief. Symptoms of acute grief include sadness, tearfulness, and possibly insomnia, and typically require no treatment. Prolonged grief disorder involves intense, painful emotions associated with a lack of adaptation to the loss of a loved one that persists for more than 1 year in adults and more than 6 months in adolescents or children. This condition is estimated to affect as many as 7% of bereaved individuals. […] There are identifiable risk factors that can increase a person’s likelihood of developing prolonged grief disorder. Traumatic circumstances such as the death of a spouse or a child, the death of a parent in early childhood or adolescence, sudden, unexpected, and untimely deaths (particularly if associated with horrific circumstances), multiple deaths (particularly disasters), and deaths by murder or manslaughter can prolong grief. Vulnerable people such as those with low self-esteem, low trust in others, previous psychiatric disorders, previous suicidal threats or attempts, young age of the deceased, lower perceived social supports, an ambivalent attachment to the deceased person, dependent or interdependent attachment to the deceased person, and insecure attachment to parents in childhood (mainly learned fear or learned helplessness) can also increase risk for prolonged grief.

• #54 Understanding Complicated Grief: Causes, Symptoms & Treatment

  https://thriveworks.com/help-with/grief-loss/complicated-grief/

  Complicated grief is characterized by the overwhelming and persistent feelings of intense grief that extend beyond what is considered normal grieving. […] Understanding the potential causes and triggers of complicated grief is essential in addressing this challenging condition effectively. Common factors that can lead to complicated grief include: The sudden and unexpected death of a loved one, The loss of a child, A lack of coping skills, Insufficient support from friends and family, Unresolved conflicts before the loved ones passing, Coexisting mental health issues such as depression and anxiety. […] Complicated grief occurs when the individual is unable to adapt to the loss of a loved one. This inability to adapt can be influenced by a variety of factors, including the circumstances of the loss, the individuals coping mechanisms, and their support network.

• #55 Psychiatry.org – Prolonged Grief Disorder

  https://www.psychiatry.org/patients-families/prolonged-grief-disorder

  Prolonged grief disorder often occurs along with other mental disorders such as PTSD, anxiety or depression. Sleep problems are also common; an estimated 80% of people with prolonged grief disorder experience long-term poor sleep. […] The inclusion of the diagnostic criteria for prolonged grief disorder in DSM-5-TR allows clinicians to use a common standard to differentiate between normal grief and this persistent, enduring, and disabling grief. […] One type of treatment, complicated grief treatment, incorporates components of CBT and other approaches to help adapt to the loss. It focuses on both accepting the reality of the loss and restoration working toward goals and a sense of satisfaction in a world without the loved one.

• #56 What Is Prolonged Grief Disorder?

  https://www.webmd.com/mental-health/prolonged-grief-disorder

  It may be confused with depression. But prolonged grief disorder involves persistent longing for someone who has passed away, while symptoms of depression involve more detached sadness and loss of interest. Studies show treatment for depression is less helpful than PGDT for those with the condition.

• #57 Complicated grief – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/complicated-grief/diagnosis-treatment/drc-20360389

  Grieving is a highly individual process for each person, and determining when normal grief becomes complicated grief can be difficult. […] Complicated grief may be considered when the intensity of grief has not decreased in the months after your loved one’s death. Some mental health professionals diagnose complicated grief when grieving continues to be intense, persistent and debilitating beyond 12 months. […] There are many similarities between complicated grief and major depression, but there are also distinct differences. In some cases, clinical depression and complicated grief occur together. Getting the correct diagnosis is essential for appropriate treatment, so a comprehensive medical and psychological exam is often done. […] There’s little solid research on the use of psychiatric medications to treat complicated grief. However, antidepressants may be helpful in people who have clinical depression as well as complicated grief.

• #58 Complicated Grief | Fact Sheet – ABCT – Association for Behavioral and Cognitive Therapies

  https://www.abct.org/fact-sheets/complicated-grief/

  Complicated grief affects between 2% to 3% of the population worldwide and 7% to 10% of bereaved people. […] While most people who lose a loved one instinctively adapt to the loss, for a substantial minority of the bereaved the adaptation process is slowed or halted by complications, and the symptoms of acute grief persist indefinitely. We call this condition complicated grief. […] Risk factors include a history of mood or anxiety disorders, alcohol or drug abuse, and multiple losses. […] Complicated grief is different from depression and/or posttraumatic stress disorder (PTSD). […] In PTSD, anxiety is focused on the fear of recurrent danger, as opposed to insecurity without the deceased as in complicated grief, and intrusive or distorted thoughts relate to the traumatizing event, as opposed to the deceased individual. […] There are two approaches: one deals with complicated grief; the other gives us strategies for accepting the loss and for restoring a sense of the possibility of future happiness.

• #59 Complicated Grief: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24951-complicated-grief

  Complicated grief can affect you mentally and physically. Complicated grief can cause long-term physical and mental health concerns that could include: Depression, Anxiety, Malnutrition or dehydration, Post-traumatic stress disorder, Heart disease, High blood pressure, Substance use disorder or alcohol use disorder. […] A healthcare provider will diagnose complicated grief if you experience symptoms of grief that affect your physical, mental and social health. […] Many people find comfort participating in cognitive behavioral therapy (CBT) as a treatment for complicated grief. […] Theres no known way to prevent complicated grief. You can reduce your risk of developing complicated grief by talking with a mental health professional after a loss. […] Treatment for complicated grief is possible through therapy and support groups. […] Visit a healthcare provider if you feel grief up to a year after your loss. If grief affects your ability to function or go about your day as you used to before a loss, a healthcare provider can help you feel better.

• #60 Psychiatry.org – Prolonged Grief Disorder

  https://www.psychiatry.org/patients-families/prolonged-grief-disorder

  Prolonged grief disorder often occurs along with other mental disorders such as PTSD, anxiety or depression. Sleep problems are also common; an estimated 80% of people with prolonged grief disorder experience long-term poor sleep. […] The inclusion of the diagnostic criteria for prolonged grief disorder in DSM-5-TR allows clinicians to use a common standard to differentiate between normal grief and this persistent, enduring, and disabling grief. […] One type of treatment, complicated grief treatment, incorporates components of CBT and other approaches to help adapt to the loss. It focuses on both accepting the reality of the loss and restoration working toward goals and a sense of satisfaction in a world without the loved one.

• #61 Complicated Grief | Fact Sheet – ABCT – Association for Behavioral and Cognitive Therapies

  https://www.abct.org/fact-sheets/complicated-grief/

  Complicated grief affects between 2% to 3% of the population worldwide and 7% to 10% of bereaved people. […] While most people who lose a loved one instinctively adapt to the loss, for a substantial minority of the bereaved the adaptation process is slowed or halted by complications, and the symptoms of acute grief persist indefinitely. We call this condition complicated grief. […] Risk factors include a history of mood or anxiety disorders, alcohol or drug abuse, and multiple losses. […] Complicated grief is different from depression and/or posttraumatic stress disorder (PTSD). […] In PTSD, anxiety is focused on the fear of recurrent danger, as opposed to insecurity without the deceased as in complicated grief, and intrusive or distorted thoughts relate to the traumatizing event, as opposed to the deceased individual. […] There are two approaches: one deals with complicated grief; the other gives us strategies for accepting the loss and for restoring a sense of the possibility of future happiness.

• #62 Complicated Grief: When Grieving Becomes a Long Journey

  https://psychcentral.com/depression/all-about-complicated-grief

  Grief is a natural response to losing someone you love. But for most people, even when challenging and hurtful, grief is a temporary experience. […] The causes of prolonged grief disorder are not yet clear, but many factors may be involved, including: trauma, biology, environmental aspects. […] Some research suggests that those with a history of substance use disorder may be more likely to develop prolonged grief disorder. […] A 2020 study also suggests that those who experience prolonged grief show impairments in their emotional processing ability, as well as increased activity in the amygdala. […] Research from 2015 has suggested that a potential cause of prolonged grief disorder is a lost sense of identity after losing someone so close to you. […] This, however, doesn’t imply causality. More research is needed to understand what leads someone to develop symptoms of complicated grief. […] Complicated grief, on the other hand, is directly caused by a specific stressful circumstance: the death of a loved one. […] Not being able to move on without the person you lost is a specific symptom of prolonged grief disorder and not depression.

• #63 Complicated grief – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/complicated-grief/symptoms-causes/syc-20360374

  For some people, feelings of loss are debilitating and don’t improve even after time passes. This is known as complicated grief, sometimes called persistent complex bereavement disorder. […] It’s not known what causes complicated grief. As with many mental health disorders, it may involve your environment, your personality, inherited traits and your body’s natural chemical makeup.

• #64 Complicated grief

  https://www.mymlc.com/health-information/diseases-and-conditions/c/complicated-grief2/?section=Causes

  Losing a loved one is one of the most distressing and, unfortunately, common experiences people face. For some people, feelings of loss are debilitating and don’t improve even after time passes. This is known as complicated grief, sometimes called persistent complex bereavement disorder. In complicated grief, painful emotions are so long lasting and severe that you have trouble recovering from the loss and resuming your own life. […] It’s not known what causes complicated grief. As with many mental health disorders, it may involve your environment, your personality, inherited traits and your body’s natural chemical makeup. […] Complicated grief occurs more often in females and with older age. Factors that may increase the risk of developing complicated grief include: An unexpected or violent death, such as death from a car accident, or the murder or suicide of a loved one.

