normal vs complicated grief

Normal Grief vs Not-So-Normal Grief

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Though I have done no official research, I feel fairly sure most people who experience a significant loss go through moments of believing they have totally lost their minds.  After spending most of your life as a relatively happy, healthy, well-adjusted person, it can be slightly terrifying to one day spiral into the unknown territory of grief.

We have spent plenty of time assuring the thousands of people out there who are feeling crazy after a loss that it is usually normal-crazy, even when it doesn’t feel like it.  We have a whole post on how grief makes you feel crazy!

But every now and again, that normal-crazy that comes with grief becomes more than normal-crazy.  It takes on a life of its own and it becomes something that requires more support than can be found from friends and family, books, church, websites, journals, or time.  This grief becomes debilitating, all-consuming, and even has an ominous name: complicated grief.  If you find yourself screaming, “of course my grief is complicated!! It’s grief!!”, we hear you.  All grief is complicated.  But language has its limitations and this is the unfortunate (and controversial) label that has been given to this type of grief.  We don’t love it either.

Hypothetical (or not so hypothetical) Case Study: You feel like total crap.  Life feels impossibly overwhelming.  You are irrationally angry.  You are crying everyday.  You can’t imagine it will get better.

Is this normal-crazy or is this complicated grief?  Sometimes it feels like a coin toss, even to us professionals.  Because the reality is that in the early days after a loss, it is normal to have the symptoms described above.  And then at some point it isn’t normal anymore.  So the question becomes, how can you figure out if you (or your friend or family member) may be in need of professional grief support?

My first thought on this: we could all benefit from a little bit of therapy!  So if you are thinking about grief counseling, why not give it a go?  It is an opportunity to spend time on yourself, learn some things about yourself, and get out of the house.  What do you have to lose?

But how do you know that you definitely need some professional grief support?  If it has been more than a few months and your symptoms seem the same or more severe than immediately following the loss, this could be a reason to consider professional help.   At the Columbia University School of Social Work they are conducting extensive research around complicated grief.  It may be helpful to consider the signs of complicated grief outlined by Columbia University researchers:

  • Strong feelings of yearning or longing for the person who died
  • Feeling intensely lonely, even when other people are around
  • Strong feelings of anger or bitterness related to the death
  • Feeling like life is empty or meaningless without the person who died
  • Thinking so much about the person who died that it interferes with doing things or with relationships with other people
  • Strong feelings of disbelief about the death or finding it very difficult to accept the death
  • Feeling shocked, stunned, dazed or emotionally numb
  • Finding it hard to care about or to trust other people
  • A feeling of constant fear and anxiety.
  • Feeling very emotionally or physically activated when confronted with reminders of the loss
  • Avoiding people, places, or things that are reminders of the loss
  • Strong urges to see, touch, hear, or smell things to feel close to the person who died

They suggest that three or more of these symptoms persisting beyond 6 months may be an indicator of complicated grief and a reason to consider professional support.  There are certain factors that could put you at greater risk for having complicated grief.  Having experienced one of these risk factors by no means is an indicator that you will experience complicated grief.  It just means you are a little more likely.  Some of these factors include things like experiencing an unexpected or violent loss, a loved one dying by suicide, a lack of support system, or past traumatic losses. To learn more about Columbia University’s research, visit http://www.complicatedgrief.org/

If you have just read over this and thought, “oh crap, this sounds like me (or a friend or family member)” you may be asking what to do next.  Please see our guide to seeking grief support here.  It is a lot easier than you may think to get help.  Really.

If you want to learn more about the many, many  types of grief you can check our post on different types of grief.

For some, grief can lead to thoughts of suicide.  If you are thinking of hurting yourself please seek immediate treatment.  You can call 911, go to your local emergency room, or call a local crisis response team.  In the US you can seek 24/7 support through National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

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COMMENTS

Crying In Public (aka sometimes socks are sad) -

Posted on March 4, 2013 at 8:57 am

[…] is not normal and your grief may have crossed into the complicated realm?  Check out our post on normal grief vs complicated grief.  Just looking for some general tips on taking care of yourself when overwhelmed by the emotions […]

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Deborah Drummond

Posted on April 9, 2014 at 5:43 pm

I go to a support group lead by a councilor . 13months now . A six month time table! I think everyone there must have crazy complicated grief !

