Complicated Grief Disorder and Concurrent Disorders: The Importance of Comprehensive Treatment

The loss of a loved one is always difficult, but some people face prolonged periods of bereavement that lead to complicated grief disorder. If your loved one is struggling with this challenge, it’s important for them to face their loss in order to properly recover. But when treating it in the presence of other underlying mental health challenges, comprehensive treatment is essential in order to prevent these challenges from exacerbating the issue. Through treatment, they can create a new future for themselves free from the burden of grief.

Death and loss are unavoidable parts of the human experience. Although they can cause us a great deal of pain, through these experiences we can also gain a greater appreciation of life. We survive the pain and emerge stronger, and although we are changed, we find ways to harness this change for the best. But sometimes, people find themselves grieving for months without an end in sight—when this happens, that person’s feelings of loss surpass the natural grieving process and become maladaptive, constituting what is considered to be complicated grief disorder (CGD) (also known as complicated bereavement disorder).

When dealing with a loss, everyone copes differently—some of us take longer than others to move on, and some express their feelings in different ways (such as oversleeping, not sleeping enough, or eating more or less than usual). Given this variability, it can be easy to overlook CGD at first, especially since the presence of its symptoms within the first few months after a loss doesn’t necessarily mean that the person has CGD. But if notice your loved one seems to be stuck in the phase of grief for a prolonged period of time—over six months is typically the line—they might require treatment that addresses their grief and the other mental health challenges that it can exacerbate.

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Facing Loss to Recover

When you see the toll that complicated bereavement takes on your loved one, remind yourself that without intervention, this period of grief can continue indefinitely. It’s not an easy process, and one that will require confronting and accepting grief, but when done properly and compassionately (and in the right environment), guided therapy can help your loved one come to terms with their loss, helping them heal and emerge stronger. And it’s never too late to start.

As of now, complicated grief treatment (CGT), a form of psychotherapy based on principles of cognitive behavioral therapy (CBT), shows the most promise for treating CGD. The treatment, designed to take place over 16 sessions, begins with the therapist helping your loved one come to terms with their loss, and then helping them find a sense of meaning and purpose. It involves facing distressing thoughts connected to a loss in order and building up an emotional tolerance to such thoughts. The goal is to ultimately allow your loved one to accept their loss and begin focusing on the personal goals, hobbies, and dreams that fell by the wayside during their struggle.

Outside of CGT, CBT can also decrease symptoms of complicated bereavement and aid in the recovery process. Similar to CGT, CBT begins by asking your loved one to imagine events and cues of their grief in order to promote desensitization and acceptance of the emotions linked to them. The main difference is the second phase, which focuses on addressing dysfunctional thought processes and challenging them. The goal here is to arrive at a more positive perception of the loss, and to help your loved one remember the person they lost in a healthier, more adaptive way.

Treating CGD in the Presence of Other Underlying Mental Health Challenges

The right diagnosis and treatment of CGD in a residential setting is important not only to treat your loved one’s prolonged period of grief, but also to shine light on signs of other mental health challenges that they might be living with and ensure that these challenges are given proper attention. People with CGD often struggle with other concurrent disorders, most commonly major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). All of these mental health challenges share some overlap—depression, anger, and other types of emotional distress—making it even more important to be aware not only of CGD symptoms, but also the possibility that it’s masking other problems that your loved one is struggling with.

When you live with CGD, you find yourself preoccupied with thoughts of your deceased loved one, longing to re-experience moments that you shared with them and spend more time together. This can lead to a yearning that makes way for intense feelings of sadness. When coupled with depression, these feelings intensify, with comorbidity associated with an increased severity of grief.

It’s no surprise that depression is often present in people living with CGD—the common link between many of the symptoms of depression, such as selective attention to negativity and a cognitive pattern rooted in pessimism, is loss (in this case, the loss of a loved one). Given that severe grief has been linked to impairment in work and social situations, concurrent treatment of these disorders is crucial—unresolved depression can greatly impact the lives of your loved one and hinder the CGD treatment process, preventing them from truly moving on.

As similar overlap is observed between PTSD and CGD, with both disorders characterized by a preoccupation with emotions. The biggest factors that influence concurrent PTSD and CGD are the nature of the loss and relationship—unpredictable losses defined by violence, such as murders or car accidents, are much more likely to lead to PTSD. This is especially true if the nature of the relationship was very intimate, making bereavement more difficult to cope with due to the combination of grief and psychological stress. If this relationship between grief and psychological stress isn’t addressed, post-loss trauma can become even worse. One of the best things that you can do for a loved one living with PTSD and CGD is to make sure that they have a support network of family and friends, as the importance of this network after a loss can cushion the trauma of the loss and improve their ability to cope.

Creating a New Future

The ups and downs of life can catch anyone off guard, but sometimes people get caught in the downs and need a hand to pull them out. In residential treatment, your loved one can address their CGD as well as any other co-occurring mental health challenges that it might be masking. Prolonged grief can overshadow the potential for personal growth and feed into the stagnation that feeds CGD. Through a development of acceptance and a focus on the future instead of the past, your loved one can find hope and positivity after their loss and learn to harness it for a healthier, more adaptive view of life.

Bridges to Recovery offers comprehensive residential treatment for people living with complicated grief disorder. Contact us if your loved one is struggling to let go of the past and needs the tools to move towards a positive future.

Lead Image Source: Unsplash user Arthur Poulin