Materiały źródłowe

• #1 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. […] 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.

• #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. […] 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. […] 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.

• #3 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 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. […] 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.

• #4

  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. […] Clinicians need to recognize symptoms of CG and differentiate this condition from usual acute grief, as well as depression and anxiety disorders. […] 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. […] Complicating thoughts include incessant questioning, worrying, or ruminating over some aspect of the circumstances or consequences of the loss.

• #5 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. […] 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.

• #6 What It Is – Center for Prolonged Grief

  https://prolongedgrief.columbia.edu/what-it-is/

  Prolonged Grief (PG) is grief that continues to be intense and pervasive, disrupting everyday life for longer than a year. This happens to about 10-20% of bereaved people, with rates differing depending on who died, when they died and how they died. People experiencing PG often describe it as feeling stuck in grief or frozen in time as if the death had just happened. Grief dominates their thoughts and feelings, making it difficult to think about or concentrate on anything else. The future seems bleak and empty. They feel lost and alone. Relationships with loved ones flounder as does their own health. […] Thoughts, feelings, and behaviors that are very natural, even helpful, during early grief can gain a foothold and make it more difficult to adapt. They can distract us from accepting the reality of the loss, recognizing the permanence of grief, and learning to live with a changed relationship with the deceased. They get in the way of restoring a sense of purpose and meaning in life and feelings of belonging and mattering with the possibility for happiness.

• #7 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. […] In 2021, the American Psychiatric Association (APA) added complicated grief, or prolonged grief disorder, to an updated version of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). […] However, the concept of complicated grief as a medical diagnosis is controversial. […] Some health organizations recognize complicated grief as a medical diagnosis. […] The APA included prolonged grief disorder in the newest edition of the DSM-5. […] Not all experts agree that complicated grief is a mental health condition, though. […] Study participants suggested that the diagnosis might pathologize grief, turning it into an illness rather than a normal experience.

• #8 Psychiatry.org – Prolonged Grief Disorder

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

  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. […] 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.

• #9 Prolonged grief disorder – Wikipedia

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

  Prolonged grief disorder (PGD), also known as complicated grief, traumatic grief, and persistent complex bereavement disorder, is a mental disorder consisting of a distinct set of symptoms following the death of a family member or close friend (i.e., bereavement). […] PGD may be associated with activation of the nucleus accumbens. […] 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.

• #10 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. […] Many doctors are now discovering that CG has many features of a disorder. […] However, new evidence shows that CG can make you feel worthless and suicidal, which is similar to depression. […] CG is most commonly caused by the death of someone you love. […] CG doesn’t have any identified biological causes. Like depression, it may happen because of: genetics, body chemistry, personality, your environment. […] CG has been shown to activate parts of the brain associated with reward. One study found that CG stimulates the nucleus accumbens, which plays a part in your expectation of a reward. […] Another study showed that CG can also stimulate your brain’s amygdala, causing avoidance behaviors. […] Complicated grief therapy (CGT) involves techniques such as repeatedly telling the story of your loved one’s death. […] Research shows that antidepressants can help treat CG if you’re also undergoing therapy.

• #11 For many who are suffering with prolonged grief, the holidays can be a time to reflect and find meaning in loss

  https://theconversation.com/for-many-who-are-suffering-with-prolonged-grief-the-holidays-can-be-a-time-to-reflect-and-find-meaning-in-loss-218906

  These symptoms persist nearly every day for at least a month. Prolonged grief disorder can be diagnosed at least one year after a significant loss for adults and at least six months after a loss for children. […] Research suggests that grief not only has negative consequences for a persons physical health, but for brain chemistry too. […] The feeling of grief and intense yearning may disrupt the neural reward systems in the brain. […] One study showed an increased activation of the amygdala when showing death-related images to people who are dealing with complicated grief, compared to adults who are not grieving a loss. […] These changes in the brain might explain the great impact prolonged grief has on someones life and their ability to function. […] Experts have developed scales to help measure symptoms of prolonged grief disorder. […] It can be easy to confuse grief with depression, as some symptoms do overlap, but there are critical differences.

• #12 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. […] Many doctors are now discovering that CG has many features of a disorder. […] However, new evidence shows that CG can make you feel worthless and suicidal, which is similar to depression. […] CG is most commonly caused by the death of someone you love. […] CG doesn’t have any identified biological causes. Like depression, it may happen because of: genetics, body chemistry, personality, your environment. […] CG has been shown to activate parts of the brain associated with reward. One study found that CG stimulates the nucleus accumbens, which plays a part in your expectation of a reward. […] Another study showed that CG can also stimulate your brain’s amygdala, causing avoidance behaviors. […] Complicated grief therapy (CGT) involves techniques such as repeatedly telling the story of your loved one’s death. […] Research shows that antidepressants can help treat CG if you’re also undergoing therapy.

• #13 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. […] Complicated grief is an official mental health diagnosis, even though its known by another name. […] As of 2020, the American Psychiatric Association has approved its addition to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) as prolonged grief disorder. […] The causes of prolonged grief disorder are not yet clear, but many factors may be involved, including: trauma, biology, environmental aspects. […] 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. […] In essence, those who live with complicated grief have brain activity similar to those engaged in an active fight-or-flight response, making it difficult to adapt to changes and move forward after loss.

