Losing a loved one is a universally painful experience, but when grief becomes prolonged and debilitating, it can feel like pathological grief.
This type of grief goes beyond normal reactions to loss, becoming a condition that significantly affects quality of life.
Like a cloudy sky that never seems to clear, this phenomenon can darken the grieving person’s life, leaving them trapped in a cycle of sadness and despair.
In this article, we’ll explore what pathological grief is, its causes, symptoms, and how to overcome it. Read on to better understand this condition and discover practical ways to deal with it.
Understanding Pathological Grief
There are some similarities between common and pathological grief, however, in the second case, it generates more harm and suffering than it causes in people on average, causing more significant damage and impacts than expected.
So let’s look at the definition in detail below.
What is pathological grief?
O pathological grief is a prolonged and intense reaction to the loss of a loved one, which significantly interferes with the daily life of the bereaved person.
Unlike common grief, which tends to ease over time, pathological grief remains intense and prevents the person from moving forward.
This type of grief is characterized by emotional and physical symptoms that persist for an excessively long period of time and do not improve over time.
Psychiatrist Elisabeth Kübler-Ross, known for her work on grief, describes the normal grieving process in five stages, but in pathological grief, these stages seem to stagnate, especially during moments of grief and denial.
Difference between normal grief and pathological grief
The main difference between common grief and pathological grief is the duration and intensity of the symptoms.
Normal grief involves a series of emotional stages that gradually subside, allowing the person to reintegrate into everyday life.
Pathological grief, also known as complicated grief, is marked by an inability to accept the loss, intrusive thoughts about the deceased, and a continuous feeling of emptiness and sadness.
While normal grief allows for eventual adaptation, pathological grief can paralyze the bereaved’s life, making each day a painful struggle.
As Sigmund Freud stated, “Grief, although painful, is a necessary and natural response to loss”; however, when it becomes pathological, it is like a wound that does not heal.
Signs and symptoms of pathological grief
Emotional symptoms
Emotional symptoms of this type of grief include:
- Deep sadness: constant feeling of sadness that does not diminish over time;
- Intense guilt: disproportionate or irrational feelings of guilt about the death;
- Anxiety: excessive worry and fear of facing life without the loved one;
- Despair: feeling that life has lost its meaning and purpose.
For more information on mental health and support, visit our articles on anxiety and depression.
Physical symptoms
Physical symptoms can be equally debilitating and include:
- Insomnia: persistent difficulty falling asleep or staying asleep;
- Loss of appetite: disinterest in food, resulting in significant weight loss;
- Body pain: physical manifestations of pain with no apparent medical cause.
Common behaviors
People with pathological grief often exhibit behaviors such as:
- Social isolation: avoiding social interactions and distancing yourself from friends and family;
- Excessive attachment to memories: keeping the deceased’s belongings unchanged or revisiting associated places frequently;
- Denial of loss: behavior that suggests an inability to accept the reality of death.
Risk factors for pathological grief
Certain factors may increase the likelihood of developing pathological griefsuch as:
- History of depression or other mental disorders: people with a history of mental disorders are more vulnerable to developing pathological grief;
- Lack of adequate social support: the lack of a support network can make it difficult to overcome grief;
- Sudden or traumatic death of a loved one: unexpected or violent losses can be more difficult to process;
- Highly dependent or conflictual relationship with the deceased: the intensity of the bond or the presence of unresolved conflicts can complicate the grieving process.
Diagnosis of pathological grief
Diagnostic criteria
The criteria for diagnosing pathological grief include the persistence of intense symptoms for a prolonged period.
Although there is no consensus on the time needed to consider grief as pathological, typically more than six months after the loss, according to mental health manuals such as the DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders), the condition would be classified as such.
These criteria help differentiate complicated grief from normal grief by identifying patterns of thinking and behavior that indicate significant difficulty accepting the loss and moving on with life.
Professional evaluation
The assessment should be carried out by mental health professionals, such as psychologists – in person or via telepsychology – or psychiatrists, who use clinical interviews and questionnaires to understand the depth and impact of symptoms.
A thorough assessment considers the individual’s mental health history, the context of the loss, and the presence of additional risk factors.
This is crucial to developing an effective and personalized treatment plan.
Treatment of pathological grief
Psychotherapy
Choosing one of the various types of therapy is essential in the treatment of pathological grief.
Therapy is effective in helping those who are grieving process their emotions and develop strategies for coping with the loss.
Medicines
In some cases, medications such as antidepressants may be prescribed to alleviate the symptoms of depression and anxiety associated with pathological grief.
These medications can be an important part of treatment, especially when combined with psychotherapy, providing symptom relief and facilitating engagement in other forms of treatment.
Support groups and networks
Joining support groups can provide a safe space to share experiences and receive emotional support from people who are going through similar situations.
Support groups provide a community of understanding and empathy, which can be extremely beneficial for those who feel isolated in their grief.
Self-care practices
Self-care practices are essential and include:
- Physical activity: Regular exercise can improve mood and increase energy;
- Healthy eating: a balanced diet can help keep your body and mind healthy;
- Adequate sleep: Ensuring good rest is crucial for emotional well-being.
Is it possible to avoid pathological grief?
Although it is not possible to completely avoid the pathological griefsome strategies can help reduce the likelihood of developing it:
- Maintain a strong social support network: cultivating meaningful relationships can provide support during grief;
- Participate in mourning rituals: funerals and other ceremonies can help process the loss;
- Allow yourself to feel and express the pain: Suppressing emotions can intensify suffering, so it’s important to give yourself permission to cry and grieve.
When to seek professional help
If grief is significantly affecting your ability to function in your day-to-day life and you feel like you can’t cope on your own, it’s crucial to seek professional help.
A healthcare professional can help in a number of ways, including:
- Assessment and diagnosis: identify the presence of pathological grief;
- Development of a treatment plan: which may include psychotherapy, medication, and self-care strategies;
- Ongoing support: regular follow-up to monitor progress and adjust treatment as needed.
O pathological grief is a serious condition that requires proper attention and treatment.
If you or someone you know is experiencing prolonged and debilitating grief, consider seek professional help.
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