• #65 Complicated grief – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/complicated-grief/symptoms-causes/syc-20360374

  For some people, feelings of loss are debilitating and don’t improve even after time passes. This is known as complicated grief, sometimes called persistent complex bereavement disorder. […] It’s not known what causes complicated grief. As with many mental health disorders, it may involve your environment, your personality, inherited traits and your body’s natural chemical makeup.

• #66 Depression vs. Complicated Grief

  https://www.healthline.com/health/depression/complicated-grief

  Complicated grief (CG), on the other hand, is caused by the death of someone close to you. CG, sometimes called persistent complex bereavement disorder, is much stronger than normal grief. […] CG is most commonly caused by the death of someone you love. If your significant other or a close family member dies suddenly, you may have trouble accepting your loss. […] CG doesn’t have any identified biological causes. Like depression, it may happen because of: genetics, body chemistry, personality, your environment. […] CG has many different descriptions. The most common one is that it’s acute grief that causes long periods of suffering after losing a loved one. Many doctors believe that it’s related to adjustment disorder, which is when you show a long and intense response to a stressor. […] Many doctors are now discovering that CG has many features of a disorder.

• #67 Prolonged Grief: Etiology and Management

  https://www.psychiatrist.com/pcc/prolonged-grief-etiology-management/

  PGD is thought to result from the derailment of the natural grief process. Typically, a bereaved individual adapts to the reality of death, painful as that reality might be. […] In the early phases of the COVID-19 pandemic, many experts predicted that there would be more intense and prevalent grief symptoms among the bereaved due to the traumatic nature of COVID-related deaths, disrupted rituals of mourning due to distancing requirements, and heightened stress throughout the population. […] Although PGD following a loss is a condition recently added to the DSM-5-TR, given that it is relatively common and highly treatable, it should be familiar to all clinicians. […] PGD has several features that overlap with MDD and PTSD (when the death was accompanied by trauma) but is a distinct entity for which a well validated, targeted treatment is available (ie, PGDT).

• #68 Prolonged Grief: Etiology and Management

  https://www.psychiatrist.com/pcc/prolonged-grief-etiology-management/

  PGD is thought to result from the derailment of the natural grief process. Typically, a bereaved individual adapts to the reality of death, painful as that reality might be. […] In the early phases of the COVID-19 pandemic, many experts predicted that there would be more intense and prevalent grief symptoms among the bereaved due to the traumatic nature of COVID-related deaths, disrupted rituals of mourning due to distancing requirements, and heightened stress throughout the population. […] Although PGD following a loss is a condition recently added to the DSM-5-TR, given that it is relatively common and highly treatable, it should be familiar to all clinicians. […] PGD has several features that overlap with MDD and PTSD (when the death was accompanied by trauma) but is a distinct entity for which a well validated, targeted treatment is available (ie, PGDT).

• #69 Prolonged Grief: Etiology and Management

  https://www.psychiatrist.com/pcc/prolonged-grief-etiology-management/

  PGD is thought to result from the derailment of the natural grief process. Typically, a bereaved individual adapts to the reality of death, painful as that reality might be. […] In the early phases of the COVID-19 pandemic, many experts predicted that there would be more intense and prevalent grief symptoms among the bereaved due to the traumatic nature of COVID-related deaths, disrupted rituals of mourning due to distancing requirements, and heightened stress throughout the population. […] Although PGD following a loss is a condition recently added to the DSM-5-TR, given that it is relatively common and highly treatable, it should be familiar to all clinicians. […] PGD has several features that overlap with MDD and PTSD (when the death was accompanied by trauma) but is a distinct entity for which a well validated, targeted treatment is available (ie, PGDT).

• #70 Prolonged Grief: Etiology and Management

  https://www.psychiatrist.com/pcc/prolonged-grief-etiology-management/

  PGD is thought to result from the derailment of the natural grief process. Typically, a bereaved individual adapts to the reality of death, painful as that reality might be. […] In the early phases of the COVID-19 pandemic, many experts predicted that there would be more intense and prevalent grief symptoms among the bereaved due to the traumatic nature of COVID-related deaths, disrupted rituals of mourning due to distancing requirements, and heightened stress throughout the population. […] Although PGD following a loss is a condition recently added to the DSM-5-TR, given that it is relatively common and highly treatable, it should be familiar to all clinicians. […] PGD has several features that overlap with MDD and PTSD (when the death was accompanied by trauma) but is a distinct entity for which a well validated, targeted treatment is available (ie, PGDT).

• #71 The Profound Sadness of Prolonged Grief | Harvard Medicine Magazine

  https://magazine.hms.harvard.edu/articles/profound-sadness-prolonged-grief

  Many of our patients actually self-identify, says Shear. […] Shear and others have determined that patients experiencing prolonged grief generally do not respond to the types of treatments traditionally used to address depression and PTSD, and they have worked to establish a separate protocol for treating the condition. […] The good news is that complicated grief patients have an immense capacity to heal and pull through, Shear says. […] Despite the fact that prolonged grief is getting more recognition these days, there remains an overall lack of awareness of it in the medical community. […] Some students may hear about bereavement when they encounter a patient who dies, but prolonged grief isnt understood or treated as a separate entity, she says. […] We do not have a system or a set of routine practices for caring for the bereaved, adds Block. […] This may be especially true now. The pandemic has at least brought grief, including prolonged grief, into a space of better awareness, Block says, but bereavement care in general has been inadequate throughout the pandemic because the health care system has been overwhelmed.

• #72 A public health perspective on Prolonged Grief Disorder | Pursuit | University of Michigan School of Public Health | Public Health Sciences | Bachelor of Science | Mental Health | Grief | Well-being | Healthcare

  https://sph.umich.edu/pursuit/2023posts/public-health-perspective-on-prolonged-grief-disorder.html

  One of these factors was COVID-19, with many bereavement experts believing that the unprecedented amount of deaths from COVID-19 would lead to an increase in incidences of PGD making PGD a major public health concern. […] Approximately 10% of bereaved children and adults experience PGD and its symptoms, although almost no studies have examined the incidence or prevalence rates of PGD in youth, which can manifest differently than in adults. PGD is characterized by intense and persistent grief reactions that can become maladaptive if these reactions cause impairment to daily life, as well as hinder a bereaved individual’s ability to be able to successfully cope with their grief in a healthy way. […] PGD often occurs alongside other mental disorders, such as PTSD, anxiety, and depression, which can make it harder to grieve for bereaved individuals.

• #73

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3384440/

  Complicated grief is a recently recognized condition that occurs in about 7% of bereaved people. […] People with complicated grief need help, and clinicians need to know how to recognize the symptoms and how to provide help. […] An important minority, currently estimated at about 7% of bereaved people, does not cope effectively with bereavement. Instead, they become entangled in grief, caught up in a futile struggle of silent protest, trying to avoid reminders, and being carried helplessly on endless waves of acutely painful emotion. These people are suffering from complicated grief (CG), a syndrome in which healing is impeded and acute grief is intense and prolonged. […] CG is a chronic impairing form of grief brought about by interference with the healing process. […] The result is delayed healing and increased pain which occurs because aspects of a person’s response to the circumstances or consequences of the death derail the mourning process, interfering with learning, and preventing the natural healing process from progressing.

• #74 Prolonged Grief: Etiology and Management

  https://www.psychiatrist.com/pcc/prolonged-grief-etiology-management/

  PGD is thought to result from the derailment of the natural grief process. Typically, a bereaved individual adapts to the reality of death, painful as that reality might be. […] In the early phases of the COVID-19 pandemic, many experts predicted that there would be more intense and prevalent grief symptoms among the bereaved due to the traumatic nature of COVID-related deaths, disrupted rituals of mourning due to distancing requirements, and heightened stress throughout the population. […] Although PGD following a loss is a condition recently added to the DSM-5-TR, given that it is relatively common and highly treatable, it should be familiar to all clinicians. […] PGD has several features that overlap with MDD and PTSD (when the death was accompanied by trauma) but is a distinct entity for which a well validated, targeted treatment is available (ie, PGDT).

• #75

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3384440/

  Complicated grief is a recently recognized condition that occurs in about 7% of bereaved people. […] People with complicated grief need help, and clinicians need to know how to recognize the symptoms and how to provide help. […] An important minority, currently estimated at about 7% of bereaved people, does not cope effectively with bereavement. Instead, they become entangled in grief, caught up in a futile struggle of silent protest, trying to avoid reminders, and being carried helplessly on endless waves of acutely painful emotion. These people are suffering from complicated grief (CG), a syndrome in which healing is impeded and acute grief is intense and prolonged. […] CG is a chronic impairing form of grief brought about by interference with the healing process. […] The result is delayed healing and increased pain which occurs because aspects of a person’s response to the circumstances or consequences of the death derail the mourning process, interfering with learning, and preventing the natural healing process from progressing.

• #76

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3384440/

  CG is not in DSM-IV, so there are no standard, official criteria. However there is considerable evidence that CG is a specific syndrome, different from normal grief and from other mood and anxiety disorders. […] Symptoms of acute grief include intense yearning or longing for the person who died, intrusive or preoccupying thoughts or images of the deceased person, a sense of loss of meaning or purpose in a life without the deceased, and a cluster of other symptoms that interfere with activities or relationships with significant others. […] Complicating thoughts include incessant questioning, worrying, or ruminating over some aspect of the circumstances or consequences of the loss. […] Complicating behaviors include excessive avoidance of reminders of the loss, compulsive proximity seeking, or both.

