Materiały źródłowe

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

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

  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. […] But if you’re unable to move through these stages more than a year after the death of a loved one, you may have complicated grief. If so, seek treatment. It can help you come to terms with your loss and reclaim a sense of acceptance and peace. […] During the first few months after a loss, many signs and symptoms of normal grief are the same as those of complicated grief. However, while normal grief symptoms gradually start to fade over time, those of complicated grief linger or get worse. Complicated grief is like being in an ongoing, heightened state of mourning that keeps you from healing.

• #2 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. You may feel intense emotions or have trouble accepting the 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. […] Complicated grief affects an estimated 7% of all adults who experience grief. Complicated grief or prolonged grief disorder is a relatively new addition to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), so research is ongoing to learn more about it.

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• #4 Complicated grief // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/complicated-grief

  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. […] Complicated grief is like being in an ongoing, heightened state of mourning that keeps you from healing. […] Signs and symptoms of complicated grief may include: Intense sorrow, pain and rumination over the loss of your loved one; Focus on little else but your loved one’s death; Extreme focus on reminders of the loved one or excessive avoidance of reminders; Intense and persistent longing or pining for the deceased; Problems accepting the death; Numbness or detachment; Bitterness about your loss; Feeling that life holds no meaning or purpose; Lack of trust in others; Inability to enjoy life or think back on positive experiences with your loved one. […] 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.

• #5 Complicated grief | Cruse Bereavement Support

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

  Over time most people start to adapt and feel better after someone dies. When someone becomes stuck or is still unable to cope after many months it is sometimes known as complicated grief or prolonged grief disorder. […] When this doesn’t happen for many months or even years it is sometimes known as complicated grief or prolonged grief disorder. It is more likely to happen if someone’s death was very tragic, traumatic or unexpected. […] Prolonged grief disorder or complicated grief is when intense, long-lasting symptoms of grief, together with ongoing problems and difficulties in coping with life, go on for more than six months after someone dies. […] Complicated grief can be difficult to identify. […] The following signs may mean you are suffering from complicated or prolonged grief.

• #6 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. […] However, some individuals experience persistent, intense grief that interferes with daily functioning and overall well-being. This disorder is increasingly recognized as a distinct mental health concern, particularly when symptoms such as longing, emotional numbness, and identity disruption persist for more than a year. […] 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. […] Most people can adequately process their grief within a year for adults or 6 months for children or adolescents. This does not mean that they have forgotten their loved one or are not still impacted by their loss, however, they are functional and are no longer severely affected by the distress of intense grief to a degree that limits their daily activities on a regular basis.

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

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

  Signs and symptoms of complicated grief may include: Intense sorrow, pain and rumination over the loss of your loved one; Focus on little else but your loved one’s death; Extreme focus on reminders of the loved one or excessive avoidance of reminders; Intense and persistent longing or pining for the deceased; Problems accepting the death; Numbness or detachment; Bitterness about your loss; Feeling that life holds no meaning or purpose; Lack of trust in others; Inability to enjoy life or think back on positive experiences with your loved one. […] Complicated grief also may be indicated if you continue to: Have trouble carrying out normal routines; Isolate from others and withdraw from social activities; Experience depression, deep sadness, guilt or self-blame; Believe that you did something wrong or could have prevented the death; Feel life isn’t worth living without your loved one; Wish you had died along with your loved one. […] Contact your doctor or a mental health professional if you have intense grief and problems functioning that don’t improve at least one year after the passing of your loved one.

• #8 Prolonged Grief Disorder | Psychology Today

  https://www.psychologytoday.com/us/conditions/prolonged-grief-disorder

  Since the death, at least three of the following symptoms have been present most days to a clinically significant degree. In addition, the symptoms have occurred nearly every day for at least the last month: Identity disruption (e.g., feeling as though part of oneself has died) since the death. A marked sense of disbelief about the death. Avoidance of reminders that the person is dead (in children and adolescents, may be characterized by efforts to avoid reminders). Intense emotional pain (e.g., anger, bitterness, sorrow) related to the death. Difficulty reintegrating into ones relationships and activities after the death (e.g., problems engaging with friends, pursuing interests, or planning for the future). Emotional numbness (absence or marked reduction of emotional experience) as a result of the death. Feeling that life is meaningless as a result of the death. Intense loneliness as a result of the death.

