End of Life Concerns Grief & Bereavement Differences Between Normal and Complicated Grief By Angela Morrow, RN Angela Morrow, RN LinkedIn Angela Morrow, RN, BSN, CHPN, is a certified hospice and palliative care nurse. Learn about our editorial process Updated on June 13, 2022 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Carly Snyder, MD Medically reviewed by Carly Snyder, MD Facebook LinkedIn Twitter Carly Snyder, MD, is a board-certified reproductive and perinatal psychiatrist who combines traditional psychiatry with integrative medicine-based treatments. Learn about our Medical Expert Board Fact checked Verywell Health content is rigorously reviewed by a team of qualified and experienced fact checkers. Fact checkers review articles for factual accuracy, relevance, and timeliness. We rely on the most current and reputable sources, which are cited in the text and listed at the bottom of each article. Content is fact checked after it has been edited and before publication. Learn more. by Marley Hall Fact checked by Marley Hall LinkedIn Marley Hall is a writer and fact checker who is certified in clinical and translational research. Her work has been published in medical journals in the field of surgery, and she has received numerous awards for publication in education. Learn about our editorial process Print Table of Contents View All Table of Contents Understanding Grief Normal Grief Complicated Grief Hot to Tell the Difference Other Types of Grief Frequently Asked Questions Grief is an expected response to a painful life event, the symptoms and duration of which can vary from one person to the next. In psychology, the variations in response can range from normal grief to complicated grief. Normal grief suggests that a person is processing their feelings in a typical way, while complicated grief suggests that they are not. The terms are not meant to imply that either response is "right" or "wrong." This article explains what grief actually is and the ways in which normal grief differs from complicated grief. Hero Images / Getty Images What Is Grief? Grief is the powerful feeling that human beings have after a painful or traumatic event. The intense feelings of grief are not something a person has much control over. Feelings of grief are usually associated with the death of a loved one, but there are also other losses that can trigger grief, including: Losing a job A significant change in lifestyle or financial status Stillbirth or miscarriage Divorce or the ending of a romantic relationship Serious illness in you or someone you love Losing your physical mobility or independence A robbery or assault that makes you feel unsafe An automobile accident or other "near-death" experience Grief is not a single emotion. It's an experience that you feel physically, emotionally, mentally, and/or spiritually when you go through something painful. Each person is affected by grief differently. Even two people who go through the same loss may grieve in different ways. For example, one person might go through grief for longer or be less able to function on a day-to-day basis. What Is Anticipatory Grief? What Is Normal Grief? Grief is a necessary part of going through something that is painful or traumatic. While grief is different for everyone, most people have common experiences and emotions in the days, weeks, or months following the major loss. This is referred to as normal grief. Symptoms of normal grief include: Crying or sobbingSleep problems (such as difficulty falling asleep or getting too much/too little sleep)A persistent lack of energyFeeling lethargic or apathetic about life in generalChanges in appetite (such as not eating at all or eating excessively)Withdrawing from usual social interactions and relationshipsDifficulty concentrating on important tasksQuestioning spiritual or religious beliefs, career choices, or life goalsFeelings of anger, guilt, loneliness, depression, emptiness, sadness There is no set timetable for grief. That said, people with normal grief will gradually establish a "new normal" in the ensuing weeks or months. They may never entirely forget the loss but, in time, will learn how to cope with it. Managing Important Tasks While You Are Grieving What Is Complicated Grief? Normal grief is temporary. With complicated grief, the response to a loss or death does not fade over time. Instead, it keeps a person from getting back to their normal lives. People refer to complicated grief in different ways, including chronic grief, atypical grief, exaggerated grief, pathological grief, and persistent complex bereavement disorder. Whatever the name, the condition infers the abnormal delay or absence of coping in a way that causes undue disability or distress. The characteristics of complicated grief can include many of the same experiences as normal grief. However, other symptoms will accompany, including: Persistent anger, irritation, or episodes of rage Inability to focus on anything but the loss Excessive avoidance of any reminders of the loss Intense feelings of sadness, pain, detachment, sorrow, hopelessness, emptiness, or low self-esteem Problems accepting the reality of the loss Self-destructive behavior, such as substance abuse use or risk-taking behaviors Suicidal thoughts or actions How to Let Go of Grief How to Know If It's Complicated Grief There is no set point at which normal grief becomes complicated grief. With that said, some people have suggested that the cut-off time is around six months