• #77

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3384440/

  CG is not in DSM-IV, so there are no standard, official criteria. However there is considerable evidence that CG is a specific syndrome, different from normal grief and from other mood and anxiety disorders. […] Symptoms of acute grief include intense yearning or longing for the person who died, intrusive or preoccupying thoughts or images of the deceased person, a sense of loss of meaning or purpose in a life without the deceased, and a cluster of other symptoms that interfere with activities or relationships with significant others. […] Complicating thoughts include incessant questioning, worrying, or ruminating over some aspect of the circumstances or consequences of the loss. […] Complicating behaviors include excessive avoidance of reminders of the loss, compulsive proximity seeking, or both.

• #78

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3384440/

  CG is not in DSM-IV, so there are no standard, official criteria. However there is considerable evidence that CG is a specific syndrome, different from normal grief and from other mood and anxiety disorders. […] Symptoms of acute grief include intense yearning or longing for the person who died, intrusive or preoccupying thoughts or images of the deceased person, a sense of loss of meaning or purpose in a life without the deceased, and a cluster of other symptoms that interfere with activities or relationships with significant others. […] Complicating thoughts include incessant questioning, worrying, or ruminating over some aspect of the circumstances or consequences of the loss. […] Complicating behaviors include excessive avoidance of reminders of the loss, compulsive proximity seeking, or both.

• #79

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3384440/

  Complicated grief is a recently recognized condition that occurs in about 7% of bereaved people. […] People with complicated grief need help, and clinicians need to know how to recognize the symptoms and how to provide help. […] An important minority, currently estimated at about 7% of bereaved people, does not cope effectively with bereavement. Instead, they become entangled in grief, caught up in a futile struggle of silent protest, trying to avoid reminders, and being carried helplessly on endless waves of acutely painful emotion. These people are suffering from complicated grief (CG), a syndrome in which healing is impeded and acute grief is intense and prolonged. […] CG is a chronic impairing form of grief brought about by interference with the healing process. […] The result is delayed healing and increased pain which occurs because aspects of a person’s response to the circumstances or consequences of the death derail the mourning process, interfering with learning, and preventing the natural healing process from progressing.

• #80 The difficult case of complicated grief and the role of phenomenology in psychiatry

  https://journals.openedition.org/phenomenology/1334

  Based on these observations, I propose that the stasis experienced in many cases of complicated grief, as described by Ratcliffe, has a particular kind of source or etiology. It is as a result of the disturbance in the processes of reintegration. […] Given the heterogeneity of such relations and grief experiences, in each and every case we might need to investigate the specific dynamics of reestablishing the relation with the deceased in the process of grief. Although disturbances in reintegration processes may take various forms and involve a variety of experiences, we can still see them as the underlying structural feature of complicated grief.

• #81 Understanding Complicated Grief: Causes, Symptoms, and Prevention Strategies

  https://www.linkedin.com/pulse/understanding-complicated-grief-causes-symptoms-rev-michael-7e3uc

  The combination of emotional, physical, and psychological symptoms can create a cycle of distress that is difficult to break without intervention. […] Understanding the biological underpinnings of complicated grief is crucial for developing targeted interventions. […] Recent research has explored how complicated grief affects the brain, revealing that it engages neural pathways typically associated with attachment and reward. […] Individuals who witness or experience traumatic events associated with the loss may be more prone to complicated grief. […] People with pre-existing mental health conditions, such as depression or anxiety, may be at a higher risk of developing complicated grief. […] Limited social support can exacerbate the impact of grief, increasing the likelihood of developing complications.

• #82 Understanding Complicated Grief: Causes, Symptoms, and Prevention Strategies

  https://www.linkedin.com/pulse/understanding-complicated-grief-causes-symptoms-rev-michael-7e3uc

  The combination of emotional, physical, and psychological symptoms can create a cycle of distress that is difficult to break without intervention. […] Understanding the biological underpinnings of complicated grief is crucial for developing targeted interventions. […] Recent research has explored how complicated grief affects the brain, revealing that it engages neural pathways typically associated with attachment and reward. […] Individuals who witness or experience traumatic events associated with the loss may be more prone to complicated grief. […] People with pre-existing mental health conditions, such as depression or anxiety, may be at a higher risk of developing complicated grief. […] Limited social support can exacerbate the impact of grief, increasing the likelihood of developing complications.

• #83 Persistent Complex Bereavement Disorder: Typical Symptoms, Causes, And Treatments For Prolonged Grief | BetterHelp

  https://www.betterhelp.com/mental-health/disorders-conditions/persistent-complex-bereavement-disorder/

  Grief after death is common, as death is a part of human existence. […] However, 10% to 20% of people have difficulties that persist rather than diminish. This can sometimes be called persistent grief disorder or complicated grief disorder. […] Doctors are unsure what causes PCBD or complex grief, but recent research indicates that the effects of grief on the body are complex. For example, cardiovascular biomarkers show consistent changes between people experiencing acute and chronic grief, which can cause physical symptoms like elevated heart rate and high blood pressure. […] Once these regions were identified, the study compared the response of those with complicated grief to those who were adapting well and identified a single area responding differently. People experiencing complicated grief experienced more activity in a part of the basal ganglia called the nucleus accumbens, which is involved in the brains reward pathway. […] This research indicates that PCBD or complicated grief may be linked to the idea that wanting and yearning for the deceased activates a part of the brains reward center, but more research is needed to understand the intense emotional connections related to this mental illness.

• #84 Persistent Complex Bereavement Disorder: Typical Symptoms, Causes, And Treatments For Prolonged Grief | BetterHelp

  https://www.betterhelp.com/mental-health/disorders-conditions/persistent-complex-bereavement-disorder/

  Grief after death is common, as death is a part of human existence. […] However, 10% to 20% of people have difficulties that persist rather than diminish. This can sometimes be called persistent grief disorder or complicated grief disorder. […] Doctors are unsure what causes PCBD or complex grief, but recent research indicates that the effects of grief on the body are complex. For example, cardiovascular biomarkers show consistent changes between people experiencing acute and chronic grief, which can cause physical symptoms like elevated heart rate and high blood pressure. […] Once these regions were identified, the study compared the response of those with complicated grief to those who were adapting well and identified a single area responding differently. People experiencing complicated grief experienced more activity in a part of the basal ganglia called the nucleus accumbens, which is involved in the brains reward pathway. […] This research indicates that PCBD or complicated grief may be linked to the idea that wanting and yearning for the deceased activates a part of the brains reward center, but more research is needed to understand the intense emotional connections related to this mental illness.

• #85 Grief: Causes, Types, Stages, How to Cope With It, and When to Get Help

  https://www.everydayhealth.com/emotional-health/grief/

  Grief and other extreme forms of emotional stress can stoke the immune system in ways that promote inflammation. […] In rare cases, grief can even cause heart trouble. Research has identified an uncommon form of heart failure known as takotsubo cardiomyopathy that is associated with severe emotional stress, including grief events like the loss of a loved one.

• #86 Complicated Grief: When Grieving Becomes a Long Journey

  https://psychcentral.com/depression/all-about-complicated-grief

  Grief is a natural response to losing someone you love. But for most people, even when challenging and hurtful, grief is a temporary experience. […] The causes of prolonged grief disorder are not yet clear, but many factors may be involved, including: trauma, biology, environmental aspects. […] Some research suggests that those with a history of substance use disorder may be more likely to develop prolonged grief disorder. […] A 2020 study also suggests that those who experience prolonged grief show impairments in their emotional processing ability, as well as increased activity in the amygdala. […] Research from 2015 has suggested that a potential cause of prolonged grief disorder is a lost sense of identity after losing someone so close to you. […] This, however, doesn’t imply causality. More research is needed to understand what leads someone to develop symptoms of complicated grief. […] Complicated grief, on the other hand, is directly caused by a specific stressful circumstance: the death of a loved one. […] Not being able to move on without the person you lost is a specific symptom of prolonged grief disorder and not depression.

• #87 What is Complicated Grief? | Talkspace

  https://www.talkspace.com/blog/complicated-grief/

  Complicated grief, also known as persistent complex bereavement disorder, results in feelings and emotions that are so painful, moving forward seems impossible. […] While complicated grieving is a fairly common mental health condition, we still dont truly understand what causes it. […] Even your natural chemical makeup may ultimately contribute to experiencing complicated grief. […] While there isnt any one identifiable cause for complicated grief, there are several risk factors that potentially make someone more susceptible. Some of these may include: History of mental disorders, Death of a child, Unusually shocking or violent death, A completely unexpected death, A history of substance abuse, Social isolation, Being absent when the loss occurred, Encountering other additional major life stressors (for example, extreme financial hardship), Multiple deaths occurring in a very short period of time, Being witness to the death or loss. […] Complicated grief could come from an enmeshed and/or codependent relationship and the loss of it could signal an absence of the grievers identity.