• #9 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. […] An individual with prolonged grief disorder may experience intense longing for the person who has died or preoccupation with thoughts of that person. […] The persistent grief is disabling and affects everyday functioning in a way that typical grieving does not. […] Symptoms of prolonged grief disorder (APA, 2022) include: Identity disruption (such as feeling as though part of oneself has died).

• #10 What distinguishes prolonged grief disorder from depression? | Tidsskrift for Den norske legeforening

  https://tidsskriftet.no/en/2017/04/klinisk-oversikt/what-distinguishes-prolonged-grief-disorder-depression

  Sleep disturbances are common in both prolonged grief and depression. However, pronounced weight loss, slowness in thinking, speaking and moving (psychomotor retardation) and difficulty in making decisions are prominent in depression, but absent in prolonged grief. […] Suicidal thoughts occur in both prolonged grief and depression. In prolonged grief, this will often be associated with a wish to be reunited with the deceased. In depression, thoughts of ending life will commonly be more associated with notions of not deserving to live and a wish to put an end to an intolerable situation or the idea that others will be better off if the sufferer disappears for good.

• #11 Understanding Complicated Grief: Symptoms And Support Strategies | BetterHelp

  https://www.betterhelp.com/advice/grief/understanding-complicated-grief-symptoms-and-support-strategies/

  Complicated grief may involve intense sadness, despair, self-blame, and guilt, alongside a sense of numbness or detachment. […] Individuals with complicated grief may experience physical symptoms, such as fatigue, exhaustion, physical aches and pains, and sleep disturbances. […] Cognitive symptoms may include persistent rumination about the deceased person or the circumstances surrounding their death, as well as difficulty concentrating. […] Common behavioral symptoms for a person living with complicated grief can include the avoidance of reminders, overall social withdrawal, and impaired functioning in daily life. […] Individuals living with complicated grief may be more likely to develop major depressive disorder and experience anxiety. […] Individuals with complicated grief may also experience a strain on their social lives and interpersonal relationships. […] Experiencing grief after the loss of a loved one can be a normal and healthy process. However, complicated grief generally refers to grief that is severe, long-lasting, and interferes with a persons daily life.

• #12 Treating Complicated Grief

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4530627/

  Ms T’s grief has become stuck with persistent very high levels of distress and impairment, including emotional paralysis, feeling lost, and daily longing for and thinking about her deceased husband so much that daily activities are hard to accomplish. […] These findings indicate a need for complicated grief intervention.

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

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

  Long-term grief often goes undiagnosed even though treatment can be pivotal to overall well-being. […] But sometimes, people like Jodi become stuck. Their grief remains acute, and they cant move forward. […] For about 7 percent of those who are bereaved, however, grief sticks around in a deeply painful manner, preventing them from moving forward and healing. Prolonged grief also referred to as complicated grief traps these individuals in a loop of despair from which they cant escape. […] 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. […] Typical thoughts that prolonged grief sufferers experience, they wrote, include second-guessing, grief-judging, and catastrophizing the future. Behaviors include excessive avoidance, social withdrawal, substance use, and negative health behaviors.

• #14 Prolonged Grief: Etiology and Management

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

  Symptoms of prolonged grief disorder (PGD) include yearning for and preoccupation about the deceased, as well as a loss of sense of self, suicidal ideation, and feeling isolated from others, with continued distress or impairment 1 year after the loss for adults (and 6 months for children and adolescents). […] 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. […] 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. Over time, the finality of the death and its consequences are accepted. In PGD, this process is sidetracked, and the bereaved individual gets stuck and becomes preoccupied with the loss for years—or even decades—as if the death had occurred very recently.

