What is Complicated Grief?
10/22/25 | By: Carissa Hannum
Frequently in therapy, many individuals seek help processing, exploring, and making sense of their grieving. Grieving is a universal set of emotions that we all can experience throughout our lifetime. Generally, a mix of emotions, such as sadness, pain, anger, frustration, confusion, and even shame can occur when grieving. Grief is not only something we feel emotionally, but also physically and spiritually. Some experience physical pain as they grieve or even need to create a new sense of meaning as they make sense of loss. There is not one way to grieve. Many individuals experience a wide variety of the above emotions as they encounter the grieving process and make sense of a loss.
Losses can be considered happy experiences as well as painful experiences. For instance, many times we grieve when we lose a loved one or a job. However, it is also perfectly natural to grieve through life’s natural transitions, i.e. a graduation, marriage, or new baby. Although these are considered to be “happy” experiences, and they are! These experiences can also cause a sense of loss as we lose an old part of ourselves and transition to a new self or new identity. For instance, as we graduate from college, we not only celebrate, but we must also process the loss of not going back to a place we spent four years of our lives.
What is considered “normal” grieving?
Again, there is not one way of grieving. However, when we go through a loss in our lives, like losing a job, relationship, loved one, or even our physical mobility, we must take time to understand how this loss fits into our life, create a new meaning around this loss, and really learn to understand how to live with this loss in our life. Sometimes, like with a death of a loved one, grief doesn’t even really “go away”, but rather grief and loss becomes easier to cope with and doesn’t feel as if the emotions and physical reactions surrounding the loss take up too much time in our day or our daily functioning.
It is perfectly acceptable and “normal” to need days, weeks, months, or even sometimes years to learn to cope with the emotional reactions of loss. The following are some examples of emotional and physical reactions you may experience while grieving:
Sleep disturbances, including frequent waking, difficulty getting to sleep, sleeping too much, or insomnia
Social isolation
Difficulty enjoying things you once enjoyed or even noticing a decrease in energy
Difficulty finding meaning in life or things that used to bring you meaning/a purpose
Crying/tearfulness
Appetite changes
Difficulty focusing or concentrating
Exploring one’s meaning or questioning certain life choices, spirituality, etc.
Physical pain
Feelings of anger or frustration, one may even lash out
Guilt or shame
Sadness or loneliness
Difficulty engaging in social activities or relationships
How does Complicated Grief Differ?
So, if we all experience grief and loss, how does complicated grief diverge from what is a normal grieving process? Complicated or sometimes called complex grief is a disruption in the grieving process that does not allow the individual to cope with the loss. Generally, those that experience complicated grief continue to be affected by the grieving process in such a way that the emotional process begins to affect daily life and daily functioning. Complicated grief is diagnosed as prolonged grief disorder. The DSM-V states that prolonged grief disorder refers to symptoms that persist for 12 or more months for adults/ six or more months for children after the loss of a loved one. The reality is, complicated grief can be experienced with any loss, not just the loss of a loved one. Some individuals even experience a series of losses back-to-back, which can cause significant difficulties moving through the grieving process due to the traumatic nature of the losses. Symptoms of complicated grief/prolonged grief disorder are:
Intrusive thoughts about the individual that is deceased or the loss
Difficulty accepting the loss
Avoidance around anything that reminds the individual of the loss
Dissociation or numbness
Intense longing
Emotional pain such as anger, anxiety, depression, etc.
Loneliness
Anger, rage, or lashing out
Something about the loss was traumatic, so the individual may experience post-traumatic stress disorder symptoms
Difficulty in shifting focus from the loss
Self-destructive or dangerous behaviors that may put the individual at risk
Suicidal thoughts or actions
Sorrow, sadness, hopelessness
These symptoms are so intense that the individual may not be able to incorporate coping strategies and feel as though these symptoms impact every aspect of their daily life in a negative way.
What Should I Do If I Feel I May be Experiencing Complicated Grief?
Reach out for support! When you are grieving, you can feel very isolated or that there is no escape from the grief. Take some time and reach out for support with a trained mental health professional, speak to friends that may understand your loss, or even consider joining a grief group to explore themes of grief with other individuals that understand.
Being able to connect with others while grieving can be impactful and begin to help you move forward in your grief. You are not alone and deserve support to deal with your unique grief related symptoms.
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