• #88 Grief: Causes, symptoms, diagnosis and Treatments to overcome your misery – SavantCare

  https://www.savantcare.com/grief/

  Complicated grief and major depression share many characteristics, but they can differ significantly. Clinical depression and complicated grief can occasionally coexist. […] The World Health Organization certified Prolonged Grief Disorder as a new diagnosis in 2018. A persistent and pervasive grief response that is characterized by longing for the deceased or persistent preoccupation with the deceased accompanied by intense emotional pain (e.g. sadness, guilt, anger, denial, blame, difficulty accepting the death, feeling one has lost a part of ones self, an inability to experience positive mood, emotional numbness, difficulty engaging in social or other activities) is one of the criteria for this diagnosis. […] The diagnostic criteria for this disease are more precise, but research shows they are consistent. DSM-5 PGD requires the occurrence of a persistent and pervasive grief response characterized by constant yearning and/or preoccupation with the deceased and at least three of eight additional symptoms, including disbelief, intense longing for support, emotional pain, identity confusion, avoiding reminders of the loss, feelings of numbness, extreme loneliness, meaninglessness, or difficulty engaging in daily life.

• #89 What is Complicated Grief? | Talkspace

  https://www.talkspace.com/blog/complicated-grief/

  Complicated grief, also known as persistent complex bereavement disorder, results in feelings and emotions that are so painful, moving forward seems impossible. […] While complicated grieving is a fairly common mental health condition, we still dont truly understand what causes it. […] Even your natural chemical makeup may ultimately contribute to experiencing complicated grief. […] While there isnt any one identifiable cause for complicated grief, there are several risk factors that potentially make someone more susceptible. Some of these may include: History of mental disorders, Death of a child, Unusually shocking or violent death, A completely unexpected death, A history of substance abuse, Social isolation, Being absent when the loss occurred, Encountering other additional major life stressors (for example, extreme financial hardship), Multiple deaths occurring in a very short period of time, Being witness to the death or loss. […] Complicated grief could come from an enmeshed and/or codependent relationship and the loss of it could signal an absence of the grievers identity.

• #90 The difficult case of complicated grief and the role of phenomenology in psychiatry

  https://journals.openedition.org/phenomenology/1334

  The disturbance causes clinically significant distress or impairment in social, occupational or other important areas of functioning. […] The debate concerning the need for diagnostic criteria for CG continues (Bandini, 2015; Brinkmann, 2018). […] The central dilemma in this discussion is whether and how to recognize and appropriately respond to complicated grief to avoid, on the one hand, the threat of medicalization of appropriate grief responses, and on the other hand, provide help to those who suffer from complicated grief (Zisook et al., 2014). […] I propose that the disturbance of the above sketched processes of reintegration may be a key component explaining the occurrence of complicated grief. […] The dynamic of grief typically implies that reintegration processes, i.e. those that lead to acknowledging the loss and finding ways of re-establishing the relation with the deceased, are at some point initiated and proceed with time (e.g. Klass et al., 2014, Boelen et al., 2006).

• #91 Grief and Prolonged Grief Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507832/

  Prolonged grief disorder is a complex condition that can emerge when an individual is unable to transition from acute grief to a more integrated form of mourning following the death of a loved one. […] This condition, identified as prolonged grief disorder, results from a failure to transition from acute to integrated grief. Symptoms of acute grief include sadness, tearfulness, and possibly insomnia, and typically require no treatment. Prolonged grief disorder involves intense, painful emotions associated with a lack of adaptation to the loss of a loved one that persists for more than 1 year in adults and more than 6 months in adolescents or children. This condition is estimated to affect as many as 7% of bereaved individuals. […] There are identifiable risk factors that can increase a person’s likelihood of developing prolonged grief disorder. Traumatic circumstances such as the death of a spouse or a child, the death of a parent in early childhood or adolescence, sudden, unexpected, and untimely deaths (particularly if associated with horrific circumstances), multiple deaths (particularly disasters), and deaths by murder or manslaughter can prolong grief. Vulnerable people such as those with low self-esteem, low trust in others, previous psychiatric disorders, previous suicidal threats or attempts, young age of the deceased, lower perceived social supports, an ambivalent attachment to the deceased person, dependent or interdependent attachment to the deceased person, and insecure attachment to parents in childhood (mainly learned fear or learned helplessness) can also increase risk for prolonged grief.

• #92 Grief and Prolonged Grief Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507832/

  Prolonged grief disorder is a complex condition that can emerge when an individual is unable to transition from acute grief to a more integrated form of mourning following the death of a loved one. […] This condition, identified as prolonged grief disorder, results from a failure to transition from acute to integrated grief. Symptoms of acute grief include sadness, tearfulness, and possibly insomnia, and typically require no treatment. Prolonged grief disorder involves intense, painful emotions associated with a lack of adaptation to the loss of a loved one that persists for more than 1 year in adults and more than 6 months in adolescents or children. This condition is estimated to affect as many as 7% of bereaved individuals. […] There are identifiable risk factors that can increase a person’s likelihood of developing prolonged grief disorder. Traumatic circumstances such as the death of a spouse or a child, the death of a parent in early childhood or adolescence, sudden, unexpected, and untimely deaths (particularly if associated with horrific circumstances), multiple deaths (particularly disasters), and deaths by murder or manslaughter can prolong grief. Vulnerable people such as those with low self-esteem, low trust in others, previous psychiatric disorders, previous suicidal threats or attempts, young age of the deceased, lower perceived social supports, an ambivalent attachment to the deceased person, dependent or interdependent attachment to the deceased person, and insecure attachment to parents in childhood (mainly learned fear or learned helplessness) can also increase risk for prolonged grief.

• #93 Complicated grief | Cruse Bereavement Support

  https://www.cruse.org.uk/understanding-grief/effects-of-grief/complicated-grief/

  If you were cut off from the person who died or you had fallen out recently, this might make grieving more difficult. […] If your child has died you may be more likely to experience complicated or prolonged grief. […] If you’ve experienced other deaths in your past, particularly at an early age, this can make complicated grief more likely. Some people can experience grief overload, from multiple bereavements or from other losses, eg of home or job, or through divorce. […] If you have an existing mental health condition then this can make the grieving process more difficult.

• #94 Grief and Prolonged Grief Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507832/

  Prolonged grief disorder is a complex condition that can emerge when an individual is unable to transition from acute grief to a more integrated form of mourning following the death of a loved one. […] This condition, identified as prolonged grief disorder, results from a failure to transition from acute to integrated grief. Symptoms of acute grief include sadness, tearfulness, and possibly insomnia, and typically require no treatment. Prolonged grief disorder involves intense, painful emotions associated with a lack of adaptation to the loss of a loved one that persists for more than 1 year in adults and more than 6 months in adolescents or children. This condition is estimated to affect as many as 7% of bereaved individuals. […] There are identifiable risk factors that can increase a person’s likelihood of developing prolonged grief disorder. Traumatic circumstances such as the death of a spouse or a child, the death of a parent in early childhood or adolescence, sudden, unexpected, and untimely deaths (particularly if associated with horrific circumstances), multiple deaths (particularly disasters), and deaths by murder or manslaughter can prolong grief. Vulnerable people such as those with low self-esteem, low trust in others, previous psychiatric disorders, previous suicidal threats or attempts, young age of the deceased, lower perceived social supports, an ambivalent attachment to the deceased person, dependent or interdependent attachment to the deceased person, and insecure attachment to parents in childhood (mainly learned fear or learned helplessness) can also increase risk for prolonged grief.

• #95 What Is Prolonged Grief Disorder?

  https://www.webmd.com/mental-health/prolonged-grief-disorder

  Prolonged grief disorder (PGD), or complicated grief, can happen after a person close to you has died within at least 6 months (12 months for children and teens). […] PGD is common in those whove lost a child or romantic partner. Its more likely to happen after a violent or abrupt death, such as murder, suicide, or an accident. […] Loss from ongoing disasters, like the COVID-19 pandemic, can also lead to PGD. […] The DSM-5 criteria for PGD are a persistent grief response, including constant yearning for a person who died and/or fixation with the death of a loved one. And at least three of eight symptoms listed above. […] In 2018, the World Health Organization (WHO) approved another trait. They state that PGD symptoms also cause significant trouble in important areas, such as ones personal, educational, or work life. If the person is still able to function in these areas, its only through intense additional effort.

• #96 Grief and Prolonged Grief Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507832/

  Prolonged grief disorder is a complex condition that can emerge when an individual is unable to transition from acute grief to a more integrated form of mourning following the death of a loved one. […] This condition, identified as prolonged grief disorder, results from a failure to transition from acute to integrated grief. Symptoms of acute grief include sadness, tearfulness, and possibly insomnia, and typically require no treatment. Prolonged grief disorder involves intense, painful emotions associated with a lack of adaptation to the loss of a loved one that persists for more than 1 year in adults and more than 6 months in adolescents or children. This condition is estimated to affect as many as 7% of bereaved individuals. […] There are identifiable risk factors that can increase a person’s likelihood of developing prolonged grief disorder. Traumatic circumstances such as the death of a spouse or a child, the death of a parent in early childhood or adolescence, sudden, unexpected, and untimely deaths (particularly if associated with horrific circumstances), multiple deaths (particularly disasters), and deaths by murder or manslaughter can prolong grief. Vulnerable people such as those with low self-esteem, low trust in others, previous psychiatric disorders, previous suicidal threats or attempts, young age of the deceased, lower perceived social supports, an ambivalent attachment to the deceased person, dependent or interdependent attachment to the deceased person, and insecure attachment to parents in childhood (mainly learned fear or learned helplessness) can also increase risk for prolonged grief.