• #15 Treating Complicated Grief

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4530627/

  In complicated grief, the progress of adapting to and accepting the finality of the loss is complicated, slowed, or halted. Complicated grief symptoms include intense longing, intrusive preoccupation with the circumstances of the loss, self-blame, avoidance of thoughts or memories of the deceased, avoidance of previously shared activities, and inadequate adaptation to the loss. Complicated grief is associated with many negative outcomes including reduced quality of life, functional impairment, high-risk behaviors, increased rates of cardiovascular illness and cancer, sleep disturbance, and heightened suicidal ideation and behaviors even after adjustment for comorbid depression and posttraumatic stress disorder. […] Ms T was identified by her clinicians as likely experiencing complicated grief, now 16 months (1-year minimum) after her husband’s death.

• #16 Complicated Grief: Symptoms, Diagnosis, Treatment

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

  The signs and symptoms of complicated grief are similar to normal grief. However, whereas symptoms fade with time with normal grief, people with complicated grief experience them more intensely and persistently. […] Symptoms of prolonged grief disorder include: Intense emotional pain, Disruptions in identity, Feelings of disbelief about the death, Avoidance of reminders that the person is dead, Difficulty reintegrating with daily life, Emotional numbness, Intense loneliness, Feeling like life is meaningless. […] Many symptoms of complicated grief might look like symptoms of depression. In certain cases, complicated grief might even evolve into depression. […] Complicated grief has also proven to be more prevalent in older individuals. One study found that around 9% of older women experience complicated grief.

• #17 What Are the Signs of Complicated Grief Disorder? | D’Amore Mental Health

  https://damorementalhealth.com/what-are-the-signs-of-complicated-grief-disorder/

  Grief looks different for everyone, so there’s not really a “normal” when it comes to this process. […] This disorder starts as a natural (and very much needed) response to a traumatic event, such as the loss of a loved one. However, instead of recovering from the state of grief and picking up their normal, daily activities, people who suffer from complicated grief disorder will get stuck in this state of grief. The feelings will get more severe, become more present, last for longer periods of time, and get worse over time. […] Once a person falls into this disorder, it becomes difficult or even impossible to recover from it on their own. […] Complicated grief looks very similar to healthy grief during the first few months (two to three). Just because you or your loved one is has a deep grieving process at this time doesn’t mean there is anything wrong with them.

• #18 What is Prolonged Grief Disorder? Symptoms and Treatments

  https://boldhealthinc.com/what-is-prolonged-grief-disorder-symptoms-and-treatments/

  Prolonged grief disorder is a relatively new diagnosable condition added to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) in March of 2022. Also referred to as complicated grief disorder, this draining mental health condition mimics grief symptoms but lasts much longer. […] Symptoms of prolonged grief disorder, otherwise known as complicated grief disorder, include the following and present six months or more after the loss: denying or becoming defensive about your grief, rarely or never leaving home, focusing on little else other than the one you lost, intense, persistent longing for your loved one who has passed away, inability to trust others, emotional numbness, obsessed with focusing on reminders of your loved one or obsessed with avoiding them, anger and bitterness, pessimistic views about life, lack of attention to grooming and appearance, talk of suicide or attempting suicide, inability to manage daily routine activities, including work and school. […] According to Psychiatry.org, an estimated 7-10% of adults who’ve experienced loss will experience prolonged grief disorder. […] Based on research, experts agree that when intense grief symptoms last for longer than six months, there is a good chance that prolonged grief exposure has developed.

• #19 Complicated Grief: Symptoms, Causes & Treatment

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

  Complicated grief lasts at least 12 months following the death of a loved one for adults and at least 6 months for children and adolescents. […] Unlike normal grief, which tends to diminish over time, complicated grief symptoms persist indefinitely, leading to ongoing emotional distress and functional impairment. […] Research by World Psychiatry (2009), Grief and bereavement: what psychiatrists need to know by Sidney ZIsook, indicates that while most bereaved individuals begin to adapt within the first six months, a significant minority, approximately 7% to 10% develop prolonged grief symptoms that warrant clinical intervention.