• #14 For many who are suffering with prolonged grief, the holidays can be a time to reflect and find meaning in loss

  https://theconversation.com/for-many-who-are-suffering-with-prolonged-grief-the-holidays-can-be-a-time-to-reflect-and-find-meaning-in-loss-218906

  These symptoms persist nearly every day for at least a month. Prolonged grief disorder can be diagnosed at least one year after a significant loss for adults and at least six months after a loss for children. […] Research suggests that grief not only has negative consequences for a persons physical health, but for brain chemistry too. […] The feeling of grief and intense yearning may disrupt the neural reward systems in the brain. […] One study showed an increased activation of the amygdala when showing death-related images to people who are dealing with complicated grief, compared to adults who are not grieving a loss. […] These changes in the brain might explain the great impact prolonged grief has on someones life and their ability to function. […] Experts have developed scales to help measure symptoms of prolonged grief disorder. […] It can be easy to confuse grief with depression, as some symptoms do overlap, but there are critical differences.

• #15 FF #254 Complicated Grief | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/complicated-grief/

  Complicated grief has also been referred to as prolonged or pathologic grief; and in the most recent revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM V), CG was relabeled as Persistent Complex Bereavement Disorder. […] CG is principally considered an attachment disorder. Insecure attachment styles (excessive dependency, compulsive care-giving, defensive separation) are correlated with CG. Additionally, supportive marital relationships (characterized as security-enhancing, confiding and emotionally supportive) are correlated with CG after the loss of a spouse suggesting that the loss of a spouse who provides emotional stability and security may lead to an exacerbated grief reaction. […] CG is associated with mental and physical health problems including depression, hypertension, work and social impairment and reduced quality of life. Additionally, CG increases an individual’s risk of suicide and suicidal behavior.

• #16 FF #254 Complicated Grief | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/complicated-grief/

  Complicated grief has also been referred to as prolonged or pathologic grief; and in the most recent revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM V), CG was relabeled as Persistent Complex Bereavement Disorder. […] CG is principally considered an attachment disorder. Insecure attachment styles (excessive dependency, compulsive care-giving, defensive separation) are correlated with CG. Additionally, supportive marital relationships (characterized as security-enhancing, confiding and emotionally supportive) are correlated with CG after the loss of a spouse suggesting that the loss of a spouse who provides emotional stability and security may lead to an exacerbated grief reaction. […] CG is associated with mental and physical health problems including depression, hypertension, work and social impairment and reduced quality of life. Additionally, CG increases an individual’s risk of suicide and suicidal behavior.

• #17

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

  Complicating emotional processes are negative valence emotions such as guilt, envy, bitterness, or anger, that are relentlessly activated and excessively painful, without periods of respite from positive emotions. […] CG symptoms cause a great deal of distress and usually interfere with functioning and with the ability to find meaning and purpose in life. […] We conceptualize CG as a condition in which the normal healing process, entailing emotion regulation and learning, is derailed by complicating thoughts or behaviors. […] Treatment targets resolving complications and facilitating healing.

• #18

  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. […] Clinicians need to recognize symptoms of CG and differentiate this condition from usual acute grief, as well as depression and anxiety disorders. […] 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. […] Complicating thoughts include incessant questioning, worrying, or ruminating over some aspect of the circumstances or consequences of the loss.

• #19

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

  Complicating emotional processes are negative valence emotions such as guilt, envy, bitterness, or anger, that are relentlessly activated and excessively painful, without periods of respite from positive emotions. […] CG symptoms cause a great deal of distress and usually interfere with functioning and with the ability to find meaning and purpose in life. […] We conceptualize CG as a condition in which the normal healing process, entailing emotion regulation and learning, is derailed by complicating thoughts or behaviors. […] Treatment targets resolving complications and facilitating healing.

• #20 Complicated Grief: Risk Factors, Interventions, and Resources for Oncology Nurses | Oncology Nursing Society

  https://www.ons.org/publications-research/cjon/21/3/complicated-grief-risk-factors-interventions-and-resources-oncology

  The negative cognitions associated with the previously mentioned attachment styles create beliefs of not being able to live without the deceased individual, feeling worthless without the presence of the deceased person, and feeling like life no longer has meaning (Boelen et al., 2006). […] These negative cognitions cause bereaved individuals to dwell on their loss rather than to focus on problem- or emotion-specific solutions (Mancini et al., 2015). […] Common comorbidities and similar symptom overlap between CG and other mental health disorders add to the challenge of identifying optimal treatments. […] Although significant symptom overlap exists whether CG is primary or secondary to PTSD, each disorder has its own unique features (OConnor, 2010; OConnor, Lasgaard, Shevlin, Guldin, 2010).

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

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

  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. […] Complicated grief can sometimes be confused with depression because some symptoms overlap. […] 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. […] Prolonged grief disorder is a formal mental health diagnosis, and it can be treated.

