Complicated grief

Mayo Clinic Health Manager

Get free personalized health guidance for you and your family.

Get Started

Free

E-Newsletter

Subscribe to receive the latest updates on health topics. About our newsletters

  • Housecall
  • Alzheimer's caregiving
  • Living with cancer

Symptoms

By Mayo Clinic staff

Mental health experts are still analyzing how complicated grief symptoms differ from those of normal grief or other bereavement reactions. During the first few months after a loss, many signs and symptoms of normal grief are the same as those of complicated grief. However, while normal grief symptoms gradually start to fade, those of complicated grief get worse or linger. Complicated grief is like being in a chronic, heightened state of mourning.

Signs and symptoms of complicated grief can include:

  • Extreme focus on the loss and reminders of the loved one
  • Intense longing or pining for the deceased
  • Problems accepting the death
  • Numbness or detachment
  • Preoccupation with your sorrow
  • Bitterness about your loss
  • Inability to enjoy life
  • Depression or deep sadness
  • Difficulty moving on with life
  • Trouble carrying out normal routines
  • Withdrawing from social activities
  • Feeling that life holds no meaning or purpose
  • Irritability or agitation
  • Lack of trust in others

When to see a doctor
It's normal to experience grief after a significant loss. Most people who experience normal or uncomplicated grief can move forward eventually with support from family and friends. But if it's been several months or more since your loss and your emotions remain so intense or debilitating that you have trouble going about your normal routine, talk to your health care provider.

Specifically, you may benefit from professional help if you:

  • Can focus on little else but your loved one's death
  • Have persistent pining or longing for the deceased person
  • Have thoughts of guilt or self-blame
  • Believe that you did something wrong or could have prevented the death
  • Feel as if life isn't worth living
  • Have lost your sense of purpose in life
  • Wish you had died along with your loved one

At times, people with complicated grief may consider suicide. If you're considering suicide, reach out to someone as soon as possible. The best choice is to call 911 or your local emergency services number.

Causes Definition
References
  1. Bereavement. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed July 13, 2009.
  2. Lipsitz JD. Interpersonal theory of depression. Gabbard GO, ed. Textbook of Psychotherapeutic Treatments. Arlington, VA: American Psychiatric Publishing; 2009. http://www.psychiatryonline.com. Accessed July 13, 2009.
  3. Marchand L. End-of-life care. In: Rakel RE. Rakel: Textbook of Family Medicine. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/149504704-3/862284999/1494/128.html#4-u1.0-B978-1-4160-2954-0..50085-5_4160. Accessed July 13, 2009.
  4. Block SD. Grief and bereavement. http://www.uptodate.com/home/index.html. Accessed July 13, 2009.
  5. Kendler KS, et al. Does bereavement-related major depression differ from major depression associated with other stressful life events? American Journal of Psychiatry.2008;165:1449.
  6. Abrahm JL. Caring for patients at the end of life. In: Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone; 2008. http://www.mdconsult.com/das/book/body/149504704-4/862286866/1709/49.html#4-u1.0-B978-0-443-06694-8..50048-8_1340. Accessed July 13, 2009.
  7. Siegel MD, et al. Psychiatric illness in the next of kin of patients who die in the intensive care unit. Critical Care Medicine. 2008;36:1722.
  8. Complicated grief. National Cancer Institute. http://www.nci.nih.gov/cancertopics/pdq/supportivecare/bereavement/Patient/page8. Accessed July 13, 2009.
  9. Major depression and complicated grief. American Cancer Society. http://www.cancer.org/docroot/MBC/content/MBC_4_1X_Major_Depression_and_Complicated_Grief.asp. Accessed July 13, 2009.
  10. Simon NM, et al. Complicated grief: A case series using escitalopram. American Journal of Psychiatry. 2007;164:1760.
  11. Prigerson HG, et al. Inventory of complicated grief: A scale to measure maladaptive symptoms of loss. Psychiatry Research. 1995;59:65.
  12. Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. July 15, 2009.

DS01023

Sept. 29, 2009

© 1998-2009 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "EmbodyHealth," "Reliable tools for healthier lives," "Enhance your life," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research.

Print Share Reprints

Text Size: smaller largerlarger