• #20 Differences Between Normal and Complicated Grief

  https://www.verywellhealth.com/grief-and-mourning-process-1132545

  Normal grief is temporary. With complicated grief, the response to a loss or death does not fade over impacts someone’s ability to feel or function normally. […] In the most current revision of the Diagnostic and Statistical Manual (DSM-5-TR), the most commonly-used reference for diagnosing mental disorders, the American Psychiatric Association included the diagnosis of prolonged grief disorder. […] It is characterized by the experience of intense longings for or preoccupations with thoughts of the deceased, accompanied by identity disturbances, disbelief about the loss, avoidance of reminders of the death, intense emotional pain, and experiences of numbness, meaninglessness, or loneliness, causing significant distress, impairment, and dysfunction in important areas of one’s life. […] The characteristics of complicated grief can include many of the same experiences as normal grief. However, other symptoms may include: Persistent anger, irritation, or episodes of rage; Inability to focus on anything but the loss; Excessive avoidance of any reminders of the loss; Intense feelings of sadness, pain, detachment, sorrow, hopelessness, emptiness, or low self-esteem; Problems accepting the reality of the loss; Self-destructive behavior, such as substance abuse use or risk-taking behaviors; Suicidal thoughts or actions. […] Complicated grief describes feelings and responses that can be extremely intense and persistent. A person with complicated grief may need more support to help them understand what they are feeling and how to move through the grieving process.

• #21 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. […] Complicated grief is often treated with a type of psychotherapy called complicated grief therapy. It’s similar to psychotherapy techniques used for depression and PTSD, but it’s specifically for complicated grief. […] 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.

• #22 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. […] A person with complicated grief may feel their loss all the time, though, long after the initial mourning period. They may feel part of themselves has died, along with the loved one. […] According to the APA, potential signs of prolonged grief disorder include: Reintegration difficulties: Usually, after a loss, people gradually reenter their daily lives and begin resuming their typical activities. The APA states that those with complicated grief have difficulty with this, affecting their work, school, and relationships. […] Complicated grief causes acute grief symptoms to last longer.

• #23 Prolonged grief disorder – Wikipedia

  https://en.wikipedia.org/wiki/Prolonged_grief_disorder

  Grief is a common response to bereavement, occurring in a variety of severities and durations, however only a minority of cases of grief meet the severity and duration criteria to merit diagnosis of PGD; it is considered when an individual’s ability to function and level of distress over the loss is extreme and persistent. […] People with PGD can experience a chronic aching and yearning for the dear departed, feel that they are not the same person anymore (identity disturbance), become emotionally disconnected from others, or lack the desire to „move on” (in some cases feeling that doing so would be betraying the person who is now deceased). […] Although normal grief remains with the bereaved person far into the future, its ability to disrupt the survivor’s life is believed to dissipate with time.

• #24 What distinguishes prolonged grief disorder from depression? | Tidsskrift for Den norske legeforening

  https://tidsskriftet.no/en/2017/04/klinisk-oversikt/what-distinguishes-prolonged-grief-disorder-depression

  Prolonged grief is the most common form of complicated grief in adults. It is different from normal grief in that the immediate grief reactions persist over time with more or less undiminished strength, causing a considerable loss of everyday functioning. One may also observe little change or flexibility with regard to the way in which this grief is handled. […] Prolonged grief is primarily characterised by an intense longing for or persistent preoccupation with the deceased person. Other characteristics include difficulties in accepting the death, the feeling of having lost a part of oneself, difficulties in continuing with life, emotional numbness and avoidance of things/places/activities that serve as reminders of the deceased. Others also emphasise rumination over how the death could have been avoided, blaming of others and self-blame as typical of persons who struggle with prolonged grief.

