![What Is Complicated Grief? When Mourning Lingers A sad man sitting on a park bench while other people walk by illustrates the question, "What is complicated grief?"](https://www.shortform.com/blog/wp-content/uploads/2025/01/sad-man-on-park-bench-750x350.jpg)
What is complicated grief? What happens when grief becomes more than just a natural response to loss? Why do some people experience grief that seems to have no end?
In The Grieving Brain, psychologist Mary-Frances O’Connor explores what complicated grief is and how it differs from typical grieving patterns. Her research reveals the intricate relationship between our brains and the grieving process, offering insights into why some people develop this prolonged form of grief.
Keep reading to discover the science behind complicated grief and learn about proven therapeutic approaches that can help those who are stuck in an endless cycle of mourning.
Understanding Complicated Grief
What is complicated grief? In some cases, grieving seems to go on longer than is typical, to the point that it becomes chronic. This type of grief is often referred to as prolonged grief disorder, though O’Connor prefers the term “complicated grief,” as it suggests complications in a natural healing process, similar to complications that can occur in physical healing. People experiencing complicated grief feel fixated on their yearning for their lost loved one, and they exhibit symptoms of trauma as a result of their loss. O’Connor emphasizes the importance of careful diagnosis of this condition, warning against over-applying the term “complicated grief” to normal grieving processes that simply take time to resolve.
(Shortform note: In contrast to prolonged or complicated grief, some people may experience grieving that appears to resolve much more quickly than expected. This is called abbreviated grief. People may experience abbreviated grief if they quickly “replace” the lost loved one (for example, by remarrying very soon after the loss of a spouse), if they didn’t have a strong attachment to the lost loved one, or if they have already experienced some anticipatory grief (meaning they had processed some of their grief before the loss occurred). Other types of grief include delayed grief, cumulative grief from many losses, and disenfranchised grief (when the type of grief you’re experiencing isn’t socially accepted, such as the loss of a pet).)
While it’s unclear what causes complicated grief, O’Connor cites research showing that people experiencing complicated grief had lower brain volume and performed slightly worse on cognitive tests than people experiencing a resilient grief trajectory. Based on this, some scientists have concluded that cognitive impairment predisposes people to complicated grief. However, O’Connor notes several issues with this research, including its reliance on averages (meaning the data can’t be generalized to specific cases), limitations in sample populations (the research focused on older adults specifically), and attributing causation (she argues that complicated grief might contribute to cognitive decline instead of being caused by it).
(Shortform note: The circumstances of a loss may also increase the likelihood of experiencing complicated grief. These circumstances can include the loss of someone due to a sudden or violent death such as an accident or suicide, loss of a child, loss of someone you’re heavily dependent on, social isolation, history of depression or trauma, and other stressors such as financial issues. A history of mood disorders or substance abuse can also be risk factors.)
O’Conner writes that treatments such as Complicated Grief Therapy (CGT), developed by Kathy Shear, can help people through this condition. CGT helps people address both loss-related and restoration-related stressors through exercises such as revisiting memories of the death, imagined conversations with the deceased, and developing new meaningful activities. If you think you may be experiencing complicated grief, consider seeking out CGT or other grief-oriented therapies.
(Shortform note: You may not know if you’re suffering from complicated grief until after you seek help. Indicators that you should consider seeking out grief-related therapies include but aren’t limited to the following: suicidal thoughts, appetite loss, sleep disturbances, panic attacks, difficulties in everyday functioning, self-destructive coping mechanisms, social withdrawal, feelings of worthlessness, or unexplained illnesses.)