Strategies for Coping with Complicated Grief

When you suffer a loss, it’s natural to grieve. You may feel sad, angry or guilty and you may long for things to go back to the way they were. Grief often includes psychological distress, separation anxiety and stress. And grief can cover more situations than you may realize.

“When most people think about the term ‘grief,’ they think about the difficult and painful period following the death of a loved one,” said Jerimya Fox, a licensed professional counselor and a doctor of behavioral health with Banner Health. “But grief can occur in many different aspects of life. You might grieve the loss of a pet, a relationship or even a close friendship.”

There’s no “right” way to grieve, but over time, most people adjust to their loss and find that their feelings aren’t so intense.

Complicated grief is different. While typical grief and complicated grief can have some of the same symptoms, with complicated grief your symptoms don’t ease up. “While normal grief gradually starts to subside, those with complicated grief can tend to make their grief even worse,” Dr. Fox said. Grief can interfere with your ability to function.

Complicated grief is also known as prolonged grief disorder or persistent complex bereavement disorder. It’s important to address it.

“Complicated grief can affect you physically, mentally and socially. Without treatment, you may suffer from depression, anxiety or significant sleep disturbances. You may be more likely to use alcohol, nicotine or other substances to try to cope with the loss,” Dr. Fox said.

If you have complicated grief, you may:

Have intense and persistent feelings of yearning.
Struggle to accept that the loss is real.
Be preoccupied with thoughts or memories of the deceased and experience the loss over and over.
Feel intense emotional pain and sorrow that does not improve over time.
Avoid reminders of the loss.
Have trouble engaging in activities you once enjoyed.
Be socially withdrawn or isolated.
Have persistent feelings of emptiness or meaninglessness.
Have difficulty experiencing positive emotions or finding joy in life.
Be unable to function properly in your daily tasks, work or relationships.
Be unable to have positive experiences in your life.

What triggers complicated grief?

Sometimes, you can’t pinpoint why someone develops complicated grief. But it can be more likely with:

Sudden or unexpected loss, such as accidents or traumatic events.
Violent or traumatic circumstances surrounding the loss.
A history of mental health issues, such as depression or anxiety.
Lack of good social support or coping resources.
Significant loss or trauma in the past.
Complicated relationships with the person who died, such as unresolved conflicts or ambivalent feelings.
Cultural or societal factors that influence attitudes toward grief and mourning.

Knowing these triggers can help you recognize when grief might become complicated so you can connect with support.

Coping with complicated grief

“Grief is a normal human process and there are many ways to cope with both grief and complicated grief in a healthy way,” Dr. Fox said.

Some or all of these strategies may help:

Get professional support

It’s a good idea to seek help from a therapist or counselor who specializes in grief and bereavement. In therapy, you can explore your feelings, process your grief and learn coping strategies.

“You should talk with your doctor or mental health professional if your complicated grief is affecting your ability to function in other areas of your life, especially if it has been a year or more since your loss,” Dr. Fox said.

Methods like cognitive behavioral therapy (CBT), grief counseling and interpersonal therapy can help you understand and manage your emotions, challenge unhelpful thoughts and develop healthier ways to cope.

A professional can also educate you about the realities of grief. You can share these insights with others who might misunderstand your responses to grief.

Prioritize self-care

Taking care of yourself is a top priority when you’re dealing with complicated grief. Self-care can help reduce symptoms and promote overall well-being.

It’s important to nourish both your body and mind by getting enough restful sleep, eating nutritious meals, exercising regularly and practicing relaxation techniques like deep breathing or meditation. You also need to be patient and compassionate with yourself. Give yourself time to rest and reflect without judging yourself.

Self-care is especially important when you’re feeling overwhelming emotions. Journaling, talking to someone you trust or taking part in a creative activity like art or music can help.

Connect with others

Reach out to family members and friends who can listen, help with day-to-day tasks and offer emotional support, empathy and validation. You may want to join in-person or online grief support groups, where you can share experiences, receive encouragement and learn from others.

“Talking about your grief is a good way to process through your grief. Seeking support from family members, friends and support groups can help you understand that you are not the only person who has had to deal with the grieving process,” Dr. Fox said. “Others can also help identify healthy coping skills to support you through your loss.”

Engage in activities

While grief may feel overwhelming, finding moments of joy and purpose can help. Try to take part in activities that bring you comfort, fulfillment and a connection to life. That might be hobbies, interests, volunteering or spending time with loved ones.

Honor the loss

Anniversaries, holidays, birthdays and other significant dates can trigger grief reactions. Look for ways to commemorate the loss while also taking care of yourself. You may want to create new traditions or rituals, plan for difficult days by scheduling comforting activities, seek support or allow yourself to feel and express your emotions.

Connect with your faith or spirituality

Drawing on your beliefs and practices can give you comfort and a sense of connection. Prayer, meditation, attending religious services or seeking guidance from spiritual leaders may help you find strength and resilience.

Supporting others through complicated grief

If a loved one is facing complicated grief, it can be challenging to support them, but giving them your compassion, empathy and assistance can make a big difference. Here are some tips to keep in mind:

Listen actively and without judgment.
Acknowledge and validate their emotions, even if you don’t fully understand their experience.
Offer to help with tasks such as cooking, cleaning or running errands.
Respect their boundaries and don’t pressure them to open up or participate in activities they’re not ready for.
Stay connected, even if they don’t always respond.
Educate yourself about grief to better understand what your loved one is going through.

When you’re talking with them about grief and loss, try to be empathetic. It can help to:

Find a quiet, private space where your loved one feels comfortable and supported.
Ask open-ended questions such as “How are you feeling today?” or “Is there anything you’d like to talk about?”
Practice active listening by giving your full attention, maintaining eye contact and responding with empathy and understanding.
Steer clear of well-meaning but unhelpful statements such as “They’re in a better place” or “Time heals all wounds.”
Respect their pace. Let them guide the conversation and share as much or as little as they feel comfortable. Don’t push them to talk about their grief if they’re not ready.

If you would like to encourage your loved one to connect with professional help, you may want to:

Express your concerns and observations with your loved one in a caring way.
Help them find a therapist or counselor who specializes in grief and bereavement and accompany them to their appointments, if they like.
Remind them that seeking professional support is a sign of strength, not weakness, and that they deserve to receive care.
Offer your support and encouragement throughout their journey.

Resources

These hotlines and helplines offer confidential support and assistance from trained counselors 24/7:

National Suicide Prevention Lifeline: 988
Crisis Text Line: Text “HOME” to 741741
SAMHSA National Helpline: 1-800-662-HELP (4357) for substance abuse and mental health support

These online communities and forums are dedicated to grief and bereavement:

The bottom line

“Grief is difficult for everyone. It is important to recognize when grief becomes more complicated and to seek help to deal with those emotions and to learn healthy coping skills to support you through the grieving process,” Dr. Fox said.

If the strategies you’re using to cope with a loss don’t seem to be working, connect with a Banner behavioral health expert for support or call 800-254-4357.

Have you listened?

What You Can Do When Dealing With Complicated Grief