• #25 What distinguishes prolonged grief disorder from depression? | Tidsskrift for Den norske legeforening

  https://tidsskriftet.no/en/2017/04/klinisk-oversikt/what-distinguishes-prolonged-grief-disorder-depression

  A key assessment to distinguish prolonged grief from depression involves whether the thoughts and emotions continue to circle around the deceased (prolonged grief) or whether these are more free-floating and generalised and less associated with the loss itself (depression). For example, a low mood (dysphoria) in prolonged grief will be associated with the separation from the deceased, while depression will involve a more persistent and pervasive dysphoria, often in combination with pessimistic rumination and a sense of hopelessness. […] Other core symptoms also differ. In prolonged grief, intense and persistent longing for the deceased person is a core symptom, which is not associated with depression. In depression, the patient will experience a generally lowered interest in or ability to enjoy everyday activities, while prolonged grief will involve a persistent preoccupation with the deceased, often accompanied by positive emotions or an intense longing. It is also common for the bereaved to seek sensory experiences that bring them closer to the deceased, for example by using their clothes to feel their smell or listening to the voice of the deceased on a mobile telephone.

• #26 Psychiatry.org – Prolonged Grief Disorder

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

  An estimated 7%-10% of bereaved adults will experience the persistent symptoms of prolonged grief disorder (Szuhany et al., 2021). […] 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. […] Prolonged grief disorder often occurs along with other mental disorders such as PTSD, anxiety or depression. […] For most people, grief-related symptoms following the death of a loved one decrease over time and do not impact their everyday functioning. […] However, for people who develop the more intense, ongoing symptoms of prolonged grief disorder, evidence-based treatments are available. […] One type of treatment, complicated grief treatment, incorporates components of CBT and other approaches to help adapt to the loss. […] Despite the existence of effective treatments, people experiencing ongoing intense grief may not seek help.

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

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

  Symptoms of anxiety and depression can occur in complicated grief, and targeted treatment of the complicated grief response will also reduce anxiety and depression. […] Risk factors include a history of mood or anxiety disorders, alcohol or drug abuse, and multiple losses. […] A short-term approach called complicated grief treatment (CGT) has been effective with 2 out of 3 people, and is more effective than other treatments for complicated grief, including interpersonal therapy and antidepressant medication, and is therefore the treatment of choice for complicated grief. […] Research suggests that interventions that include strategies to reduce avoidance of thoughts about the death and avoidance of activities and places that are reminders of the loss are more effective than those that do not.

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

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

  However, there are some people who develop what is called prolonged grief disorder and continue to have severe symptoms of grief for a prolonged period of time. […] There are identifiable risk factors that can increase a person’s likelihood of developing prolonged grief disorder. […] 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 can also increase risk for prolonged grief. […] Most bereaved persons adapt over 6 months to 1 year. […] This condition is managed best with prolonged or complicated grief therapy, which incorporates elements of cognitive behavioral therapy and other techniques aimed at promoting adaptation to the loss, including acceptance of the loss and restoring a sense of meaning and satisfaction in life without the deceased loved one.

• #29 Get help with grief after bereavement or loss – NHS

  https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/feelings-and-symptoms/grief-bereavement-loss/

  For most people grief will become less intense over time. But for some people, grief lasts many months or years. This is known as prolonged grief disorder or complicated grief. […] Symptoms of prolonged grief disorder include: very difficult feelings such as sadness or guilt for over 6 months, spending a lot of time thinking about the person who’s died, difficulty accepting the death, not being able to return to everyday activities, suicidal thoughts. […] You’re more likely to have prolonged grief disorder if the death was traumatic or sudden and unexpected.

• #30 Complicated grief | Cruse Bereavement Support

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

  If you feel stuck feeling one way for many months it can be a warning sign. […] It’s normal to find it very difficult to get on with normal life after someone dies. But if you are struggling to feed yourself, shop for groceries or return to work after several months that can be a warning sign that you need more help. […] If you find that the following are true for you may be experiencing complicated grief: you’ve withdrawn from daily life, you’re avoiding things that you would normally like, you can’t find any enjoyment in anything, this lasts for a long period of time. […] In complicated or prolonged grief these can be very intense and go on for a long time with no lessening or change in strength. […] There’s still a lot more to learn about complicated grief, but the following things are risk factors: If the person died in a sudden or traumatic way this can affect the grieving process.

• #31 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. […] If you have an existing mental health condition then this can make the grieving process more difficult.

