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Few things hurt like the death of a loved one, especially when that loss comes suddenly or violently, such as in a natural disaster or terrorist attack.

Grieving is a normal human process of dealing with great loss, and although it’s very painful, it’s also healthy and necessary.

In some cases though, people get stuck in perpetual or very severe grieving (traumatic grieving), or intense grieving triggers another serious problem, like a major depression.

While normal grieving is a process that eases over time, traumatic grieving or other mental illnesses do not necessarily get better without treatment. People who have lost loved ones to natural disaster may be at greater risk of traumatic grieving and so it is helpful to understand the differences between normal grieving and complicated grieving.

What Is Grief?

Grief is the process and feeling of loss, experienced most intensely after the loss of a loved one. The emotions of grief can include sadness, loneliness, fear, guilt, anger, anxiety and others, and physical symptoms of bereavement can include insomnia, a loss of appetite, trembling, dry mouth and others.

Grief is an individual process, and the duration of the grieving process can range from weeks to years, depending on how close the loss, the circumstances of the loss, your personality, culture and coping style, the nature of the death and other factors.

According to SAMHSA, the grieving process occurs over 4 distinct stages, and the grieving period ends only after a person progresses through all stages and moves on with life.

The 4 stages of grief

  1. Accepting the death
  2. Coming to feel and processing through the emotions of grief (loss, sadness, anger, guilt, etc.)
  3. Accepting a life without your loved one
  4. Moving on in life

Normal grief is a painful but healthy process. In some cases, the grieving process seems to go on indefinitely or with too much intensity, as people get ‘stuck’ in perpetual bereavement – a condition called traumatic grief or complicated grief.

The Risk of Complicated Grief after a Disaster

While it’s difficult to put into words the pain and suffering of loss, healthy grief eases in time – things do get better. Unfortunately, people who have lost a loved one in a disaster may be more likely to experience traumatic grief or have intense grief trigger another mental illness.

For those that have also experienced a traumatic event, the grieving process is complicated by stress reactions to the disaster. The person in bereavement may feel emotionally numb at first or they may have difficulty with the bereavement process that triggers stressful memories of the disaster experience.

People grieving a loved one lost to trauma are at an increased risk of...1

  • Traumatic grief
  • PTSD
  • Depression
  • Alcohol or drug abuse
  • Decreased health
  • Suicidal thoughts
  • Panic disorder
  • Others

What is Traumatic Grief (Complicated Grief)?

Complicated grief is bereavement without end and without progress. While for most people the intensity of grief symptoms will diminish somewhat in time (within a few months) someone with complicated grief may experience no reduction or even intensification in grief symptoms over many months or even years.

Also known as ‘unresolved grief’ someone with complicated grief is stuck in the sadness, anger and loneliness of the bereavement process, and may need some help to break free.

Some of the symptoms of complicated grief include:

  • Feeling angry about the death
  • Having a hard time accepting the death
  • Thinking obsessively about the deceased (also, having nightmares or intrusive thoughts about the deceased)
  • Feeling deep loneliness and longing for the deceased loved one
  • Feeling distrustful of others
  • Minimizing social contact or feeling unable to maintain regular responsibilities
  • Maintaining an artificial or pretend relationship with the a deceased loved one (setting a plate at the table, for example)
  • Feeling bitterness about life and envying others not affected
  • Losing interest in others beyond the deceased
  • Hearing the voice or even seeing the deceased

Getting Help

Most major centers have grief support groups, and these can provide comfort to those going through a difficult but normal grieving process.

Anyone with a very intense or long lasting bereavement (or anyone who feels stuck in grief) should consider talking to a mental health professional. This professional can determine whether a treatable condition exists (she will be looking for complicated grief, depression, PTSD, anxiety and others). The treatment will depend on the diagnosis, but some options may include:

  • Cognitive behavioral therapy
  • Talk therapy
  • Medication, such as anti-depressants or anti anxiety medications
  • Others
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Page last updated Nov 07, 2014

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