Treatment for Complicated Grief Disorder
Complicated grief disorder (CGD) is excessive, persistent grief that is more intense and lasts much longer than what is normally expected when a loved one is lost. CGD can be treated with a therapeutic approach called complicated grief treatment, which involves facing the loss while also planning for the future and working with a therapist for several weeks. Patients struggling with CGD may also benefit from medications and can use healthy coping strategies and social support to overcome symptoms and to be able to function normally again.
Grief is a normal and healthy emotion. This reaction to loss is a powerful negative feeling, but it is also the expected reaction, usually to the death of a loved one. Grief can last for a long time, although for most people the intensity will begin to decrease, providing relief. When grief extends for an unusually long period of time, causing intense feelings and significant impairment, a person may be diagnosed with complicated grief disorder.
Complicated grief disorder, or CGD, is not yet an officially recognized mental illness according to the guide that mental health professionals use to diagnose patients, but it is considered a valid issue that affects many people and that is the subject of further study. For someone going through grief that does not get better and does not lessen in intensity, treatment can be helpful. Professional therapy, coping mechanisms, social support, and in some cases medication, are all useful strategies in treating complicated grief and helping someone overcome and accept loss.
Recognizing and Diagnosing Complicated Grief Disorder
There are no official diagnostic criteria for CGD, but there are clear signs that someone is struggling with it, and mental health professionals often make unofficial diagnoses so that treatment can be provided. The criteria that have been proposed can be used to make a diagnosis. These include that the person experiencing grief has had symptoms of bereavement for six months or longer. The criteria also include the presence of at least one of these signs:
- An intense and persistent longing for the person who has been lost
- Intense and frequent feelings of loneliness
- Persistent thoughts about the loss being unfair or unbearable, or about wanting to die to be with a loved one
- Preoccupying thoughts about the lost loved one
The criteria for CGD also include other symptoms that must persist for a month or more. A person should have at least two of these to be diagnosed:
- Frequent thoughts about the loss
- An inability to accept the loss
- Persistently feeling numb or shocked about the loss
- Persistent anger and bitterness
- An inability to trust or care about others, especially those who have not experienced loss
- Intense emotions related to memories of the lost loved one
- Experiencing symptoms that the lost loved one had, or hearing his or her voice
- Unusual behaviors, including either avoiding reminders of the lost loved one or excessively seeking out reminders
Complicated Grief Treatment
Researchers comparing treatment methods for complicated grief have found that a specific treatment method, called complicated grief treatment, is more effective than simply using standard, one-on-one psychotherapy. Studies through the National Institute of Mental Health have proven that this type of treatment helps an average of 70 percent of participants as compared to 44 percent who benefit from therapy used to treat depression. Complicated grief treatment follows a specific protocol and lasts for 16 weeks.
Therapists providing complicated grief treatment act as guides for patients, helping them maneuver through grief and loss. Treatment includes two elements: talking about and processing the loss and focusing on the future, adjusting to the loss, and moving forward. The therapist takes the patient through both elements alternately so that he or she can deal with the loss while also restoring a normal way of life. There are three phases of treatment:
- In the introductory phase, the therapist discusses normal grief and complicated grief and how the patient will be facing grief and loss while also trying to move forward.
- In the middle phase of treatment, the patient actually goes through the process of talking about the loss and negative feelings, alternating with discussions about restoring a normal life.
- In the final phase of treatment, the patient is encouraged to review the progress made and to come up with positive goals for the future.
The studies that have looked at complicated grief treatment have proven that it is a more effective way to help patients than is standard therapy for depression. This suggests further evidence that CGD is a valid condition that requires its own treatment plan.
Complicated Grief Treatment in a Residential Setting
The complicated grief treatment process may be administered on an outpatient basis for those patients who need to stay home. However, this treatment procedure also works in a residential setting, and there are some good reasons to choose this option. Complicated grief is very serious, and a residential facility offers a safe place in which to heal. The condition can make it impossible to do normal activities or keep up with responsibilities at home, so staying in a facility gives a person the chance to really focus on getting better. Additionally, residential treatment centers typically offer a range of holistic services, including things like nutrition and meditation to complement standard treatment.
Medications for CGD
Therapy is the backbone of treatment for CGD, and while there is no medication specifically for this condition, for some people medications have some benefits. Antidepressants, for instance, may help mitigate some of the symptoms, although they take several weeks to begin showing effects. Anti-anxiety medications can provide relief when stress levels are high and may help a patient be more receptive to therapy. Medication should never be a substitute for more comprehensive treatment.
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Coping Strategies and Social Support
In addition to therapeutic treatment for CGD, patients can benefit from learning and practicing healthy coping strategies and from having social support. For connecting with others, patients may participate in group therapy sessions or in support groups, either in a treatment facility or after treatment for ongoing support. Friends and family are another important source of social support. During and after treatment it is important for patients to spend time with those closest to them for support and connection.
There are many ways in which a patient can learn to cope with negative emotions in healthy ways. A good treatment program will include an exploration of the possibilities so that patients can select those that work best for them and practice using coping strategies that will benefit them once they get home after treatment. Some examples of healthy coping mechanisms include:
- Stress management practices, like yoga, meditation, or deep breathing
- Regular exercise
- Good nutrition
- Adequate sleep
- Participating in a faith community
- Hobbies and creative activities, or learning new skills
- Volunteer work
- Celebrating a lost loved one in positive ways
Can Complicated Grief Be Prevented?
Any normal period of grief has the potential to become CGD, and there are certain risk factors that make it more likely:
- A personal history of mental illness, especially depression and anxiety
- A childhood that was not emotionally secure
- The loss of someone very young
- Multiple losses
- A violent loss or a suicide
- Loss of a long-term romantic partner
It may not always be possible to prevent CGD, but if there are risk factors for it, certain steps and factors may help reduce the chances that a person’s normal grief will turn into this devastating condition. Talking about the grief and the loss, for instance, may help ward off complicated grief. Taking advantage of social support systems is also helpful. Connections to other people help reduce negative emotions and give a person a chance to work through grief.
Therapy may also be useful, even before there are any signs of CGD. Professional treatment can help a person process the loss and learn healthy coping skills. These all may act as protective factors, and although there is no guarantee they can prevent someone from suffering from complicated grief, they are healthy ways to get through a difficult time.
Complicated grief is a devastating condition that causes intense negative feelings, loss of function, and a sense of hopelessness and that nothing will ever be good again. Without dedicated treatment it is very challenging to overcome these feelings. Patients who suffer with CGD can benefit from professional, residential treatment that is tailored specifically to complicated grief. With commitment to this treatment process, as well as other factors like social support, it is possible to finally overcome grief and get relief from symptoms.