• #32

  https://aeon.co/essays/how-to-ease-the-seemingly-endless-pain-of-prolonged-grief

  Sudden loss includes death by murder, suicide, accident or an unexpected illness, like COVID-19. A loss may become more traumatic when you don’t have a chance to say goodbye. […] Both her denial and avoidance pattern are telltale signs of prolonged grief disorder. […] Studies back up this experience. One, from 2016, found that the commonly prescribed antidepressant citalopram performed no better than a placebo. […] This might indeed explain why my mom felt a little better for a while when she, too, finally tried an antidepressant; she found that some depression lifted for a while, but her prolonged grief-specific symptoms didn’t subside at all. […] It is true that bereaved mothers never recover from the loss of a child. […] A 2022 study shows that the experience changes their brain activity.

• #33 Prolonged grief disorder – Wikipedia

  https://en.wikipedia.org/wiki/Prolonged_grief_disorder

  The individual’s relationship to the deceased accounts for a large amount of variance in symptoms. Spouses, parents, and children of deceased tend to display highest severities, followed by siblings, in-laws, and friends. […] Bereaved persons often feel a need to understand why their loved one died by suicide, particularly if a message was not left behind by the deceased. […] PGD behavioral symptoms include elevated rates of suicidal ideation and attempts, functional impairment, high treatment-seeking behaviors, and adverse health behaviors. […] PGD is also a risk factor for a variety of somatic symptoms possibly including reduced quality of life in adults and in children, cancer, immunological dysfunction, hypertension, and cardiac events. […] These risk factors and clinical correlates have been largely shown to relate to PGD symptoms and not symptoms of major depressive disorder, posttraumatic stress disorder and generalized anxiety disorder.

• #34 What is Complicated Grief? | Talkspace

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

  Complicated grief could come from an enmeshed and/or codependent relationship and the loss of it could signal an absence of the grievers identity. […] While there isn’t 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. […] Fortunately, there is treatment available for complicated grief. Some treatments have been shown to be extremely effective in helping people recover. Typically, complicated grief treatment focuses on helping you live a healthier life as you begin to heal from loss throughout the grief process.

• #35

  https://www.healthshare.com.au/questions/2990-when-is-grief-complicated-as-opposed-to-normal/

  Complicated grief is given various names, such as delayed grief, chronic grief, pathological grief, distorted grief, abnormal grief. […] Sometimes (Raphael suggests in as many as 1 in 3!!) the grief pattern is more complicated. […] In these cases, the more complex grief reactions may require extra counselling or other interventions. […] Some common complicated grief patterns are: 1. Delayed grief Where for some reason the grief responses are put on hold for a long time. […] 2. Distorted grief Where one aspect of grief process is emphasised; other aspects suppressed. […] What factors may lead to particularly complicated grief? […] When the relationship between the bereaved and the lost object or person is problematic. […] When there are problematic circumstances surrounding the death, such as when the loss is uncertain (as in separation), or when there are multiple losses (Rest of family killed), or where no body found (deaths at sea), or with very difficult deaths such as suicide, murder, or self-neglect deaths.

• #36 Treating Complicated Grief

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4530627/

  The resulting syndrome of complicated grief causes substantial distress and functional impairment even years after a loss, yet knowing when and how to intervene can be a challenge. […] A strong research literature led to inclusion of complicated grief in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (termed persistent complex bereavement disorder as a subtype of other specified trauma and stressor-related disorders), although it is a condition for which more research is formally recommended, and there is still ongoing discussion about the optimal name and diagnostic criteria for the disorder. […] Individuals with complicated grief have greater risk of adverse health outcomes, should be diagnosed and assessed for suicide risk and comorbid conditions such as depression and posttraumatic stress disorder, and should be considered for treatment.

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

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

  Indicators of complicated grief may include: Having overwhelming, intrusive or preoccupying thoughts about loss. Feeling intense longing or emotional pain. Denying, avoiding or ignoring reminders of loss or surrounding yourself with reminders of a loss. Feeling like you no longer have a purpose after a loss. Difficulty accepting that the loss happened. […] 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. Continue for at least one year after the loss happened for adults and six months for children or adolescents. Happen daily for at least the last month before a diagnosis.

