Ask the Doctors: Complicated grief extends the time it takes to heal from loss

Dear doctors: My mother and stepfather were married for 42 years when he passed away a year ago, and she’s still struggling. I talked to my doctor about it, and he said it sounds like “complicated grief.” What can we do to help her?

Dear reader: Grief is a response to loss so profound that it can temporarily disrupt our most basic connections to daily life.

Someone who is grieving might find it difficult to perform routine tasks, have trouble sleeping or eating and might be unable to feel interested or involved in others.

Sorrow can prevent them from feeling contentment, happiness, curiosity or joy. Anger might also make a baffling appearance in their lives.

The rigors of grieving can give way to depression, lead to health problems and even cause changes in cognition.

For most people, the intensity of grief eases. They cope with their loss, resume their lives and become able to forge new relationships. This typically occurs over a period of time. Unlike in theories about specific stages of grief, recovery is typically fragmented, uneven and perhaps chaotic.

For some, though, the distress of grief fails to lessen. As it persists, it puts them at risk of physical and mental health issues, suicidal thoughts and even premature death.

This has led to the term that your doctor used: complicated grief.

Sometimes referred to as prolonged grief disorder, it was identified in the early 1990s. It’s estimated that up to 10% of people who suffer a loss experience complicated grief. Older adults have been found to have an increased risk for this disorder.

For some, treatment includes medications to manage depression and anxiety.

Complicated grief shares some aspects of post-traumatic stress disorder. This has led to the development of a targeted type of psychotherapy that includes helping people learn about the signs and symptoms of complicated grief to better understand what they are experiencing. The therapy also helps people explore the ways in which grief has affected them, focuses on coping skills and gives them a space in which to express and explore feelings that also often include despair, guilt and hopelessness.

Behavioral therapy often is part of this treatment approach. So are support groups with others dealing with similar losses.

It’s important to get a diagnosis. This usually includes a medical history, a physical exam and a mental health evaluation. The results will guide treatment.

Dr. Eve Glazier and Elizabeth Ko are UCLA Health internists.