Grief. It’s Complicated.

I know people are yearning for positive content in an effort to escape our distressing reality, but for many, the path to “normal” post-COVID will be through grief. So while this may not be what anyone necessarily wants to read right now, this is what everyone needs to read.

*This will not be my most eloquent writing as I found myself in tears drafting this post. Please read this with an open and kind heart. And think of those around you in our universal time of need.*


My intent is not to write a “downer” post. Rather, this is about love.

“Grief. It’s Complicated” provides context for what to do when grief becomes unhealthy. Whether you lost a loved one, lost a job, maybe you’re an essential worker or just an individual who struggled watching so many pass as the pandemic raged, you may be suffering from grief. Generally grief is a healthy response to loss. But what to do when grief becomes unbearable and you can’t recover?

All grief is not equal. Some people will move through only one, two, or all of the stages of grief quickly, while for others grieving seemingly never ends. Enter Complicated Grief, an ongoing, heightened state of mourning that keeps you from healing. People with a preexisting mental health illness are among those most likely to suffer from complicated grief. Understanding how grief relates to mental health is critical to getting well and recovering from loss.


What Is Complicated Grief?

Losing a loved one (as an example) is one of the most distressing and, unfortunately, common experiences people face. Most people experiencing normal grief and bereavement have a period of sorrow, numbness, and even guilt and anger. Gradually these feelings ease, and it’s possible to accept loss and move forward.

For some people, feelings of loss are debilitating and don’t improve even after time passes. This is known as complicated grief, sometimes called persistent complex bereavement disorder. In complicated grief, painful emotions are so long lasting and severe that you have trouble recovering from the loss and resuming your own life.

Different people follow different paths through the grieving experience. The order and timing of these phases may vary from person to person:

  • Accepting the reality of your loss
  • Allowing yourself to experience the pain of your loss
  • Adjusting to a new reality in which the deceased is no longer present
  • Having other relationships

These differences are normal. But if you’re unable to move through these stages more than a year after the death of a loved one, you may have complicated grief. If so, seek treatment. It can help you come to terms with your loss and reclaim a sense of acceptance and peace.

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

Causes

It’s not known what causes complicated grief. As with many mental health disorders, it may involve your environment, your personality, inherited traits and your body’s natural chemical makeup.

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
    (Resource: Mayo Clinic, Complicated Grief)

I’ve provided additional resources at the end of this post that go into more scientific detail about grief and more specifically, complicated grief. For today, I’m going to talk about complicated grief through my own lived experience.


October 14th | the day that fell off the calendar

“This is the way the world ends
This is the way the world ends
This is the way the world ends
Not with a bang but a whimper.”
– “The Hollow Men,” T. S. Eliot

On October 7, 2014, my grandmother was hospitalized after exhibiting stroke-like symptoms. She was home in New Jersey while my immediate family was returning from our last day of a vacation in Florida. Before we left my grandmother had been unwell but stable. That being so, for weeks I felt uneasy about leaving for this specific trip, as if I knew.

We hopped on a plane and upon landing in Philadelphia my mother and I jetted to the hospital. When we arrived we heard the news: cancer. everywhere.
There was no treatment to be had. It would only be a matter of days. I basically sat at her bedside for the next week. Waiting.

On October 13th plans were secured to move her to hospice. But I remember saying “no.” I thought she wouldn’t make it through the night. Again, I just knew.

I had a special bond with my grandmother. She had given me my Italian culture and my love of cooking. She was kind, happy, generous. Everyone had a soft spot for “Aunt T” as the rest of the family called her.

Early in the morning on October 14th, with my grandfather by her side, she past.
We got a call and that was it. “She’s expired.” Quite anticlimactic. Now it was time to start making arrangements. Having known this was coming I was of course sad, but there’s that sigh of relief you breathe when you know someone you love is no longer in pain.

By 10AM on October 14th we headed to Earle funeral home to start setting plans for her viewing and funeral. That’s when everything came crashing down.