• #22 Coping with Grief and Loss: Stages of Grief and How to Heal

  https://www.helpguide.org/mental-health/grief/coping-with-grief-and-loss

  Complicated grief usually arises from the death of a loved one, where the loss has left you stuck in a state of bereavement. You may be unable to accept your loved one has gone, search for them in familiar places, experience intense longing, or even feel that life isn’t worth living. […] If you’re experiencing complicated grief and the pain from your loss remains unresolved, it’s important to reach out for support and take the steps that will enable you to heal.

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

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

  Physiologic stress resulting from intense grief can have a wide range of consequences. Increased cardiovascular and cerebrovascular events have been associated with intense grief, in some cases leading to myocardial infarctions or cardiomyopathy. […] Various mechanisms have been theorized to explain the association between intense grief and physiologic pathology. Emotional triggers are linked to increases in stress hormones, catecholamine release, and increased sympathetic nervous system stimulation. This stress can result in hemodynamic changes, including vasoconstriction, increased blood pressure, increased heart rate, arrhythmias, increased platelet activity and aggregation, release of proinflammatory cytokines, increased release of endothelin, and production of fibrinogen. […] Prolonged grief can also give rise to more subtle physiological consequences, potentially stemming from anhedonia or social isolation. People may be less prone to address their healthcare needs, decrease their nutritional intake, exercise, and sleep, and become socially isolated, all of which have negative mental and physical health consequences.

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

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

  Physiologic stress resulting from intense grief can have a wide range of consequences. Increased cardiovascular and cerebrovascular events have been associated with intense grief, in some cases leading to myocardial infarctions or cardiomyopathy. […] Various mechanisms have been theorized to explain the association between intense grief and physiologic pathology. Emotional triggers are linked to increases in stress hormones, catecholamine release, and increased sympathetic nervous system stimulation. This stress can result in hemodynamic changes, including vasoconstriction, increased blood pressure, increased heart rate, arrhythmias, increased platelet activity and aggregation, release of proinflammatory cytokines, increased release of endothelin, and production of fibrinogen. […] Prolonged grief can also give rise to more subtle physiological consequences, potentially stemming from anhedonia or social isolation. People may be less prone to address their healthcare needs, decrease their nutritional intake, exercise, and sleep, and become socially isolated, all of which have negative mental and physical health consequences.

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

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

  Physiologic stress resulting from intense grief can have a wide range of consequences. Increased cardiovascular and cerebrovascular events have been associated with intense grief, in some cases leading to myocardial infarctions or cardiomyopathy. […] Various mechanisms have been theorized to explain the association between intense grief and physiologic pathology. Emotional triggers are linked to increases in stress hormones, catecholamine release, and increased sympathetic nervous system stimulation. This stress can result in hemodynamic changes, including vasoconstriction, increased blood pressure, increased heart rate, arrhythmias, increased platelet activity and aggregation, release of proinflammatory cytokines, increased release of endothelin, and production of fibrinogen. […] Prolonged grief can also give rise to more subtle physiological consequences, potentially stemming from anhedonia or social isolation. People may be less prone to address their healthcare needs, decrease their nutritional intake, exercise, and sleep, and become socially isolated, all of which have negative mental and physical health consequences.

• #26 Processing Complicated Grief In Healthy Ways | BetterHelp

  https://www.betterhelp.com/advice/grief/how-to-process-complicated-grief-in-healthy-ways/

  Complicated grief can also manifest as physical symptoms in addition to emotional symptoms, such as weight loss or gain, extreme fatigue, nausea and vomiting, insomnia, and aches and pains for no apparent reason. […] Complicated grief may also coexist with or cause other mental health conditions such as substance abuse or drug abuse disorders, clinical depression, or post-traumatic stress disorder (PTSD). […] Note that for complicated grief to be present, some or all of the above are typically experienced over a term thats longer than what might be expected for societal or religious normstypically a year or more. […] One study estimates that approximately 10% of people experiencing grief will develop this complicated grief, which generally requires treatment to resolve. […] While professional treatment isnt necessary in every case of standard grief, it is typically recommended for cases of complicated grief. This condition is a mental illness and typically wont resolve on its own, and when left untreated, its effects can be detrimental to a persons daily functioning, relationships, and overall well-being. Treatment for complicated grief, such as complicated grief therapy (CGT), may be tailored to address the circumstances of the death and facilitate the grieving process.

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

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

  Prolonged grief disorder (PGD) was added as a new disorder to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) in 2022. PGD is defined as an intense yearning or longing for the deceased and preoccupation with thoughts or memories of the deceased. […] The official diagnostic criteria for PGD do not include physical symptoms, but it is sometimes associated with somatic symptoms. […] This case report highlights the physical symptoms experienced by those bereaved by a deceased loved one. […] Exposure therapy and behavioral activation approaches based on the dual-process model of grief response were effective in reducing the physical symptoms of facsimile illness. […] 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.

• #28 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. […] 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.