• #38 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/

  Grief can affect the whole body, so it is normal to feel physical effects when someone dies. […] Grief increases inflammation, which worsens any existing health problems or may lead to new ones. It can harm the immune system, leaving people vulnerable to infections and various physical health problems. […] 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. […] Complicated grief can affect someone physically, mentally, and socially. […] While the cognitive effects of grief can affect a persons short-term memory and impact their ability to problem solve, think clearly, or make good decisions, complicated grief can impact mental function more severely, including long-term memory and memory recall.

• #39 Persistent Complex Bereavement Disorder DSM-5

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

  A prolonged state of abnormal grief has been associated with elevated rates of suicidal ideation and suicide attempts. […] Adverse health behaviors are more frequent, and reported functional impairment is greater. […] Persistent complex bereavement disorder may present in isolation, or comorbid with other conditions. […] 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.

• #40 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/

  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.

• #41 Assessing and Treating Grief | Mental Health Academy

  https://www.mentalhealthacademy.com.au/blog/assessing-and-treating-prolonged-grief-disorder

  Behavioural symptoms can include: Withdrawal from others, Difficulty participating in previously enjoyed activities, Substance abuse, Changes in eating or sleeping patterns, Increased absenteeism from work or school. […] Diagnosis of prolonged grief disorder typically involves a comprehensive evaluation by a mental health professional, including a clinical interview, a review of symptoms and medical history, and a consideration of any other factors that may be contributing to the individual’s symptoms. […] In order to be diagnosed with prolonged grief disorder, an individual must meet the criteria outlined in the DSM-5-TR, which we listed above. […] The treatment of prolonged grief disorder will vary depending on the individual and the nature of their loss. […] Some common treatments for grief include: Psychotherapy can be a valuable tool for individuals who are struggling with grief. […] Because grief is such a highly individual experience, different individuals may respond differently to the various treatments.

• #42 Compounded Grief: Symptoms, Causes, Diagnosis, and Coping

  https://www.verywellmind.com/compounded-grief-symptoms-causes-diagnosis-and-coping-6979518

  According to Dr. Marcum, these are some of the symptoms you may experience if you’re struggling with compounded grief: Shock, Disbelief, Anger, Sadness, Guilt, Regret, Anxiety, Distress, Yearning, Helplessness, Emotional numbness, A feeling of being overwhelmed, Inability to sleep (insomnia), Loss of appetite, Isolation from friends and family, Difficulty functioning at work, Inability to perform everyday tasks like showering and paying bills. […] It may take several weeks or months for someone dealing with compounded grief to return to their baseline level of functioning, says Dr. Marcum. […] It’s important to note that compounded grief is not an official diagnosis; however, it is similar to complicated grief, says Dr. Marcum. Oftentimes, it may not require an official diagnosis since grief is a common experience that most of us face at some point in life.

• #43 Complicated Grief: Symptoms, Diagnosis, Treatment

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

  The treatment of complicated grief focuses on helping people living with the condition begin their healing process. Your doctor will determine the best treatment plan for you. A combination of medication and therapy might be used to treat complicated grief. […] Where complicated grief evolves or is accompanied by another mental health condition, its also important to treat this condition.

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

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

  Many people find comfort participating in cognitive behavioral therapy (CBT) as a treatment for complicated grief. CBT can help you: Accept the reality of a loss. Adapt to a loss. Reengage in activities or with people as you did before the loss. Work toward goals of feeling better mentally and physically. […] There isnt a set amount of time as to when youll feel better after getting help to treat complicated grief. Each person deals with grief in their own way. It may take months to years before you start to feel better. […] 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. Building a support system of loved ones. Joining a bereavement group after a loss. […] Loss is difficult to go through. Your thoughts may be flooded with emotions that affect your physical well-being. When these thoughts and feelings take over your ability to live your life, you should reach out to a healthcare provider.