• #97 Grief and Prolonged Grief Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507832/

  Prolonged grief disorder is a complex condition that can emerge when an individual is unable to transition from acute grief to a more integrated form of mourning following the death of a loved one. […] This condition, identified as prolonged grief disorder, results from a failure to transition from acute to integrated grief. Symptoms of acute grief include sadness, tearfulness, and possibly insomnia, and typically require no treatment. Prolonged grief disorder involves intense, painful emotions associated with a lack of adaptation to the loss of a loved one that persists for more than 1 year in adults and more than 6 months in adolescents or children. This condition is estimated to affect as many as 7% of bereaved individuals. […] There are identifiable risk factors that can increase a person’s likelihood of developing prolonged grief disorder. Traumatic circumstances such as the death of a spouse or a child, the death of a parent in early childhood or adolescence, sudden, unexpected, and untimely deaths (particularly if associated with horrific circumstances), multiple deaths (particularly disasters), and deaths by murder or manslaughter can prolong grief. Vulnerable people such as those with low self-esteem, low trust in others, previous psychiatric disorders, previous suicidal threats or attempts, young age of the deceased, lower perceived social supports, an ambivalent attachment to the deceased person, dependent or interdependent attachment to the deceased person, and insecure attachment to parents in childhood (mainly learned fear or learned helplessness) can also increase risk for prolonged grief.

• #98 Complicated Grief: How To Understand, Express, and Reconcile Your Especially Difficult Grief – Center for Loss & Life Transition

  https://www.centerforloss.com/bookstore/complicated-grief/

  Grief is always difficult, but if yours feels especially painful, stuck, or complex, you may be experiencing complicated grief. […] Complicated grief is not an illness or disorder. It’s simply normal grief that’s been made more challenging by circumstances that overwhelm the person in mourning. […] If someone you love has died of suicide, homicide, or accidental causes; if the death was violent or premature or ambiguous; if you are struggling with additional life issues right now, such as health challenges (physical or mental), family problems, or financial stress; if your relationship with the person who died was extremely close or troubled; if you have suffered several losses in quick succession—this concise guide is for you. […] You’ll inventory the reasons your grief is complicated.

• #99 Grief and Prolonged Grief Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507832/

  Prolonged grief disorder is a complex condition that can emerge when an individual is unable to transition from acute grief to a more integrated form of mourning following the death of a loved one. […] This condition, identified as prolonged grief disorder, results from a failure to transition from acute to integrated grief. Symptoms of acute grief include sadness, tearfulness, and possibly insomnia, and typically require no treatment. Prolonged grief disorder involves intense, painful emotions associated with a lack of adaptation to the loss of a loved one that persists for more than 1 year in adults and more than 6 months in adolescents or children. This condition is estimated to affect as many as 7% of bereaved individuals. […] There are identifiable risk factors that can increase a person’s likelihood of developing prolonged grief disorder. Traumatic circumstances such as the death of a spouse or a child, the death of a parent in early childhood or adolescence, sudden, unexpected, and untimely deaths (particularly if associated with horrific circumstances), multiple deaths (particularly disasters), and deaths by murder or manslaughter can prolong grief. Vulnerable people such as those with low self-esteem, low trust in others, previous psychiatric disorders, previous suicidal threats or attempts, young age of the deceased, lower perceived social supports, an ambivalent attachment to the deceased person, dependent or interdependent attachment to the deceased person, and insecure attachment to parents in childhood (mainly learned fear or learned helplessness) can also increase risk for prolonged grief.

• #100 Grief and Prolonged Grief Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507832/

  Prolonged grief disorder is a complex condition that can emerge when an individual is unable to transition from acute grief to a more integrated form of mourning following the death of a loved one. […] This condition, identified as prolonged grief disorder, results from a failure to transition from acute to integrated grief. Symptoms of acute grief include sadness, tearfulness, and possibly insomnia, and typically require no treatment. Prolonged grief disorder involves intense, painful emotions associated with a lack of adaptation to the loss of a loved one that persists for more than 1 year in adults and more than 6 months in adolescents or children. This condition is estimated to affect as many as 7% of bereaved individuals. […] There are identifiable risk factors that can increase a person’s likelihood of developing prolonged grief disorder. Traumatic circumstances such as the death of a spouse or a child, the death of a parent in early childhood or adolescence, sudden, unexpected, and untimely deaths (particularly if associated with horrific circumstances), multiple deaths (particularly disasters), and deaths by murder or manslaughter can prolong grief. Vulnerable people such as those with low self-esteem, low trust in others, previous psychiatric disorders, previous suicidal threats or attempts, young age of the deceased, lower perceived social supports, an ambivalent attachment to the deceased person, dependent or interdependent attachment to the deceased person, and insecure attachment to parents in childhood (mainly learned fear or learned helplessness) can also increase risk for prolonged grief.

• #101 What Causes Complicated Grief Disorder? – Bridges to Recovery

  https://www.bridgestorecovery.com/complicated-grief/causes-complicated-grief-disorder/

  Complicated grief disorder creates a web of emotional suffering for people who’ve lost a loved one. Over time grief should diminish, but when it doesn’t it can turn into a life-altering mental health condition that will not disappear without treatment. […] Complicated grief, which is also known as complicated bereavement, does not at present have official status as a mental health disorder. It is likely to attain such recognition, however, in the very near future, as mental health professionals continue to learn more about the way it impacts people who cannot overcome the loss of a spouse, parent, child, grandparent, or close friend. […] Complicated bereavement is a condition associated with mourning. But it can develop in some instances even if a person has not died, or is not known to have died.

• #102 Treatment Program for Complicated Grief | St. Joseph Institute for Addiction

  https://stjosephinstitute.com/complicated-grief-treatment/

  Complicated grief is called complicated grief, or persistent complex bereavement disorder. People experiencing complicated grief find it challenging to adapt to life without their loved ones, leading to significant emotional distress and functional impairment. […] People are most at risk for complicated grief when their loss is unusually extreme or challenging. For example, a lack of closure around the loss can make grief especially difficult. This can include grieving for someone who is presumed dead but whose body has not been recovered or grieving for someone who is still alive but unreachable, such as someone with dementia or someone who has been incarcerated. […] In addition, grieving for someone or something that society doesn’t value can be challenging, as you feel as if your grief isn’t as valid. Loss that occurs due to trauma can also lead to complicated grief.

• #103 Treatment Program for Complicated Grief | St. Joseph Institute for Addiction

  https://stjosephinstitute.com/complicated-grief-treatment/

  Complicated grief is called complicated grief, or persistent complex bereavement disorder. People experiencing complicated grief find it challenging to adapt to life without their loved ones, leading to significant emotional distress and functional impairment. […] People are most at risk for complicated grief when their loss is unusually extreme or challenging. For example, a lack of closure around the loss can make grief especially difficult. This can include grieving for someone who is presumed dead but whose body has not been recovered or grieving for someone who is still alive but unreachable, such as someone with dementia or someone who has been incarcerated. […] In addition, grieving for someone or something that society doesn’t value can be challenging, as you feel as if your grief isn’t as valid. Loss that occurs due to trauma can also lead to complicated grief.

• #104 Bereavement: Definition, Symptoms, Causes, Traits, Treatment

  https://www.verywellmind.com/bereavement-definition-symptoms-causes-traits-treatment-5197038

  The loss of a loved one is one of the most painful experiences we’ll have in life. Bereavement refers to the state of having experienced the loss of a loved one. It most often refers to the time after a loss when emotions are at their most profound. This time is marked by intense grief and tremendous sorrow. […] While bereavement is usually associated with death, it can also occur after other significant losses. The end of an important relationship or a major change in a person’s health, for example, can also lead to feelings of bereavement. […] Bereavement is a response to loss. The circumstances that surround the loss, as well as the closeness of the relationship, can play a role in how intense the grief is that people experience. Some types of losses that can cause bereavement include:

• #105 Complicated Grief: Symptoms, Causes & Treatment

  https://laopcenter.com/mental-health/disorder/complicated-grief/

  Environmental factors, including social isolation and lack of support networks, exacerbate grief responses. Individuals who are alone or lack close relationships struggle more significantly with their grief, as they have fewer resources to process their emotions and seek help. […] The risk factors for complicated grief include mental health, unexpected loss, miscarriage, divorce, traumatic childhood experiences, and a history of depression, according to Zisook, S et al.s 2009 study entitled Grief and bereavement, published in the World Psychiatry Journal. […] The complications of complicated grief include mental health, unexpected loss, miscarriage, divorce, traumatic childhood experiences, and a history of depression, according to Zisook, S., Shear, K. (2009). In Grief and bereavement: What psychiatrists need to know. published by World Psychiatry.