• #29 Understanding Complicated Grief | Comprehensive Wellness Centers

  https://www.cwcrecovery.com/blog/understanding-complicated-grief/

  Several factors can contribute to the development of complicated grief. A sudden or unexpected loss will lead to grief. The significance of the relationship with the deceased will also contribute. A lack of closure or a strained relationship before a loved ones death may result in prolonged grief disorder. A history of mental health issues, a lack of adequate social support, and pre-existing attachment difficulties increase the likelihood of experiencing complicated grief increases. […] Complicated grief can have profound effects on well-being and functioning. It may lead to prolonged emotional distress, resulting in exhaustion, mental fatigue, and impaired social relationships. Individuals are more likely to develop mental health disorders like depression, anxiety, or post-traumatic stress disorder. […] Complicated grief represents a distinct and challenging form of grief. Prolonged grief disorder can significantly impact a persons life. Understanding prolonged grief disorders nature, symptoms, and impact is crucial in providing practical support.

• #30 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. […] Anytime grief continues for longer than six months, with no diminishment in intensity, it may indicate the presence of complicated grief disorder. […] 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.

• #31 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. […] 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.

• #32 Grief: Types, Signs and Co-Occurring Substance Abuse | The Recovery Village Palm Beach at Baptist Health

  https://www.floridarehab.com/co-occurring-disorders/grief/

  Complicated grief disorder, also known as persistent grief disorder, refers to severe, ongoing and long-lasting emotions following loss. Complicated grief symptoms can include feeling very angry, dwelling on aspects of loss or feeling like life is meaningless. Complicated grief can be common in cases of suicide or dementia, where a loss or experience is particularly traumatic. […] Grief statistics show that 9.8% of those who experience non-violent bereavement will experience prolonged grief disorder. Evidence also supports that the rates of complicated grief are higher among those who experience violent or traumatic loss, such as suicide or sudden infant death. […] Substance abuse can occur as a result of unresolved or complicated grief. This is not considered a part of the normal grieving process, and one study found that over a third of participants with substance use disorders presented symptoms of complicated grief.

• #33 Processing Complicated Grief In Healthy Ways | BetterHelp

  https://www.betterhelp.com/advice/grief/how-to-process-complicated-grief-in-healthy-ways/

  Complicated or prolonged grief are the terms used to describe unresolved, chronic grief or grief that is delayed. It can be described as an ongoing, heightened state of mourning. […] The symptoms of standard grief and complicated grief are similar in the beginning. However, while general grief symptoms can begin to ease and slowly subside over time, the symptoms of complicated grief can linger and even feel worse over time, potentially impacting a persons life, relationships, and well-being. At this point, an individual may meet the diagnostic criteria for Prolonged Grief Disorder or Persistent Complex Bereavement Disorder in accordance with DSM-V (Diagnostic and Statistical Manual of Mental Disorders). […] Complicated grief happens in about 7% of individuals, and risk factors include having a history of diagnosed mood disorders such as major depression or separation anxiety, experiencing multiple traumas early in life, or having a particularly close relationship with the deceased person.

• #34 Bereavement and Complicated Grief | Ausmed

  https://www.ausmed.com/learn/articles/bereavement-and-complicated-grief

  Most people experiencing bereavement will come to cope with their loss over time. However, in some cases, grief is so debilitating that the bereaved person will have difficulty recovering from the loss and resuming their life, even after a significant period of time. This is known as complicated grief or persistent complex bereavement disorder (Mayo Clinic 2022). […] Complicated grief negatively impacts a persons relationships, employment and life. It is generally characterised by a sustained intensity of grief over a very long period of time (Mayo Clinic 2022). […] Risk factors for complicated grief include: traumatic loss, sudden loss, witnessing the death, not being present during the death, the loss of a child, having a close relationship with the deceased person, multiple losses, either over time or all at once, a history of depression, separation anxiety or post-traumatic stress disorder (PTSD), coexisting stressors, e.g. financial hardship, an insecure childhood, early separation from one or both parents, insomnia (Mayo Clinic 2022; Ohwovoriole Block 2024).

• #35 FF #254 Complicated Grief | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/complicated-grief/

  CG shares characteristics with major depressive disorder (suicidal ideation, preoccupation with worthlessness) and post-traumatic stress disorder (re-experiencing intrusive thoughts of the deceased, avoidance of reminders of the deceased and emotional numbness). However these are separate entities differentiated by precipitating events, risk factors, course of illness and response to intervention. […] A recent meta-analysis on the treatment of CG showed efficacy of interventions including cognitive-behavioral and group therapy in alleviating symptoms with a duration of benefit from 3-6 months. Limitations of the meta-analysis include under-representation of men (average 71% female), small number of studies included (n=5), and small number of participants (n=485, 109 lost to follow up). There have been no randomized controlled trials evaluating the pharmacologic treatment of CG and there is currently no defined role for drug therapy. A randomized trial is currently underway to evaluate the effect of a selective serotonin reuptake inhibitor on CG.