• #45 Physical symptoms in prolonged grief disorder: a case report – Matsuoka – Annals of Palliative Medicine

  https://apm.amegroups.org/article/view/127790/html

  Although somatic symptoms are not included in the diagnostic criteria for PGD, it is known that somatic symptoms may be present. In this case, a patient suffering from similar physical symptoms as her deceased husband showed improvement after outpatient psychotherapy based on the dual-process model. […] Some patients with PGD can have prominent physical symptoms and the predominance of somatic symptoms means they may seek non-psychiatric medical care. […] These patients may see improvement in their physical symptoms with psychotherapy that combines behavioral activation therapy and exposure therapy, based on the dual-process model of grief. […] Our case highlights a condition that can be easily overlooked because patients with facsimile illnesses tend to seek non-psychiatric medical care, but it is treatable once diagnosed and should be kept in mind by all healthcare professionals.

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

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

  Patients experiencing prolonged grief may also benefit from pharmacological treatment of bereavement-related anxiety or depression. […] Prolonged grief disorder has a classic symptom presentation of yearning and sorrow, along with the preoccupied thoughts of the deceased and the inability to accept the reality of death, help in differentiating this condition from major depressive disorder and posttraumatic stress disorder. […] The course depends on how patients adapt to their new reality. This is contingent upon their personal resiliency, support system, and psychiatric assistance.

• #47 When Mourning Does Not End: Identifying and Treating Complicated Grief – Psychiatry Advisor

  https://www.psychiatryadvisor.com/features/identifying-and-treating-complicated-grief/

  She emphasized that it is important to differentiate between normal grief, CG, MDD, and PTSD because these conditions respond to different treatments. […] Several assessment instruments are found to be helpful in diagnosing CG. […] Dr Skritskaya pointed to short-term complicated grief treatment (CGT) as the most extensively tested and evidence-based treatment for CG. […] CGT is designed to remove impediments to adaptation and facilitate natural adaptive processes, with adaption having both a loss focus and a restoration focus. […] Pharmacologic interventions are typically not helpful as monotherapy for CG. […] However, adjunctive antidepressant therapy can be helpful for some clients. […] An important component of working with CG is active listening and establishing a therapeutic alliance.

• #48 Coping With Complicated Grief: Finding Your Way

  https://wellbeingscounselling.ca/coping-with-complicated-grief/

  Persistent severe emotional distress relentless feelings of bitterness, guilt, detachment, emptiness. […] Extreme focus on the loss constant rumination or avoidance of reminders. […] Inability to move forward feeling life is meaningless without a loved one. […] Isolation and destructive behaviours addiction, recklessness, self-harm. […] Problems performing daily responsibilities cant fulfill work/family duties. […] If complicated grief symptoms linger longer than 12 months and disrupt your ability to function, seeking professional support is strongly advised. […] The good news is that highly effective treatment options exist, combining therapy, social support groups, and self-care skills. […] Combined approaches addressing mindsets, behaviours and social connections have proven most effective. Through professional support, seemingly endless grief can transform into manageable waves rather than a perpetual tsunami.

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

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

  HAVING AT LEAST FIVE OF THE FOLLOWING SYMPTOMS ARE INDICATORS OF COMPLICATED GRIEF: Avoidance of reality, Inability to accept the death, Avoidance of triggers and loss reminders, Refusal to seek help, Rumination over memories and the past, Heightened emotions such as feeling empty, numb, detached or meaningless; suicidal thinking; impaired social functioning; difficulty trusting others; confusion about your role in life; feeling life is unfulfilling; missed days at work or school; bouts of crying. […] The Mayo Clinic adds that people who experience complicated grief may have difficulty continuing with normal routines, may experience social isolation, and may have feelings of self-blame. […] Grief affects more than emotional responses its also linked to physical responses. […] The body responds physically to grief through stress response in the brain, loss of sleep, lack of appetite, and weakened immune function in the cardiac system. […] Many people who grieve feel pressure to recover from a loss. […] We dont grieve well alone. […] Grieving a loss can be strenuous and debilitating.

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

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

  To improve how prolonged grief was identified and diagnosed, Prigerson and her colleagues established a 19-item inventory for screening patients. […] 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. […] In general, their treatment protocol focuses on helping people accept the reality of the loss and restore their capacity for well-being. […] These are healing milestones that mark progress, says Shear.

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