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Litsa

Posted on April 9, 2014 at 5:48 pm

13 months is absolutely normal! There is this pervasive myth that somehow we ‘move on’ or stop grieving after one year. The reality is many people have intense symptoms of grief for more than one year. Working in this field we often hear people express that sometimes the second year is actually harder than the first! Grief happens in its own way and time for everyone.

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nicola martin

Posted on May 3, 2014 at 8:46 pm

18 months after the death of my son i am still devastated-its not complicated just a fact.

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Litsa

Posted on May 4, 2014 at 2:08 pm

Nicola, I am so sorry about the death of your son. 18 months is not long at all after a loss. We grieve in some way forever after a loss. We are devastated forever. Grief does change and get easier with time, but for many grievers that timeframes is far longer than just a year or two. We hope you find some support and resources on our site that may be of help.

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Robyn Coppedge

Posted on July 27, 2014 at 2:32 am

The Columbia University researchers “suggest that three or more of these symptoms persisting beyond 6 months may be an indicator of complicated grief and a reason to consider professional support.”
I suggest that a parent who has lost a child and does NOT have three or more of these symptoms persisting beyond six months DOESN’T EXIST.
Ah, yes, of course we should all “consider professional support.” And certainly we should all be on massive doses of antidepressants. Because mourning your child for more than SIX MONTHS is entirely abnormal.
I lost my beautiful daughter one year ago. I would say that I suffer, to some extent, with EVERY SINGLE ONE of the listed “symptoms.”
I’m calling bullshit on their “research.” It’s not “complicated,” it’s simple. I had a wonderful daughter that I loved with every fiber of my being for 32 years. I will never see her again.

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Eleanor

Posted on July 27, 2014 at 1:01 pm

Robyn,

I am very sorry about the death of your daughter, I would in no way expect the passing of a year to lessen your pain. Here on this site we believe that there are no timelines when it comes to grief and that you will experience grief “symptoms” in one form or another, at one time or another, possibly forever.

Although we don’t advocate for antidepressants when they aren’t actually warranted and absolutely necessary, if someone’s symptoms are worsening and/or they are living with high levels of anger, emptiness, isolation, anxiety, shock, depression, we might recommend they talk to a counselor. Going to a counselor in our eyes means talking things out with someone who can help their client find insight and provide a nonjudgemental ear and honestly this would be our recommendation to anyone experiencing these types symptoms for prolonged periods of time – grief or no grief.

You are not alone in questioning the research behind “Complicated Grief”, many think ‘Complicated Grief’ may just be grief coupled with a pre-existing condition like depression, anxiety disorder, etc. I assure you we are not here trying to classify grief as a pathology, in fact we know grief can make you feel totally crazy for a long long time. If anything we are here trying to normalize grief, but a part of this is also normalizing effective coping methods like counseling, support groups, etc.

Thank you for your comment. Again, I am so very sorry about your daughter’s death.

Sincerely,
Eleanor Haley

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Robyn Coppedge

Posted on July 27, 2014 at 2:19 pm

Dear Eleanor –
Thank you for your kind and well-thought-out response.
I didn’t really mean to direct my anger at you and Litsa, but at the “researchers” who don’t know grief.
Sorry for my rant.
– Robyn

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Trish Forbes

Posted on January 14, 2015 at 12:33 am

I lost my soulmate two years ago this March and while I have lost other loved ones in my life – no one’s death has ever affected me like his. I think a big part of it is because we only had 16 months together and I feel like he was taken from me way too soon. The rest is that I never had a releationship like I had with him with any one else. He totally got me and supported me in anything I took on. I miss him terribly and still wish he was here with me. I look for him everywhere and I see him everywhere. A person who resembles him, walks like him, a song, a smell – and I often go back and sit at his house (which sits in a time warp) and long to see him step out the door.
Yes, there have been plenty times past and present that I have isolated myself and felt isolated when I am in a group. I have wondered if I am going crazy or if I am moving through grief as I should. I have done group counseling through a couple of churches. I have researched and read a lot on the subject of grief.
What I have come to realize is grief is a roller coaster and there is no time frame to getting over it – in fact I don’t think we ever really get over it. We some how just learn to live with it.