• #36 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. It is characterized by feelings of intense grief that last a year or longer and interfere with the healing process. […] A person with complicated grief might also display certain dysfunctional behaviors and might experience irrational thoughts, such as thoughts that the person who has died might come back to life. Its a chronic form of grief that could impair ones life. About 7% to 10% of bereaved people might experience complicated grief. […] Complicated grief itself is not a recognized mental health condition. However, in the latest edition of the „Diagnostic and Statistical Manual of Mental Disorders” (DSM-5-TR), a new condition called prolonged grief disorder was added.

• #37 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). […] While intense and persistent longing for the deceased person is a core symptom of prolonged grief, a generally reduced interest in or ability to enjoy everyday matters is a core symptom of depression. […] In depression, the patient will often harbour feelings of worthlessness and self-contempt, which are not found in prolonged grief. […] Grief-specific psychotherapy has proven effective for prolonged grief, while a combination of psychotherapy and drugs (depending on the degree of severity) is recommended for depression.

• #38 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). […] While intense and persistent longing for the deceased person is a core symptom of prolonged grief, a generally reduced interest in or ability to enjoy everyday matters is a core symptom of depression. […] In depression, the patient will often harbour feelings of worthlessness and self-contempt, which are not found in prolonged grief. […] Grief-specific psychotherapy has proven effective for prolonged grief, while a combination of psychotherapy and drugs (depending on the degree of severity) is recommended for depression.

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

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

  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. […] Complicated grief can sometimes be confused with depression because some symptoms overlap. […] 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. […] Prolonged grief disorder is a formal mental health diagnosis, and it can be treated.

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

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

  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. […] Complicated grief can sometimes be confused with depression because some symptoms overlap. […] 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. […] Prolonged grief disorder is a formal mental health diagnosis, and it can be treated.

• #41 Complicated Grief: Risk Factors, Interventions, and Resources for Oncology Nurses | Oncology Nursing Society

  https://www.ons.org/publications-research/cjon/21/3/complicated-grief-risk-factors-interventions-and-resources-oncology

  CG symptoms include an intense longing for the deceased and distress over the loss of the relationship, which is not a central component of PTSD (OConnor et al., 2010). […] To further differentiate, when experiencing PTSD after a loss, intrusive thoughts fixate on the death event itself, leading individuals to avoid internal and external reminders of the death event specifically, rather than reminders of the deceased. […] However, the cardinal symptom of emotional numbness since the time of the loss is shared by both CG and PTSD (Alexander Litz, 2014). […] Despite an abundance of hospice and palliative care programs offering support groups and counseling for grieving individuals, only a small percentage of people use these services (Steiner, 2006). […] Early palliative care interventions for family caregivers, delivered by advanced practice nurses via telephone while the patient is in advanced stages of malignancy, may reduce depression and CG, but require further study (Dionne-Odom et al., 2016).

• #42 Complicated Grief: Symptoms, Diagnosis, Treatment

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

  Categorized as a trauma- and stressor-related disorder, prolonged grief disorder is characterized by intense distress and longing for a loved one a year or longer after their death. These symptoms create distress, preoccupation with the loss, and disruptions in a person’s ability to function in their daily life. […] However, intense grief that is disruptive and lasts longer than you would expect may indicate complicated or prolonged grief. […] Complicated grief is sometimes misidentified as depression. […] Complicated grief might even evolve into depression. […] 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. […] The treatment of complicated grief focuses on helping people living with the condition begin their healing process. […] Where complicated grief evolves or is accompanied by another mental health condition, its also important to treat this condition.

• #43 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. […] 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.

• #44 Psychiatry.org – Prolonged Grief Disorder

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

  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. […] 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.

• #45 Treating Prolonged Grief Disorder: Innovations and Future Directions

  https://www.psychiatrictimes.com/view/treating-prolonged-grief-disorder-innovations-and-future-directions

  The conceptualization of grief and adaptation to loss is based in attachment theory and an understanding of attachment loss as a traumatic stressor. The treatment uses a modified form of prolonged exposure for posttraumatic stress disorder as the core loss-focused component and adds a focus on restoration of well-being based upon principles of self-determination theory. […] PGT requires confrontation with death and loss, emphasizing mortality salience for treatment providers. For therapists who do not often work with grief, doing so can elicit thoughts about their own potential or actual losses or their own death. Many have difficulty regulating the resulting anxiety and other emotional responses. Terror Management Theory posits that confrontation with death can also be associated with a tendency to rigid adherence to a therapeutic style, an emphasis on being right, and efforts to bolster self-esteem, as a way of managing the difficult emotions. Elements of evidence-based grief therapy require confrontation with the reality of the loss and this may also be difficult for therapists because it is painful for clients and causes distress. Additionally, implementation challenges have historically been linked to the absence of an official diagnosis and this was an important reason we worked to support inclusion of the PGD diagnosis in the DSM-5.

