Grief is a natural response to losing someone important, but sometimes the pain remains intense, persistent, and disruptive long after a loss. When grief continues to dominate everyday life and makes it difficult to reconnect with relationships, responsibilities, interests, or future plans, we may be dealing with what is commonly called complicated grief. In clinical settings, persistent and disabling grief may be diagnosed as prolonged grief disorder (PGD).
Learning how to deal with complicated grief does not mean forgetting the person who died or forcing ourselves to stop feeling sadness. Instead, recovery involves learning how to carry the loss while gradually rebuilding a meaningful life around it. With appropriate emotional support, healthy coping strategies, and professional treatment when needed, we can begin moving forward without abandoning the memories and relationships that remain important to us.
What Is Complicated Grief?
Complicated grief describes a pattern in which feelings associated with bereavement remain unusually intense and interfere significantly with daily functioning. The American Psychiatric Association recognizes prolonged grief disorder as a mental health diagnosis in the DSM-5-TR. Symptoms may include persistent longing or preoccupation with the person who died, difficulty accepting the death, emotional numbness, intense emotional pain, avoidance of reminders, identity disruption, loneliness, and difficulty returning to everyday activities.
Normal grief can also involve sadness, anger, guilt, disbelief, loneliness, and changes in daily functioning. The important distinction is not simply how strongly we miss someone. Concern increases when grief remains persistently overwhelming and causes substantial problems in important areas of life.
Signs We May Be Struggling With Complicated Grief
There is no single emotional pattern that everyone follows after bereavement. However, certain experiences can suggest that additional support may be beneficial.
Common Signs to Watch For
We may want to speak with a qualified mental health professional if we experience:
- Persistent and intense longing for the person who died
- Ongoing preoccupation with the deceased or circumstances surrounding the death
- Difficulty accepting that the death has occurred
- A feeling that part of our identity disappeared with the person
- Strong avoidance of people, places, possessions, or situations connected with the loss
- Persistent anger, bitterness, guilt, sorrow, or emotional pain
- Difficulty experiencing positive emotions
- Emotional numbness or detachment
- Withdrawal from friends, relatives, work, or enjoyable activities
- Difficulty imagining or planning a meaningful future
- Significant disruption in social, occupational, or everyday functioning
These experiences are among the symptoms clinicians consider when assessing prolonged grief disorder.
How to Deal With Complicated Grief in Healthy Ways
There is no need to rush grief or meet someone else’s expectations about how quickly we should recover. However, when grief becomes persistently disabling, actively working toward recovery can help us regain stability and purpose.
1. Allow Ourselves to Acknowledge the Loss
Avoiding the reality of a death may provide temporary relief, but consistently escaping reminders can make adaptation more difficult. We can begin gently acknowledging what happened rather than demanding that ourselves feel “fine.”
This may involve talking about the person, writing about our experiences, looking through meaningful photographs when we feel ready, visiting an important location, or discussing the circumstances of the loss with a therapist.
Acknowledgement is not the same as approval. We can accept that a death happened while still wishing deeply that circumstances had been different.
2. Stop Comparing Our Grief With Other People’s Grief
Grief is highly individual. Relationships, circumstances surrounding a death, cultural expectations, family dynamics, previous experiences, and available support can all influence how bereavement feels.
We should therefore avoid judging ourselves because someone else appears to have “moved on” more quickly.
Recovery should not be measured by whether we still miss the person. Instead, we can look at whether we are gradually becoming better able to function, connect with others, experience meaningful moments, and engage with life despite continuing to carry the loss.
3. Maintain Connection Instead of Isolating Ourselves
Complicated grief can create a powerful urge to withdraw. We may believe other people cannot understand what we are experiencing or feel uncomfortable repeatedly discussing the loss.
However, prolonged isolation can make emotional distress harder to manage.
We can identify one or two trustworthy people who are willing to listen without judging or rushing the grieving process. Support may come from family members, friends, religious or community leaders, bereavement groups, therapists, or others who have experienced significant loss.
We do not have to talk about grief constantly. Sometimes companionship itself can reduce loneliness.
4. Rebuild a Basic Daily Routine
Grief can disrupt sleep, eating habits, concentration, motivation, work, and self-care. When everything feels overwhelming, we can start with small areas of structure.