after the loss has occurred. Even so, many people find that the first year following a major loss is hard to get through. There are holidays, birthdays, anniversaries, and other significant dates and events that serve as reminders of a loss. If you are experiencing complicated grief, you may feel "trapped" in your grief. You might feel as if your grief has stayed the same or gotten worse over time. Working with a mental health professional can help you learn about your grief response and find ways to cope. You may also want to consider joining a bereavement support group, particularly one for people who are going through a similar loss as yours. Grief can make a person feel very alone. Talking about your situation with others who are mourning may help you understand your own feelings. Four Phases and Tasks of Grief Factors Related to Complicated Grief There are certain types of grief that may serve as a gateway and predispose to complicated grief. Or, they may occur on their own and resolve in the same way as normal grief. Delayed Grief Delayed grief is when a person's normal grief response is put off until a later time. A person might be doing this intentionally or without even realizing it. In some cases, a person may feel the need to "put on a brave face" and "be strong." Or, they might feel a responsibility to help other loved ones cope. The pressure to take on this role may start during the funeral arrangements or in the weeks and months that follow. There may be other reasons for delayed grief. For example, a person may be under too much stress, need more time to process the loss, or feel that they can't grieve until something "triggers" those feelings. How Grief Is Different During COVID-19 Disenfranchised Grief Disenfranchised grief, also known as silent grief, occurs when a grieving person feels they cannot openly acknowledge a person's death because of real or imagined pressures. The source of this pressure could be family and friends, cultural or religious beliefs, or society in general. For example, the stigma around HIV, miscarriage, and same-sex marriage can affect whether people feel they can grieve openly. Grieving a Challenging Medical Diagnosis Traumatic Grief Traumatic grief can occur when a death takes place violently, unexpectedly, or causes the loss of someone who "dies before their time." Examples include the death of an infant or child, a friend or family member who has been murdered, or a loved one who had died violently in an accident. Sudden or traumatic grief can lead to very intense reactions. In some cases, people may develop and require treatment for post-traumatic stress disorder (PTSD). Summary Grief is part of how humans respond to significant losses. Each person experiences grief differently. However, there are many things that most people commonly experience as they process their grief. Normal grief describes the typical feelings that people have in the first weeks or months after a loss. This type of grief will get better with time as people learn to cope with the loss. Complicated grief describes atypical feelings and responses that can be extremely intense and persistent. A person with complicated grief may need more support to help them understand what they are feeling and how to move through the grieving process. A Word From Verywell If you are experiencing delayed, disenfranchised, or traumatic grief, it does not mean that you will develop complicated grief. Many people are still able to process their grief even in the process is not typical. If you're having a hard time with your grief experience, it's important to work with a mental health professional. They can help you figure out if you have complicated grief and help you cope with what you are going through. Frequently Asked Questions What is bereavement? Bereavement is the period of grief and mourning following a loss or death. It can manifest in emotional reactions like anger, anxiety, despair, guilt, and sadness. Physical reactions are also possible and may include illness or disability, changes in appetite, and problems with sleep. Is there complicated grief treatment? Working with a therapist is the go-to method of managing complicated grief. It may involve one-on-one or group counseling, While there are no medications to treat complicated grief, antidepressants are often prescribed for co-occurring depression or post-traumatic stress disorder (PTSD). Learn More: What Type of Psychotherapist Do I Need? What is the difference between grief and mourning? There are small differences between grief and mourning. Grief refers to a person's emotional reaction following a loss. Mourning is the outward or public-facing display of grief and depends on a person's beliefs, religion, and culture. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 8 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Newson RS, Boelen PA, Hek K, Hofman A, Tiemeier H. The prevalence and characteristics of complicated grief in older adults. J Affect Disord. 2011;132(1-2):231-8. doi:10.1016/j.jad.2011.02.021 National Cancer Institute. Grief, bereavement, and coping with loss (PDQ®): health professional version. In: PDQ Cancer Information Summaries [Internet]. Bethesda MD: National Cancer Institute; 2020. Hamilton IJ. Understanding grief and bereavement. Br J Gen Pract. 2016 Oct;66(651):523. doi:10.3399/bjgp16X687325 Shear MK. Grief and mourning gone awry: pathway and course of complicated grief. 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