• #46 Complicated Grief: Risk Factors, Interventions, and Resources for Oncology Nurses | Oncology Nursing Society

  https://www.ons.org/publications-research/cjon/21/3/complicated-grief-risk-factors-interventions-and-resources-oncology

  These promising new interventions, developed and evaluated by nurse scientists, aim to guide nursing practice in specific interventions to alleviate grief; however, more research is needed to evaluate their effectiveness in CG. […] A 2011 meta-analysis of interventions for CG, which pooled data from 14 randomized, controlled trials testing interventions to prevent or treat CG, determined that treatment of CG significantly improved grief-related symptoms, whereas prevention interventions have not demonstrated consistent efficacy (Wittouck et al., 2011). […] Katherine Shear, MD, a faculty physician in the School of Social Work at Columbia University, has been instrumental in moving the science of grief therapy forward. […] Complicated Grief Treatment has also demonstrated efficacy in a group setting, which affords a more economical option and higher access to treatment (Supiano Luptak, 2014).

• #47 Coping With Complicated Grief | Cedars-Sinai

  https://www.cedars-sinai.org/blog/understanding-prolonged-grief-disorder.html

  Prolonged grief, though, features an immense desire or obsession with bringing back a loved one who has died. […] Loss of sleep, regular functioning and hope are indicators that you’re stuck in prolonged grief. […] Treatment can include a mixture of: Complicated grief therapy, specifically tailored to maladaptive grief. […] Therapists can help grievers work through memories of the person and develop healthier ways to remember them and reflect, Dr. Danovitch notes.

• #48 Bereavement and Complicated Grief | Ausmed

  https://www.ausmed.com/learn/articles/bereavement-and-complicated-grief

  In the case of complicated grief, therapy may be beneficial in the form of specialist bereavement counselling, palliative care services, cognitive behavioural therapy (CBT) or complicated grief therapy (CGT) (Psychology Today 2021; CareSearch 2021). […] CBT focuses on changing a persons thought patterns to alter their response to situations. CGT involves setting recovery goals, talking about the loss and making plans for the future (Psychology Today 2021).

• #49 Complicated Grief: Risk Factors, Interventions, and Resources for Oncology Nurses | Oncology Nursing Society

  https://www.ons.org/publications-research/cjon/21/3/complicated-grief-risk-factors-interventions-and-resources-oncology

  Pilot studies have demonstrated positive effects of selective serotonin reuptake inhibitors on CG (Hensley et al., 2009; Simon, Thompson, et al., 2007; Zygmont et al., 1998); however, a clinical trial involving 395 people with CG found that providing citalopram (Celexa) and Complicated Grief Treatment in combination reduced depression-related outcomes, but did not lead to specific improvements in CG when compared to Complicated Grief Treatment plus placebo (Shear et al., 2016). […] Current evidence suggests that psychotherapy and pharmacologic treatments may be helpful in alleviating CG symptoms.

• #50 A complicated grief intervention model | Drenth | Health SA Gesondheid

  https://hsag.co.za/index.php/hsag/article/view/415/480

  Complicated grief refers to a prolonged state of grief and indicates the inability of the client to incorporate the death into his or her life. […] Complicated grief is characterised by a constant yearning and searching for the deceased, consistent thoughts of the deceased and intense and painful emotions. […] The existence of complicated grief is also reflected in the increased interest of psychiatrists to include complicated grief as a pathological form of grief in the Diagnostic and Statistical Manual of Mental Disorders (DSM). […] The CGIM is specifically developed for complicated grief intervention. The CGIM focuses on the completion of loss-related tasks, as well as the completion of tasks related to the restoration after death. […] The CGIM has the DPM (Stroebe Schut 1999) and the Task-Centred social work approach as a theoretical framework. The CGIM is a three-step process: assessment, intervention and evaluation/termination. […] The CGIM is developed to use the strengths and resources of the client and therefore holds the possibility to be implemented amongst different cultures, age groups and genders, which allows it to be of value in the diverse environment of South Africa.

• #51 How can coping strategies prevent prolonged grief? – NIHR Oxford Health Biomedical Research Centre

  https://oxfordhealthbrc.nihr.ac.uk/how-can-coping-strategies-prevent-prolonged-grief/

  Research supported by University of Oxfords Department of Experimental Psychology Prof. Anke Ehlers, Theme Lead of the BRCs Psychological Treatments Theme, has found that the type of coping strategy used in the early months following loss has a significant impact on later symptoms of prolonged grief disorder (PGD). […] PGD is characterised by intense and debilitating feelings of loss and can lead to changes in a persons functioning. […] The article, published recently in ScienceDirect, From loss to disorder: The influence of maladaptive coping on prolonged grief, identifies which coping strategies lead to poorer or better outcomes for bereaved people.

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

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

  Prolonged grief disorder (PGD) was added as a new disorder to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) in 2022. PGD is defined as an intense yearning or longing for the deceased and preoccupation with thoughts or memories of the deceased. […] The official diagnostic criteria for PGD do not include physical symptoms, but it is sometimes associated with somatic symptoms. […] This case report highlights the physical symptoms experienced by those bereaved by a deceased loved one. […] Exposure therapy and behavioral activation approaches based on the dual-process model of grief response were effective in reducing the physical symptoms of facsimile illness. […] 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.