A manageable routine might include waking at approximately the same time, eating regular meals, taking a shower, completing one important responsibility, spending a short period outdoors, and maintaining a predictable bedtime routine.
The aim is not maximum productivity. Consistency can provide stability when our emotional world feels unpredictable.
5. Gradually Reconnect With Meaningful Activities
A common feature of prolonged grief can be difficulty reintegrating into everyday life or pursuing interests and future plans.
We may initially feel guilty about enjoying ourselves after someone has died. Yet experiencing happiness does not mean the deceased mattered less.
We can begin with small activities rather than expecting ourselves to immediately return to our previous lifestyle. This might include meeting a trusted friend, returning to a hobby, exercising, attending a community event, volunteering, learning something new, or working toward a manageable personal goal.
Each step helps demonstrate that grief and meaningful living can exist together.
Professional Therapy for Complicated Grief
When grief continues to interfere significantly with our lives, professional treatment can provide structured support.
Research and clinical guidance have identified grief-focused psychotherapy approaches that directly address persistent grief reactions. Treatment may involve understanding grief, managing painful emotions, strengthening relationships, confronting avoided reminders gradually, processing the story of the death, reconnecting with meaningful activities, and developing goals for the future.
How Grief Therapy Can Help
Working with a qualified therapist may help us:
- Understand patterns that are keeping grief highly distressing
- Express emotions in a safe and structured environment
- Address excessive guilt or self-blame
- Process painful memories surrounding the death
- Reduce avoidance of reminders
- Reconnect with supportive relationships
- Restore activities that provide meaning
- Develop realistic personal goals
- Learn strategies for managing intense waves of grief
- Maintain a healthy continuing connection with the person’s memory
Certain cognitive behavioural approaches for prolonged grief may incorporate techniques such as exposure, cognitive restructuring, and behavioural activation.
Treatment should be personalised rather than based on the assumption that everyone grieves in exactly the same way.
Create Healthy Ways to Remember the Person Who Died
Recovering from complicated grief does not require removing the deceased from our lives emotionally. Many people benefit from developing a continuing connection through memories, values, traditions, or meaningful rituals.
We might create a memory book, write letters, preserve photographs, prepare a favourite meal, support a cause that mattered to the person, celebrate meaningful traditions, visit an important location, or share positive stories with family members.
These practices can help transform remembrance from something we only associate with intense pain into something that can also contain gratitude, connection, and meaning.
Learn to Manage Grief Triggers
Birthdays, anniversaries, holidays, songs, photographs, locations, family events, and unexpected reminders may produce sudden waves of grief.
Instead of expecting ourselves never to feel triggered, we can prepare for difficult moments.
Before a significant date, for example, we might decide where we want to be, whom we want nearby, what responsibilities can be reduced, and how we would like to remember the deceased.
When an unexpected wave of grief occurs, grounding strategies may also help. We can slow our breathing, notice what is happening around us, name the emotions we are experiencing, contact someone supportive, or temporarily move to a quiet environment.
The goal is not to eliminate emotion. It is to develop greater confidence in our ability to experience difficult emotions without becoming completely overwhelmed by them.
Take Care of Physical Health During Grief
Emotional and physical health are closely connected. Intense bereavement can make everyday self-care difficult, so we should focus on realistic habits rather than perfection.
Regular meals, adequate hydration, physical activity appropriate for our health, sufficient rest, and consistent sleep routines can support overall functioning.
Alcohol or other substances may appear to numb painful emotions temporarily, but relying on them to escape grief can create additional difficulties. When coping habits begin causing problems, discussing them openly with a healthcare professional is important.
Address Guilt and Unanswered Questions
Complicated grief is sometimes accompanied by repetitive thoughts such as:
“I should have done more.”
“Why didn’t I notice something was wrong?”
“I should have been there.”
“I don’t deserve to enjoy life.”
Some questions surrounding death may never have completely satisfying answers. Therapy can help us examine guilt more realistically, distinguish responsibility from hindsight, and develop a more balanced understanding of events.
Self-compassion is particularly important. We can acknowledge mistakes where they genuinely occurred without turning those mistakes into permanent punishment.