• #106 Disenfranchised Grief: Causes and How to Manage and Validate It

  https://psychcentral.com/health/disenfranchised-grief

  Disenfranchised grief can occur when other people dont recognize or validate your grief or if you think they may not feel comfortable sharing your grief. A feeling of no one understands can overwhelm you. […] Here are a few examples of situations that might cause disenfranchised grief: loss of a person that others dont recognize as painful for you, such as an ex-spouse, abusive partner, person you were having an extramarital affair with, co-worker, teacher, or classmate […] loss related to a loved one who is or was suspected to have committed a crime and died after police contact […] grievance over a loved one dealing with mental health conditions, including addiction […] loss due to stigmatized death, such as suicide, substance overdose, or abortion. […] Complicated grief has to do with a persons response to a loss, whereas disenfranchised and anticipatory grief have to do with the nature of the loss, she says. […] Because complicated grief is a sign that something is interfering with a persons ability to adapt to the loss and integrate their grief into their lives, it can be experienced regardless of the nature of the loss (disenfranchised, anticipatory, traumatic, etc.), explains St-Germain.

• #107 Bereavement: Definition, Symptoms, Causes, Traits, Treatment

  https://www.verywellmind.com/bereavement-definition-symptoms-causes-traits-treatment-5197038

  The loss of a loved one is one of the most painful experiences we’ll have in life. Bereavement refers to the state of having experienced the loss of a loved one. It most often refers to the time after a loss when emotions are at their most profound. This time is marked by intense grief and tremendous sorrow. […] While bereavement is usually associated with death, it can also occur after other significant losses. The end of an important relationship or a major change in a person’s health, for example, can also lead to feelings of bereavement. […] Bereavement is a response to loss. The circumstances that surround the loss, as well as the closeness of the relationship, can play a role in how intense the grief is that people experience. Some types of losses that can cause bereavement include:

• #108 Prolonged Grief: Etiology and Management

  https://www.psychiatrist.com/pcc/prolonged-grief-etiology-management/

  PGD is thought to result from the derailment of the natural grief process. Typically, a bereaved individual adapts to the reality of death, painful as that reality might be. […] In the early phases of the COVID-19 pandemic, many experts predicted that there would be more intense and prevalent grief symptoms among the bereaved due to the traumatic nature of COVID-related deaths, disrupted rituals of mourning due to distancing requirements, and heightened stress throughout the population. […] Although PGD following a loss is a condition recently added to the DSM-5-TR, given that it is relatively common and highly treatable, it should be familiar to all clinicians. […] PGD has several features that overlap with MDD and PTSD (when the death was accompanied by trauma) but is a distinct entity for which a well validated, targeted treatment is available (ie, PGDT).

• #109 Prolonged Grief: Etiology and Management

  https://www.psychiatrist.com/pcc/prolonged-grief-etiology-management/

  PGD is thought to result from the derailment of the natural grief process. Typically, a bereaved individual adapts to the reality of death, painful as that reality might be. […] In the early phases of the COVID-19 pandemic, many experts predicted that there would be more intense and prevalent grief symptoms among the bereaved due to the traumatic nature of COVID-related deaths, disrupted rituals of mourning due to distancing requirements, and heightened stress throughout the population. […] Although PGD following a loss is a condition recently added to the DSM-5-TR, given that it is relatively common and highly treatable, it should be familiar to all clinicians. […] PGD has several features that overlap with MDD and PTSD (when the death was accompanied by trauma) but is a distinct entity for which a well validated, targeted treatment is available (ie, PGDT).

• #110 Prolonged Grief: Etiology and Management

  https://www.psychiatrist.com/pcc/prolonged-grief-etiology-management/

  Grief is the reaction to a meaningful loss. While grief can stem from different kinds of loss, it is perhaps most well understood in the context of losing someone important, particularly to death. […] When an individual gets stuck in the acute grief phase and is unable to integrate the painful loss into their lives, prolonged grief disorder (PGD) is diagnosed. […] Despite PGD being a relatively new diagnosis, added to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), in March 2022, numerous studies have looked at the risk factors for PGD. […] In other words, those who practice in primary care settings should be aware that individuals who have higher levels of depression and/or difficulty adapting to the loved ones illness or disability (ie, pre-loss grief) may benefit from a referral for specialized mental health services.

• #111 Prolonged Grief Disorder: What It Looks Like and How to Help

  https://www.verywellhealth.com/prolonged-grief-disorder-5218745

  Prolonged grief disorder can be diagnosed when symptoms persist for more than 12 months after the passing of a loved one in adults and at least six months in children. […] Prolonged grief is a new DSM-5 diagnosis that refers to the preoccupation with a deceased person. This can lead to significant emotional distress and make it difficult to get through the day and function in important ways.

• #112 A public health perspective on Prolonged Grief Disorder | Pursuit | University of Michigan School of Public Health | Public Health Sciences | Bachelor of Science | Mental Health | Grief | Well-being | Healthcare

  https://sph.umich.edu/pursuit/2023posts/public-health-perspective-on-prolonged-grief-disorder.html

  To avoid pathologizing the normal grief process, the DSM-5-TR committee specifically chose 12 months as the cutoff point at which a bereaved adult can be diagnosed for PGD; for children, that cutoff point is 6 months. […] PGD is a public health issue that can lead to significant adverse physical and mental health problems for years to come. Not only have millions of Americans lost loved ones to the COVID-19 pandemic (including more than over 200,000 children who lost a parent to COVID-related deaths), but many others continue to lose loved ones every day to other public health issues, such as chronic diseases (e.g., heart disease and cancer), gun violence (e.g., homicide and suicide), and drug overdoses. Bereaved individuals with PGD should be provided with the assistance and support needed in order to prevent adverse health outcomes, while also promoting adaptive grief reactions that can help them reintegrate into a life without this important person they lost.

• #113 Grief: Causes, symptoms, diagnosis and Treatments to overcome your misery – SavantCare

  https://www.savantcare.com/grief/

  Complicated grief and major depression share many characteristics, but they can differ significantly. Clinical depression and complicated grief can occasionally coexist. […] The World Health Organization certified Prolonged Grief Disorder as a new diagnosis in 2018. A persistent and pervasive grief response that is characterized by longing for the deceased or persistent preoccupation with the deceased accompanied by intense emotional pain (e.g. sadness, guilt, anger, denial, blame, difficulty accepting the death, feeling one has lost a part of ones self, an inability to experience positive mood, emotional numbness, difficulty engaging in social or other activities) is one of the criteria for this diagnosis. […] The diagnostic criteria for this disease are more precise, but research shows they are consistent. DSM-5 PGD requires the occurrence of a persistent and pervasive grief response characterized by constant yearning and/or preoccupation with the deceased and at least three of eight additional symptoms, including disbelief, intense longing for support, emotional pain, identity confusion, avoiding reminders of the loss, feelings of numbness, extreme loneliness, meaninglessness, or difficulty engaging in daily life.

• #114 Prolonged Grief: Etiology and Management

  https://www.psychiatrist.com/pcc/prolonged-grief-etiology-management/

  PGD is thought to result from the derailment of the natural grief process. Typically, a bereaved individual adapts to the reality of death, painful as that reality might be. […] In the early phases of the COVID-19 pandemic, many experts predicted that there would be more intense and prevalent grief symptoms among the bereaved due to the traumatic nature of COVID-related deaths, disrupted rituals of mourning due to distancing requirements, and heightened stress throughout the population. […] Although PGD following a loss is a condition recently added to the DSM-5-TR, given that it is relatively common and highly treatable, it should be familiar to all clinicians. […] PGD has several features that overlap with MDD and PTSD (when the death was accompanied by trauma) but is a distinct entity for which a well validated, targeted treatment is available (ie, PGDT).

• #115 Complicated Grief: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24951-complicated-grief

  Complicated grief can affect you mentally and physically. Complicated grief can cause long-term physical and mental health concerns that could include: Depression, Anxiety, Malnutrition or dehydration, Post-traumatic stress disorder, Heart disease, High blood pressure, Substance use disorder or alcohol use disorder. […] A healthcare provider will diagnose complicated grief if you experience symptoms of grief that affect your physical, mental and social health. […] Many people find comfort participating in cognitive behavioral therapy (CBT) as a treatment for complicated grief. […] Theres no known way to prevent complicated grief. You can reduce your risk of developing complicated grief by talking with a mental health professional after a loss. […] Treatment for complicated grief is possible through therapy and support groups. […] Visit a healthcare provider if you feel grief up to a year after your loss. If grief affects your ability to function or go about your day as you used to before a loss, a healthcare provider can help you feel better.

• #116 The Profound Sadness of Prolonged Grief | Harvard Medicine Magazine

  https://magazine.hms.harvard.edu/articles/profound-sadness-prolonged-grief

  Many of our patients actually self-identify, says Shear. […] Shear and others have determined that patients experiencing prolonged grief generally do not respond to the types of treatments traditionally used to address depression and PTSD, and they have worked to establish a separate protocol for treating the condition. […] The good news is that complicated grief patients have an immense capacity to heal and pull through, Shear says. […] Despite the fact that prolonged grief is getting more recognition these days, there remains an overall lack of awareness of it in the medical community. […] Some students may hear about bereavement when they encounter a patient who dies, but prolonged grief isnt understood or treated as a separate entity, she says. […] We do not have a system or a set of routine practices for caring for the bereaved, adds Block. […] This may be especially true now. The pandemic has at least brought grief, including prolonged grief, into a space of better awareness, Block says, but bereavement care in general has been inadequate throughout the pandemic because the health care system has been overwhelmed.