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Eleanor

Posted on February 3, 2015 at 4:59 pm

Trish,

Totally agree. There’s no timelines for grieving your soulmate. On some level I’m sure you will always love, miss and look for him. My heart goes out to you.

Eleanor

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Vicki

Posted on September 9, 2015 at 6:43 pm

Well, it’s difficult NOT to feel intense anger at the type of death since it so happens that someone literally flew out of a clear blue sky and exploded the plane into the building in which he worked. Then for the next 102 minutes, while the terrorists died instantly, people inside the towers suffered grotesque endings that in some cases took more than 10 minutes to occur.
I don’t see how it’s “normal” NOT to feel intense emotions about it but I’m convinced that nobody else would experience much more than fury at what they did. Especially when you’re constantly reminded how the suspects who are still living feel zero remorse for what they’ve done yet have gone as far as to stage “not-eating protests” so that they die or you have to feed them through a tube, and either way YOU look like the ‘bad guy.’
These are the people who already had evidence against them linking them to the 9/11 operation beFORE anyone carried out the utterly insane idea of torturing them for MORE details. These people have the gall to feel no guilt whatsoever for what they know they did (if they DID it), then manipulate a situation to make themselves look like the victims.
I find it insulting, but I don’t believe I have complicated grief. I think I have grief created from a death by unnecessary violence.
Besides, I have a friend whose daughter was killed at the Aurora movie theater when she was watching ‘The Dark Knight Rises,’ and the mother is so enraged about it she makes my anger look tame.
She says things like “My daughter was killed – no, slaughtered – by someone who never should have had access to a gun.” Which I agree with; he never should have been allowed to have a PEA shooter. She reproduced part of her daughter’s death report, so people would know what the bullets did to the body. Being a paramedic, I already knew. But I couldn’t imagine many people being able to handle it if that was their introduction to a coroner’s details of a violent death. She’s really intense but I still think she’s “more normal,” whatever that is, than I am.
She was mentally stable before her daughter was killed by James Holmes.
I was never “normal.” When I was 13 a boy in my class committed suicide by shooting himself with a .357 and my mom made us go to the funeral and look at him in the casket. A year before that someone in my 6th grade class died of cancer. I don’t think that’s a normal chain of events for a tween child to see. A child dying of cancer and another committing suicide but those were my introductions to death. A child dying of cancer, a teenager committing suicide. It seemed wrong from the moment I heard of it; I expected my first death experience to be with someone older, who succumbed to an illness. Not an 11-yr old dying of cancer and a 13-yr old shooting himself with a handgun that wasn’t made for a child.

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Vanessa

Posted on October 15, 2015 at 7:01 pm

My sister would normally tell me what are you reading there?Still reading these things on the net?Still not being able to eat normally, to sleep,to feel better.Well, the truth is that it’s been almost two years now (23 months actually) since I lost my fiance of melonoma.My friends call me telling me that they’re getting married,have children,worry about losing their job. And what do I do? I every day begin by telling my self that I feel better.That there’s nothing wrong with me If I laugh with a joke, If I meet a friend for a drink or a coffee.Still most of the times I’ve seen them and done so,it was only to re assure them that I was fine, I was not depressed,I did not need them.No, I do not cry everyday,I never cried a lot I think after the loss.I felt numb, getting crazy,angry,alone,different(I am a young widow), I am different, sad,depressed.I just avoid doing things we did together,that is living a life. I cannot think my self of feeling worried or love and affection for someone else.I don’t even care If friends cope with their lives.My heart is still aching, my mind in despair and the only comfort I find is smoking, walking and believe it or not worrying about how not to look devastated anymore. I pretend that yes, it’s the second memorial in a month, but I am here and I am doing just fine.The truth is that I am not.Depression?Complicated grief?I do not really care.The thing is that sometimes it is hard to pretend anymore.Do not tell me that he would want me to be happy.I already know that.

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