Set Small Goals for Moving Forward
When grief is severe, thinking months or years ahead can feel impossible. Instead, we can focus on small and achievable goals.
Our first goal may simply be responding to an important message, preparing a meal, going outside, attending an appointment, completing a work responsibility, or spending time with someone supportive.
As stability improves, we can gradually introduce larger goals involving relationships, education, work, hobbies, travel, finances, spirituality, or personal development.
Moving forward does not erase the past. We can continue loving and remembering someone while creating new experiences.
When Should We Seek Professional Help for Complicated Grief?
We should consider professional support when grief remains intensely distressing, prevents us from managing important responsibilities, causes significant social withdrawal, or makes it extremely difficult to engage with daily life.
A mental health professional can also determine whether symptoms may involve prolonged grief disorder, depression, post-traumatic stress, anxiety, or another condition, because these experiences can sometimes overlap and may require different approaches to treatment.
The DSM-5-TR formally includes prolonged grief disorder as a diagnosis, while the World Health Organization also recognizes prolonged grief disorder within ICD-11.
Seeking an assessment does not mean our grief is abnormal simply because it is painful. It provides an opportunity to understand what we are experiencing and identify the most appropriate form of support.
Supporting Someone With Complicated Grief
When someone we care about is struggling, we do not need perfect words. Reliable presence is often more valuable than advice.
We can listen without immediately trying to solve their feelings, continue checking in after the initial period following the death, invite them to manageable activities, offer practical assistance, and encourage professional support when their ability to function remains severely affected.
We should avoid statements that pressure them to “move on,” suggest there is a fixed deadline for grieving, or minimise the significance of the relationship.
Instead, we can acknowledge both their loss and their need for continued support.
Building a Meaningful Life After Complicated Grief
Healing does not require us to choose between remembering someone and continuing our own life.
Over time, we can create room for both.
We can remember what the person meant to us while strengthening relationships that remain. We can feel sadness while gradually experiencing moments of happiness. We can honour the past while building plans for the future.
Progress may not happen in a straight line. Some days can feel manageable while another day brings an unexpectedly intense wave of grief. A difficult day does not erase earlier progress.
FAQs about How to Deal with Complicated Grief
1. What is complicated grief?
Complicated grief, sometimes called prolonged grief, involves intense and persistent feelings of loss that significantly interfere with daily life, relationships, work, or emotional wellbeing.
2. How can we deal with complicated grief?
We can begin by acknowledging the loss, allowing ourselves to experience difficult emotions, maintaining supportive relationships, and seeking professional grief counselling or therapy when grief becomes overwhelming.
3. When should we seek professional help for grief?
Professional support may be helpful when intense sadness, longing, guilt, emotional numbness, isolation, or difficulty functioning continues for an extended period and disrupts everyday responsibilities.
4. What therapy is used for complicated grief?
Treatment may include grief-focused psychotherapy, cognitive behavioural therapy (CBT), supportive counselling, and other approaches tailored to the person’s symptoms, circumstances, and mental health needs.
5. Can complicated grief cause anxiety or depression?
Yes. Persistent grief can occur alongside depression, anxiety, sleep difficulties, and other emotional challenges. A qualified mental health professional can assess these symptoms and recommend appropriate treatment.
6. How can we support someone experiencing complicated grief?
We can listen without judgement, remain patient, offer practical assistance, encourage healthy routines, and gently support them in seeking professional care when necessary.
7. Can complicated grief get better?
Yes. With appropriate support and treatment, many people can gradually adjust to their loss, manage painful emotions, reconnect with meaningful activities, and improve their overall quality of life.
Conclusion
Learning how to deal with complicated grief involves more than trying to distract ourselves from painful emotions. We may need to acknowledge the reality of the loss, maintain supportive relationships, rebuild daily routines, gradually return to meaningful activities, address guilt and avoidance, care for our physical health, and seek specialised grief therapy when symptoms continue to interfere significantly with everyday life.
Complicated grief can feel consuming, but the relationship we had with someone does not have to disappear for life to become meaningful again. With appropriate support and gradual, purposeful steps, we can learn to live with the reality of loss while reconnecting with relationships, goals, experiences, and a future that still deserves our attention.