• #53

  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. […] Clinicians need to recognize symptoms of CG and differentiate this condition from usual acute grief, as well as depression and anxiety disorders. […] 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. […] Complicating thoughts include incessant questioning, worrying, or ruminating over some aspect of the circumstances or consequences of the loss.

• #54 Persistent Complex Bereavement Disorder DSM-5

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

  There is, however, activation in brain imaging of the nucleus accumbens that is not seen in non-complicated grief, suggesting that reminders of the deceased may activate the neural reward system and interfere with adaptation (OConnor, Wellisch, Stanton, Eisenberger, Irwin Lieberman, 2008). […] 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 (Boelen van den Bout, 2005), although it was elected in the preparation of DSM-5 to defer the establishment of this diagnosis for further study (Boelen Prigerson, 2012).

• #55 Complicated Grief: Risk Factors, Interventions, and Resources for Oncology Nurses | Oncology Nursing Society

  https://www.ons.org/publications-research/cjon/21/3/complicated-grief-risk-factors-interventions-and-resources-oncology

  When a loved one dies of cancer, complicated grief (CG) may occur because of the trauma associated with family caregivers perceptions of their loved ones suffering, either from advanced cancer or from side effects of cancer treatment. […] Individuals who have difficulty accepting the death and assimilating into life without the deceased experience what is known as complicated grief (CG), or prolonged grief disorder (Shear, 2010). […] CG is associated with numerous psychological problems, including loneliness, social isolation, anxiety, clinical depression, cognitive impairment, and post-traumatic stress disorder (PTSD) (Ghesquiere, Shear, Duan, 2013; Shear, Ghesquiere, Glickman, 2013). […] The nature of the relationship to the deceased, personality traits, coping style, psychiatric history and comorbidities, and socioeconomic factors all contribute to the risk of CG.

• #56 Grief: Types, Signs and Co-Occurring Substance Abuse | The Recovery Village Palm Beach at Baptist Health

  https://www.floridarehab.com/co-occurring-disorders/grief/

  Complicated grief disorder, also known as persistent grief disorder, refers to severe, ongoing and long-lasting emotions following loss. Complicated grief symptoms can include feeling very angry, dwelling on aspects of loss or feeling like life is meaningless. Complicated grief can be common in cases of suicide or dementia, where a loss or experience is particularly traumatic. […] Grief statistics show that 9.8% of those who experience non-violent bereavement will experience prolonged grief disorder. Evidence also supports that the rates of complicated grief are higher among those who experience violent or traumatic loss, such as suicide or sudden infant death. […] Substance abuse can occur as a result of unresolved or complicated grief. This is not considered a part of the normal grieving process, and one study found that over a third of participants with substance use disorders presented symptoms of complicated grief.

• #57 Treating complicated grief | Open Arms

  https://www.openarms.gov.au/health-professionals/assessment-and-treatment/treating-complicated-grief

  Substantial evidence now suggests that complicated grief is distinct from other disorders. Despite some similarities and frequent comorbidity. […] It is important to recognise complicated grief. As interventions only targeting anxiety, depression, or PTSD are not usually effective. Careful assessment of symptoms is therefore required. […] Complicated grief can be a significant risk factor for suicide. As veterans may feel that life is meaningless, or express a wish to die in order to be reunited with the deceased. […] Complicated grief can be treated in an outpatient setting and does not usually require admission to a psychiatric hospital unit. […] However, evidence suggests an adjunctive course of newer antidepressants can help veterans tolerate grief-focused CBT.

• #58 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.

• #59 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.

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

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

  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. […] Treatment for complicated grief is possible through therapy and support groups.

• #61 Processing Complicated Grief In Healthy Ways | BetterHelp

  https://www.betterhelp.com/advice/grief/how-to-process-complicated-grief-in-healthy-ways/

  Complicated grief can also manifest as physical symptoms in addition to emotional symptoms, such as weight loss or gain, extreme fatigue, nausea and vomiting, insomnia, and aches and pains for no apparent reason. […] Complicated grief may also coexist with or cause other mental health conditions such as substance abuse or drug abuse disorders, clinical depression, or post-traumatic stress disorder (PTSD). […] Note that for complicated grief to be present, some or all of the above are typically experienced over a term thats longer than what might be expected for societal or religious normstypically a year or more. […] One study estimates that approximately 10% of people experiencing grief will develop this complicated grief, which generally requires treatment to resolve. […] While professional treatment isnt necessary in every case of standard grief, it is typically recommended for cases of complicated grief. This condition is a mental illness and typically wont resolve on its own, and when left untreated, its effects can be detrimental to a persons daily functioning, relationships, and overall well-being. Treatment for complicated grief, such as complicated grief therapy (CGT), may be tailored to address the circumstances of the death and facilitate the grieving process.

• #62 Complicated Grief: Symptoms, Diagnosis, Treatment

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

  Categorized as a trauma- and stressor-related disorder, prolonged grief disorder is characterized by intense distress and longing for a loved one a year or longer after their death. These symptoms create distress, preoccupation with the loss, and disruptions in a person’s ability to function in their daily life. […] However, intense grief that is disruptive and lasts longer than you would expect may indicate complicated or prolonged grief. […] Complicated grief is sometimes misidentified as depression. […] Complicated grief might even evolve into depression. […] 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. […] The treatment of complicated grief focuses on helping people living with the condition begin their healing process. […] Where complicated grief evolves or is accompanied by another mental health condition, its also important to treat this condition.