• #117 Psychiatry.org – Prolonged Grief Disorder

  https://www.psychiatry.org/patients-families/prolonged-grief-disorder

  Prolonged grief disorder often occurs along with other mental disorders such as PTSD, anxiety or depression. Sleep problems are also common; an estimated 80% of people with prolonged grief disorder experience long-term poor sleep. […] The inclusion of the diagnostic criteria for prolonged grief disorder in DSM-5-TR allows clinicians to use a common standard to differentiate between normal grief and this persistent, enduring, and disabling grief. […] One type of treatment, complicated grief treatment, incorporates components of CBT and other approaches to help adapt to the loss. It focuses on both accepting the reality of the loss and restoration working toward goals and a sense of satisfaction in a world without the loved one.

• #118 Psychiatry.org – Prolonged Grief Disorder

  https://www.psychiatry.org/patients-families/prolonged-grief-disorder

  Prolonged grief disorder often occurs along with other mental disorders such as PTSD, anxiety or depression. Sleep problems are also common; an estimated 80% of people with prolonged grief disorder experience long-term poor sleep. […] The inclusion of the diagnostic criteria for prolonged grief disorder in DSM-5-TR allows clinicians to use a common standard to differentiate between normal grief and this persistent, enduring, and disabling grief. […] One type of treatment, complicated grief treatment, incorporates components of CBT and other approaches to help adapt to the loss. It focuses on both accepting the reality of the loss and restoration working toward goals and a sense of satisfaction in a world without the loved one.

• #119 Reddit – The heart of the internet

  https://www.reddit.com/r/science/comments/2i6msf/science_ama_series_im_dr_katherine_shear_of/

  I am the senior author of a new study that showed that complicated grief treatment was twice as effective as interpersonal psychotherapy (70% v 32%). […] Complicated grief is the name we give to the syndrome that results when this natural progression is slowed or even halted. […] There is a lot of evidence that a small percentage of bereaved people suffer in this way and when they do their lives can be dramatically impacted.

• #120 Complicated grief – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/complicated-grief/diagnosis-treatment/drc-20360389

  Grieving is a highly individual process for each person, and determining when normal grief becomes complicated grief can be difficult. […] Complicated grief may be considered when the intensity of grief has not decreased in the months after your loved one’s death. Some mental health professionals diagnose complicated grief when grieving continues to be intense, persistent and debilitating beyond 12 months. […] There are many similarities between complicated grief and major depression, but there are also distinct differences. In some cases, clinical depression and complicated grief occur together. Getting the correct diagnosis is essential for appropriate treatment, so a comprehensive medical and psychological exam is often done. […] There’s little solid research on the use of psychiatric medications to treat complicated grief. However, antidepressants may be helpful in people who have clinical depression as well as complicated grief.

• #121 Complicated Grief: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24951-complicated-grief

  Complicated grief can affect you mentally and physically. Complicated grief can cause long-term physical and mental health concerns that could include: Depression, Anxiety, Malnutrition or dehydration, Post-traumatic stress disorder, Heart disease, High blood pressure, Substance use disorder or alcohol use disorder. […] A healthcare provider will diagnose complicated grief if you experience symptoms of grief that affect your physical, mental and social health. […] Many people find comfort participating in cognitive behavioral therapy (CBT) as a treatment for complicated grief. […] Theres no known way to prevent complicated grief. You can reduce your risk of developing complicated grief by talking with a mental health professional after a loss. […] Treatment for complicated grief is possible through therapy and support groups. […] Visit a healthcare provider if you feel grief up to a year after your loss. If grief affects your ability to function or go about your day as you used to before a loss, a healthcare provider can help you feel better.

• #122 Complicated Grief: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24951-complicated-grief

  Complicated grief can affect you mentally and physically. Complicated grief can cause long-term physical and mental health concerns that could include: Depression, Anxiety, Malnutrition or dehydration, Post-traumatic stress disorder, Heart disease, High blood pressure, Substance use disorder or alcohol use disorder. […] A healthcare provider will diagnose complicated grief if you experience symptoms of grief that affect your physical, mental and social health. […] Many people find comfort participating in cognitive behavioral therapy (CBT) as a treatment for complicated grief. […] Theres no known way to prevent complicated grief. You can reduce your risk of developing complicated grief by talking with a mental health professional after a loss. […] Treatment for complicated grief is possible through therapy and support groups. […] Visit a healthcare provider if you feel grief up to a year after your loss. If grief affects your ability to function or go about your day as you used to before a loss, a healthcare provider can help you feel better.

• #123 Persistent Complex Bereavement Disorder DSM-5

  https://www.theravive.com/therapedia/persistent-complex-bereavement-disorder-dsm–5

  A number of risk factors have been identified for the development of pathological grief after bereavement. These include first-degree relationship to the deceased, separation anxiety in childhood, controlling parents, abuse by or death of parents during childhood, a poorly-functioning marriage or insecure attachment style prior to widowhood, emotional dependency on the deceased, lack of preparation for the death and in-hospital death of the loved one. […] A prolonged state of abnormal grief has been associated with elevated rates of suicidal ideation and suicide attempts. […] This has led to the proposal of a separate psychiatric disorder of persistent and complex bereavement, although it was elected in the preparation of DSM-5 to defer the establishment of this diagnosis for further study.

• #124 The Profound Sadness of Prolonged Grief | Harvard Medicine Magazine

  https://magazine.hms.harvard.edu/articles/profound-sadness-prolonged-grief

  After this pandemic, rates of prolonged grief among older adults may move even higher, says Simon, but given the DSM-5s requirement that grief persist for twelve months following a loss, not enough time has elapsed for data to be assessed. […] Regardless of who experiences it, prolonged grief comes with increased health risks. In Shears work, suicidality, heart trouble, cancer, and other physical ailments often accompany the conditions emotional effects. […] One of the first researchers to identify it as a distinct condition was sociologist Holly Prigerson during her postdoctoral career in the mid-1990s at what was then the Western Psychiatric Institute and Clinic at the University of Pittsburgh School of Medicine. […] To improve how prolonged grief was identified and diagnosed, Prigerson and her colleagues established a 19-item inventory for screening patients.

• #125 Complicated Grief: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24951-complicated-grief

  Complicated grief can affect you mentally and physically. Complicated grief can cause long-term physical and mental health concerns that could include: Depression, Anxiety, Malnutrition or dehydration, Post-traumatic stress disorder, Heart disease, High blood pressure, Substance use disorder or alcohol use disorder. […] A healthcare provider will diagnose complicated grief if you experience symptoms of grief that affect your physical, mental and social health. […] Many people find comfort participating in cognitive behavioral therapy (CBT) as a treatment for complicated grief. […] Theres no known way to prevent complicated grief. You can reduce your risk of developing complicated grief by talking with a mental health professional after a loss. […] Treatment for complicated grief is possible through therapy and support groups. […] Visit a healthcare provider if you feel grief up to a year after your loss. If grief affects your ability to function or go about your day as you used to before a loss, a healthcare provider can help you feel better.

• #126 Complicated Grief: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24951-complicated-grief

  Complicated grief can affect you mentally and physically. Complicated grief can cause long-term physical and mental health concerns that could include: Depression, Anxiety, Malnutrition or dehydration, Post-traumatic stress disorder, Heart disease, High blood pressure, Substance use disorder or alcohol use disorder. […] A healthcare provider will diagnose complicated grief if you experience symptoms of grief that affect your physical, mental and social health. […] Many people find comfort participating in cognitive behavioral therapy (CBT) as a treatment for complicated grief. […] Theres no known way to prevent complicated grief. You can reduce your risk of developing complicated grief by talking with a mental health professional after a loss. […] Treatment for complicated grief is possible through therapy and support groups. […] Visit a healthcare provider if you feel grief up to a year after your loss. If grief affects your ability to function or go about your day as you used to before a loss, a healthcare provider can help you feel better.

• #127 The Profound Sadness of Prolonged Grief | Harvard Medicine Magazine

  https://magazine.hms.harvard.edu/articles/profound-sadness-prolonged-grief

  After this pandemic, rates of prolonged grief among older adults may move even higher, says Simon, but given the DSM-5s requirement that grief persist for twelve months following a loss, not enough time has elapsed for data to be assessed. […] Regardless of who experiences it, prolonged grief comes with increased health risks. In Shears work, suicidality, heart trouble, cancer, and other physical ailments often accompany the conditions emotional effects. […] One of the first researchers to identify it as a distinct condition was sociologist Holly Prigerson during her postdoctoral career in the mid-1990s at what was then the Western Psychiatric Institute and Clinic at the University of Pittsburgh School of Medicine. […] To improve how prolonged grief was identified and diagnosed, Prigerson and her colleagues established a 19-item inventory for screening patients.

• #128 How the Physical Symptoms of Grief Display in Your Body – thewaveclinic.com

  https://thewaveclinic.com/blog/how-the-physical-symptoms-of-grief-display-in-your-body/

  Intense grief that is accompanied by painful emotions that are so severe and long-lasting that a person has great difficulty recovering from loss or resuming their loss, is called complicated grief. […] The exact causes of complicated grief are unknown, but research conducted by the Columbia University School of Social Work estimates that it occurs in about 7% of bereaved people. Many factors seem to play a role, including the environment, personality, inherited traits, chemical makeup, and the relationship with the deceased person. […] While anxiety is a natural component of the grieving process, symptoms that do not lessen after six months following a loss could indicate an anxiety disorder or that someone is experiencing complicated grief. […] The prolonged experience of these emotional symptoms can lead to: depression, anxiety (including PTSD, phobias, and social anxiety), significant sleep problems, long-term difficulty with relationships, work, or daily living, suicidal thoughts or behaviours, increased risk of physical illness such as high blood pressure, cancer, or heart disease.

