Then someone close to you dies, it's natural to grieve. The ache may never go away entirely, but you gradually accept that your loved one is gone, and you find a new way for life to feel normal.

But for up to 15% of bereaved people, intense grief can linger for years or even decades. This so-called complicated grief is powerful enough to disrupt the bereaved person's ability to work, get along with others and/or to find much pleasure in anything. Although elements of depression are present, complicated grief also is marked by chronic and persistent yearning and longing for the deceased...and an inability to accept the loss.

Especially in older adults, complicated grief can go undetected by doctors and family members-or even the sufferers themselves. Regardless of age, the condition can contribute to chronic depression, drug and alcohol abuse and certain infectious diseases (by weakening the immune system). In people who have heart disease, the emotional stress created by complicated grief can worsen their condition.

Hurt But Healing

A person who is grieving is bound to experience feelings of sadness, emptiness, loss—and often anger. Physical symptoms are also common. You lack energy and feel fatigued. You may have trouble sleeping-or do nothing but sleep. You find it hard to concentrate and may even wonder about the meaning of life. Some people lose their appetites, while others eat uncontrollably. Headaches, digestive problems, and other aches and pains often occur.

These grief responses may actually serve a purpose. The psychological pain and physical symptoms force you to slow down, giving your mind and body the opportunity to heal.

Important: There's no fixed timetable for grieving. No one can say "you should be over it" in three months, six months or even a year. As long as the general trend is toward feeling better, it's normal to have ups and downs.

Grief Can Be Complicated

If painful feelings last for more than a few months and don't seem to be getting better-something may have gone wrong with the grieving process.

Red flags: Thoughts of the lost person constantly intrude throughout the day...or you're simply unable to speak about your loss...or normal life seems impossible, and you feel you can't survive without the person.

Complicated grief is more likely to occur if your relationship with the person you lost was characterized by…

  • Dependence. We all depend on those we love. But such dependence is excessive when you can't let yourself acknowledge that the person you need so badly is dead and no longer there for you.
  • Ambivalence. Virtually all relationships have some degree of ambivalence. For example, it's common to love a parent for his/her strength and reliability, but resent that person's tendency toward harsh judgment. Even in the most loving of marriages, anger comes up from time to time. Recognizing our negative feelings toward the deceased person can trigger guilt, so we instinctively push away those thoughts. However, the negative thoughts invariably find their way back into our consciousness, until we acknowledge them.

Regardless of the nature of the relationship, a sudden or otherwise traumatic death can complicate the task of grieving. You relive the moment—or keep trying to push it out of your mind. Problems also arise when death follows an extended illness, triggering both grief and guilt-inducing relief that the person is no longer suffering and perhaps that you no longer have to take care of him.

Allowing Yourself To Grieve

Grieving involves experiencing your full range of emotions, including anger, resentment and relief as well as sadness. These feelings may be hard to bear, especially if you have no one with whom to share them. Most people find it helpful to have the emotional support of others.

What to do…

  • Don't isolate yourself. Spend time with compassionate, understanding friends and family members who are willing to listen, and tell them how you feel.

If you need to talk more than these people are willing to listen, consider joining a grief support group. Meeting regularly with people who share a similar loss gives you the opportunity to express your feelings. Local hospitals, hospices and mental health facilities can help you find a support group.

On-line support groups can be helpful if you live in a remote area, prefer not to deal with others face-to-face or lack transportation. To find an on-line support group, go to the Internet community Grief Net,

  • Be active. For many people, doing is better than simply talking. Volunteer work can be especially healing-helping others diverts you from your own sadness and is a powerful way to help yourself.

Physical exercise also is a potent mood-lifter, a general aid to mental health. Anything that gets you moving is a step in the right direction.

  • Take time to grieve. Particularly if you have a busy schedule, spend five to 10 minutes a day in a quiet, private place where you feel safe and comfortable experiencing your grief. Focus on your feelings and on thoughts about the deceased. This way, if your grief intrudes during the day, you can remind yourself that you will have a chance to grieve at some point later,

When To Get Help

If your own efforts to deal with grief aren't enough, a professional can help you find where and why you’re stuck.

Consider therapy or counseling if you're showing signs of depression-you can't work, can't sleep, can't eat, can't get interested in anything or can't deal with other people. Ask your physician to direct you to a therapist or counselor with experience in dealing with grief. Or you can find a list of "thanatologists"--grief specialists—from the Association for Death Education and Counseling, 847-509-0403,

You also may want to consult your doctor about short-term use of medication to help you function in your day-to-day activities.

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