Complicated Loss

Some people have difficult relationships with the person they lost, leading to ambivalent feelings after the death. Sometimes there are individuals in our lives that are hard to love. You may have had a difficult relationship with them, with many ups and downs, or maybe you cut them out of your life completely. The people we lose often had very human problems: addictions, mental health issues, abuse/neglect, gambling, and infidelity, to name a few. These problems had a lasting impact on your life. So, when death strikes, you are left with conflicting emotions about the individual, yourself, and your relationship with them. You need a safe place to explore those feelings and unresolved issues with others who understand.

Some important considerations when experiencing this type of grief:
• When the death occurred, so did the opportunity to resolve the relationship with the deceased. Any chance of  reconciliation is now gone.
• Many individuals feel relieved as this relationship was an overwhelming, emotional burden. The individual may be  shocked or even feel guilty at the relief they feel.
• Secrets build in complicated relationships. This may be the first time individuals are able to share the true nature of the deceased. You need to have a safe place to share things that have been kept hidden for so long.
• Some people may be angry that in death, their loved one has been labeled a saint.
• There is an unwritten rule in our culture, “you do not speak ill of the dead.” But if you can’t speak honestly about the dynamics of your relationship with the deceased, where does it go?

Symptoms
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 over time, those of complicated grief linger or get worse. Complicated grief is like being in an ongoing, heightened state of mourning that keeps you from healing.
Signs and symptoms of complicated grief may include:
• Intense sorrow, pain and rumination over the loss of your loved one
• Focus on little else but your loved one’s death
• Extreme focus on reminders of the loved one or excessive avoidance of reminders
• Intense and persistent longing or pining for the deceased
• Problems accepting the death
• Numbness or detachment
• Bitterness about your loss
• Feeling that life holds no meaning or purpose
• Lack of trust in others
• Inability to enjoy life or think back on positive experiences with your loved one

Complicated grief also may be indicated if you continue to:
• Have trouble carrying out normal routines
• Isolate from others and withdraw from social activities
• Experience depression, deep sadness, guilt or self-blame
• Believe that you did something wrong or could have prevented the death
• Feel life isn’t worth living without your loved one
• Wish you had died along with your loved one

Risk Factors
Complicated grief occurs more often in females and with older age.
Factors that may increase the risk of developing complicated grief include:
• An unexpected or violent death, such as death from a car accident, or the murder or suicide of a loved one
• Death of a child
• Close or dependent relationship to the deceased person
• Social isolation or loss of a support system or friendships
• Past history of depression, separation anxiety or post-traumatic stress disorder (PTSD)
• Traumatic childhood experiences, such as abuse or neglect
• Other major life stressors, such as major financial hardships

Complications
Complicated grief can affect you physically, mentally and socially.
Without appropriate treatment, complications may include:
• Depression
• Suicidal thoughts or behaviors
• Anxiety, including PTSD
• Significant sleep disturbances
• Increased risk of physical illness, such as heart disease, cancer or high blood pressure
• Long-term difficulty with daily living, relationships or work activities
• Alcohol, nicotine use or substance misuse