~ Complications of Grief ~
There are many sequelae of loss, change, grief
and bereavement; they can affect the grieving in many different spheres
of life—physical, psychological, behavioral, social, emotional, economical,
philosophical and spiritual. Repressed, unrecognized, unprocessed and untreated
the grief response following a significant loss can result in personal
anguish, increased anxiety, multiple physical complaints, functional impairment,
strained relationships, marital discord, disrupted sleep, impaired childhood,
increased substance abuse—tobacco, alcohol, drugs, tranquilizers; clinical
depression, and an increased mortality from heart disease and suicide.
Several definitions apply to the complications
is a delayed or incomplete adaptation to loss or failure in the process
Prolonged Grief (Chronic Mourning, Protracted
Mourning) is acute mourning that persissts interminably. Mourning
that fails to draw to its natural conclusion and in which intense reactions
do not abate over time.
Unresolved Grief is
a halting of the grief process, which becomes chronic unless treated.
Major Depression, Anxiety, Suicide and Post Traumatic
Stress Disorder are all potential sequalae of complicated mourning. Follow
the links below to more information on the different possible complications:
Getting More Help and/or Referring
Cases of complicated bereavement or grief should
be referred for more extensive grief therapy, with a therapist that is
knowledgeable about the grief process. Several "Red Flags" and warning
signs exist that should be clear indicators of the need to refer for evaluation
by their Primary Care Physician or a Mental Health Practitioner ASAP.
We must also recognize that grief is not isolated
to the grieving person. Despite pressures to keep the emotions hidden and
repressed, loss and the resulting grief response affect the family, friends,
social network, workplace environment, and overall community of the bereaved.
Thus one person's grief can impact many, many others.
Expression of suicidal intent.
A pattern of alcohol abuse and/or dependence.
Inability to care for self e.g. not getting sleep,
Uncontrollable rage directed at others.
Physical harm to self or others.
Uncontrollable phobias, such as an inability to be
by themselves at any time.
Characteristics of mourning that do not appear to
change at all over a period of months.
Inhibited or absent grieving.
Rando TA. Complications in Mourning
Traumatic Death. In Doka KA (ed). Living with Grief After Sudden Loss:
Suicide, Homicide, Accident, Heart Attack, Stroke. Washington D.C.: American
Hospice Foundation, 1996.
Rando TA. Treatment of Complicated
Mourning. Champaign, IL: Research Press: 1993.
Wolfelt AD. How to Start and Lead
a Bereavement Support Group. Batesville Management Services, 1994.
Grief is a journey, often perilous and without clear direction, that must be
The experience of grieving cannot be ordered or categorized,
hurried or controlled, pushed aside or ignored indefinitely.
It is inevitable as breathing, as change, as love. It may be postponed, but it will not be denied.
See the Emergency
911 Page for links to immediate resources
if you are feeling helpless,
hopeless, overwhelmingly depressed, or suicidal.
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