On October 14th, my sister, who was in grad school at the time, got a rejection letter for an internship she needed to finish her master’s degree.
On October 14th, my partner at the time decided not to take a role which would have relocated us from of a toxic environment. That decision effectively ended our relationship.
All of this news came within minutes while sitting in the Earle offices.

I walked outside, alone, collapsed to the ground, and screamed. The grief passed over me like a tsunami. I was hit with the most visceral pain, one I will never forget.
I sat crouched in that parking lot screaming for help. Screaming why. Why. Why all at once.
How. How could all of these events be compounded on this single day that was already breaking each of us.

Just when we thought our hearts were already in pieces, in the few moments as news rolled in they were completely shattered. And to be perfectly honest, they would never be fully put back together.

October 14th, 2014, the day the world stopped turning.
And it’s the axis has never been the same.


At first, my grief was probably like anyone grieving the loss of a grandparent. We all tried to keep moving on, myself included. My sister did get an internship which ironically brought her back to Florida a few months later. But what about my relationship? On October 14th the last hope for saving something somewhat loveless was gone. Eight months later we would split up.

While all of these outward events were taking place I was dying on the inside. I was riddled with grief. Years later I look back and realize I was suffering from complicated grief.
October 14th triggered a two-year long depression that would “end” with me in Dr. Baruch’s office receiving TMS treatment. See my “Miracle Monday” post for more details.


What can you do if you think your grief is unhealthy?

Seek Professional Help: Visit a bereavement counselor or therapist. See a professional who can help you manage the grief and find healthy outlets for healing.
For example, after TMS I started seeing a cognitive behavioral therapist to help me manage my moods, thoughts, and emotions.
Support: Talk with family and friends. Also, find a confidant. I struggle with my faith to this day as a result of the grief I endured after my grandmother’s death. So on a few occasions I’ve spoken with priests to help me heal spiritually.
On one occasion I actually walked into a priest’s office at a parish I had never visited before; the priest sat me down and heard me out. He never asked me about my creed or if I even believed in God. But he listened and provided comfort. He even called on my birthday and Christmas, just to make sure I was okay. Get treatment, for your mental health, but also if you see fit, for your spiritual health.

If you know someone who may be suffering from complicated grief, please do not say the following:
“You need to move on.”
“You need to get over it.”
“This happens to lots of people.”
“It’s part of life.”

While all of these might be true, none are helpful. We know it’s part of life, but complicated grief is complex. Let a therapist work with the individual to tackle those “reality” touch points if you will. Obviously I didn’t want to wallow in my own depression. And if I could have moved on I would have. So be supportive, listen, and try to recognize everyone heals in their own time. Maybe help your grieving friend or family member get the medical or spiritual assistance they need to heal. Be the shoulder to cry on.


Moving On

When we realize the world starts turning again, the sun will rise again, life goes on despite our loss, that’s perhaps when grief hurts the most. And as traumatic the loss may have been, grief is silent. It’s internal. It’s a pain no one can see. So please, know yourself. Know that especially in these times, grief is common and might be unhealthy. Be attentive to when grief has taken hold and seek help. As it was once said:

“Grief never ends, but it changes. It is a passage, not a place to stay. Grief is not a sign of weakness nor a lack of faith: it is the price of love.”


Resources

Maco Clinic – “Complicated Grief”
https://www.mayoclinic.org/diseases-conditions/complicated-grief/symptoms-causes/syc-20360374

Mental Health America – “Bereavement and Grief”
https://www.mhanational.org/bereavement-and-grief

Headspace – “dealing with grief and loss & the effects on mental health”
https://headspace.org.au/young-people/dealing-with-grief-and-loss-and-the-effects-on-mental-health/

Scientific American – “Shades of Grief: When Does Mourning Become a Mental Illness?”
https://www.scientificamerican.com/article/shades-of-grief/


In dedication to the generation who showed us how to love, how to live.

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