• #129 Complicated Grief: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24951-complicated-grief

  Complicated grief can affect you mentally and physically. Complicated grief can cause long-term physical and mental health concerns that could include: Depression, Anxiety, Malnutrition or dehydration, Post-traumatic stress disorder, Heart disease, High blood pressure, Substance use disorder or alcohol use disorder. […] A healthcare provider will diagnose complicated grief if you experience symptoms of grief that affect your physical, mental and social health. […] Many people find comfort participating in cognitive behavioral therapy (CBT) as a treatment for complicated grief. […] Theres no known way to prevent complicated grief. You can reduce your risk of developing complicated grief by talking with a mental health professional after a loss. […] Treatment for complicated grief is possible through therapy and support groups. […] Visit a healthcare provider if you feel grief up to a year after your loss. If grief affects your ability to function or go about your day as you used to before a loss, a healthcare provider can help you feel better.

• #130 How the Physical Symptoms of Grief Display in Your Body – thewaveclinic.com

  https://thewaveclinic.com/blog/how-the-physical-symptoms-of-grief-display-in-your-body/

  Intense grief that is accompanied by painful emotions that are so severe and long-lasting that a person has great difficulty recovering from loss or resuming their loss, is called complicated grief. […] The exact causes of complicated grief are unknown, but research conducted by the Columbia University School of Social Work estimates that it occurs in about 7% of bereaved people. Many factors seem to play a role, including the environment, personality, inherited traits, chemical makeup, and the relationship with the deceased person. […] While anxiety is a natural component of the grieving process, symptoms that do not lessen after six months following a loss could indicate an anxiety disorder or that someone is experiencing complicated grief. […] The prolonged experience of these emotional symptoms can lead to: depression, anxiety (including PTSD, phobias, and social anxiety), significant sleep problems, long-term difficulty with relationships, work, or daily living, suicidal thoughts or behaviours, increased risk of physical illness such as high blood pressure, cancer, or heart disease.

• #131 Complicated Grief: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24951-complicated-grief

  Complicated grief can affect you mentally and physically. Complicated grief can cause long-term physical and mental health concerns that could include: Depression, Anxiety, Malnutrition or dehydration, Post-traumatic stress disorder, Heart disease, High blood pressure, Substance use disorder or alcohol use disorder. […] A healthcare provider will diagnose complicated grief if you experience symptoms of grief that affect your physical, mental and social health. […] Many people find comfort participating in cognitive behavioral therapy (CBT) as a treatment for complicated grief. […] Theres no known way to prevent complicated grief. You can reduce your risk of developing complicated grief by talking with a mental health professional after a loss. […] Treatment for complicated grief is possible through therapy and support groups. […] Visit a healthcare provider if you feel grief up to a year after your loss. If grief affects your ability to function or go about your day as you used to before a loss, a healthcare provider can help you feel better.

• #132 Complicated Grief: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24951-complicated-grief

  Complicated grief can affect you mentally and physically. Complicated grief can cause long-term physical and mental health concerns that could include: Depression, Anxiety, Malnutrition or dehydration, Post-traumatic stress disorder, Heart disease, High blood pressure, Substance use disorder or alcohol use disorder. […] A healthcare provider will diagnose complicated grief if you experience symptoms of grief that affect your physical, mental and social health. […] Many people find comfort participating in cognitive behavioral therapy (CBT) as a treatment for complicated grief. […] Theres no known way to prevent complicated grief. You can reduce your risk of developing complicated grief by talking with a mental health professional after a loss. […] Treatment for complicated grief is possible through therapy and support groups. […] Visit a healthcare provider if you feel grief up to a year after your loss. If grief affects your ability to function or go about your day as you used to before a loss, a healthcare provider can help you feel better.

• #133 Prolonged Grief: Etiology and Management

  https://www.psychiatrist.com/pcc/prolonged-grief-etiology-management/

  Grief is the reaction to a meaningful loss. While grief can stem from different kinds of loss, it is perhaps most well understood in the context of losing someone important, particularly to death. […] When an individual gets stuck in the acute grief phase and is unable to integrate the painful loss into their lives, prolonged grief disorder (PGD) is diagnosed. […] Despite PGD being a relatively new diagnosis, added to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), in March 2022, numerous studies have looked at the risk factors for PGD. […] In other words, those who practice in primary care settings should be aware that individuals who have higher levels of depression and/or difficulty adapting to the loved ones illness or disability (ie, pre-loss grief) may benefit from a referral for specialized mental health services.

• #134 Prolonged Grief: Etiology and Management

  https://www.psychiatrist.com/pcc/prolonged-grief-etiology-management/

  Grief is the reaction to a meaningful loss. While grief can stem from different kinds of loss, it is perhaps most well understood in the context of losing someone important, particularly to death. […] When an individual gets stuck in the acute grief phase and is unable to integrate the painful loss into their lives, prolonged grief disorder (PGD) is diagnosed. […] Despite PGD being a relatively new diagnosis, added to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), in March 2022, numerous studies have looked at the risk factors for PGD. […] In other words, those who practice in primary care settings should be aware that individuals who have higher levels of depression and/or difficulty adapting to the loved ones illness or disability (ie, pre-loss grief) may benefit from a referral for specialized mental health services.

• #135 Complicated Grief: Symptoms, Causes & Treatment

  https://laopcenter.com/mental-health/disorder/complicated-grief/

  Environmental factors, including social isolation and lack of support networks, exacerbate grief responses. Individuals who are alone or lack close relationships struggle more significantly with their grief, as they have fewer resources to process their emotions and seek help. […] The risk factors for complicated grief include mental health, unexpected loss, miscarriage, divorce, traumatic childhood experiences, and a history of depression, according to Zisook, S et al.s 2009 study entitled Grief and bereavement, published in the World Psychiatry Journal. […] The complications of complicated grief include mental health, unexpected loss, miscarriage, divorce, traumatic childhood experiences, and a history of depression, according to Zisook, S., Shear, K. (2009). In Grief and bereavement: What psychiatrists need to know. published by World Psychiatry.

• #136 The Profound Sadness of Prolonged Grief | Harvard Medicine Magazine

  https://magazine.hms.harvard.edu/articles/profound-sadness-prolonged-grief

  Many of our patients actually self-identify, says Shear. […] Shear and others have determined that patients experiencing prolonged grief generally do not respond to the types of treatments traditionally used to address depression and PTSD, and they have worked to establish a separate protocol for treating the condition. […] The good news is that complicated grief patients have an immense capacity to heal and pull through, Shear says. […] Despite the fact that prolonged grief is getting more recognition these days, there remains an overall lack of awareness of it in the medical community. […] Some students may hear about bereavement when they encounter a patient who dies, but prolonged grief isnt understood or treated as a separate entity, she says. […] We do not have a system or a set of routine practices for caring for the bereaved, adds Block. […] This may be especially true now. The pandemic has at least brought grief, including prolonged grief, into a space of better awareness, Block says, but bereavement care in general has been inadequate throughout the pandemic because the health care system has been overwhelmed.

• #137 What is complicated grief? Symptoms and treatment

  https://www.medicalnewstoday.com/articles/complicated-grief

  Complicated grief is grief that lasts longer and is more intense than a culture may consider typical. It may disrupt someones daily life, alter their sense of identity, and cause frequent, strong emotions, such as longing, anger, or loneliness. […] According to the APA, it may cause someone to become preoccupied by their loss in a way that disrupts daily life. […] According to a 2022 article, complicated grief may affect up to 710% of people who experience bereavement. […] Researchers are not sure why some people develop prolonged grief, and others do not. Different studies have identified various risk factors. Some include: a loved one dying in a way that is sudden, painful, violent, or otherwise traumatic; the nature of the relationship with the departed loved one, as closer relationships may inspire more grief; denial or difficulty accepting the death; avoidance of difficult emotions, which may prevent someone from processing what has happened; a negative view of the self and the world.

• #138 A public health perspective on Prolonged Grief Disorder | Pursuit | University of Michigan School of Public Health | Public Health Sciences | Bachelor of Science | Mental Health | Grief | Well-being | Healthcare

  https://sph.umich.edu/pursuit/2023posts/public-health-perspective-on-prolonged-grief-disorder.html

  To avoid pathologizing the normal grief process, the DSM-5-TR committee specifically chose 12 months as the cutoff point at which a bereaved adult can be diagnosed for PGD; for children, that cutoff point is 6 months. […] PGD is a public health issue that can lead to significant adverse physical and mental health problems for years to come. Not only have millions of Americans lost loved ones to the COVID-19 pandemic (including more than over 200,000 children who lost a parent to COVID-related deaths), but many others continue to lose loved ones every day to other public health issues, such as chronic diseases (e.g., heart disease and cancer), gun violence (e.g., homicide and suicide), and drug overdoses. Bereaved individuals with PGD should be provided with the assistance and support needed in order to prevent adverse health outcomes, while also promoting adaptive grief reactions that can help them reintegrate into a life without this important person they lost.

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