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

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

  It has been argued that some unremitting forms of grief, commonly labeled as complicated grief, pose a serious threat to the well-being and life of the mourner and may require clinical attention. […] One central issue in this debate is whether and how we could draw a divide between uncomplicated and complicated grief to avoid, on the one hand, the medicalization of appropriate grief responses, and on the other hand, to provide help to those who suffer from complicated grief. […] Complicated grief (CG) is a commonly used term to describe the latter. […] The need for diagnostic criteria for CG has been recognized in recent and forthcoming editions of diagnostic manuals that provide operationalized criteria for mental disorders. […] It has been argued that some forms of grief may, indeed, be in some sense pathological and require clinical attention.

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

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

  The unremitting nature of complicated grief poses a serious threat to the well-being and life of the mourner. […] Establishing a set of operationalized criteria for complicated grief may be one, but need not be the best solution. […] It has been argued that the characteristic phenomenology, behavioural symptoms, trajectory, and clinical correlates of complicated grief form a distinguishable nosological unit that cannot be captured by any other currently established diagnostic unit. […] Following the above arguments and desiderata, the need for diagnostic criteria for CG has been recognized by the authors of recent and forthcoming editions of the operationalized diagnostic criteria for mental disorders. […] The disturbance causes clinically significant distress or impairment in social, occupational or other important areas of functioning.

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

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

  The characteristic dynamics of grief is one important feature distinguishing it from depression. […] 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. […] I propose that the disturbance of the above sketched processes of reintegration may be a key component explaining the occurrence of complicated grief. […] The divide between uncomplicated and complicated grief could rely on whether, when and how the grieving person enters the so described reintegration processes. […] Phenomenological analysis is crucial for uncovering the presence or absence of individual experiences involved in the process of reintegration and for assessing possible disturbances. […] The above presented phenomenological reflections on the nature of experiences involved in grief can serve as a starting point for understanding the nature of complicated grief.

• #66 FF #254 Complicated Grief | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/complicated-grief/

  CG shares characteristics with major depressive disorder (suicidal ideation, preoccupation with worthlessness) and post-traumatic stress disorder (re-experiencing intrusive thoughts of the deceased, avoidance of reminders of the deceased and emotional numbness). However these are separate entities differentiated by precipitating events, risk factors, course of illness and response to intervention. […] A recent meta-analysis on the treatment of CG showed efficacy of interventions including cognitive-behavioral and group therapy in alleviating symptoms with a duration of benefit from 3-6 months. Limitations of the meta-analysis include under-representation of men (average 71% female), small number of studies included (n=5), and small number of participants (n=485, 109 lost to follow up). There have been no randomized controlled trials evaluating the pharmacologic treatment of CG and there is currently no defined role for drug therapy. A randomized trial is currently underway to evaluate the effect of a selective serotonin reuptake inhibitor on CG.

• #67 Feeling Connected to Nature Attenuates the Association between Complicated Grief and Mental Health

  https://www.mdpi.com/1660-4601/21/9/1138

  We thus conclude that a sense of feeling connected to nature—not simply spending more time in nature or being surrounded by nature—may serve an important role in the mental health status of people experiencing complicated grief, perhaps because CN replenishes general belonging when someone significant has passed away. […] Given that complicated grief predicts decreased mental health over time and complicated grief may be on the rise, we expect that bereavement-related depression and anxiety may pose increased risk to public health. […] We provide evidence that feeling connected to nature attenuates the association between complicated grief and depression for people bereaved by the death of a close other because of COVID-19 infection. […] In contrast, we found that simply spending more time in nature or residing in greener environments did not moderate the association between CG and depression or anxiety. […] Our findings suggest that nature-related factors may, in fact, be implicated in differences in the association between CG and mental health, extending work on identifying factors that affect anxiety and depression comorbid with complicated grief.

• #68 FF #254 Complicated Grief | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/complicated-grief/

  CG shares characteristics with major depressive disorder (suicidal ideation, preoccupation with worthlessness) and post-traumatic stress disorder (re-experiencing intrusive thoughts of the deceased, avoidance of reminders of the deceased and emotional numbness). However these are separate entities differentiated by precipitating events, risk factors, course of illness and response to intervention. […] A recent meta-analysis on the treatment of CG showed efficacy of interventions including cognitive-behavioral and group therapy in alleviating symptoms with a duration of benefit from 3-6 months. Limitations of the meta-analysis include under-representation of men (average 71% female), small number of studies included (n=5), and small number of participants (n=485, 109 lost to follow up). There have been no randomized controlled trials evaluating the pharmacologic treatment of CG and there is currently no defined role for drug therapy. A randomized trial is currently underway to evaluate the effect of a selective serotonin reuptake inhibitor on CG.

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