This article is for informational purposes only and does not constitute medical, legal, or financial advice. Always consult with qualified professionals regarding your specific situation.

When grief gets complicated — knowing when you need professional help

Grief is normal. Grief is painful. Grief lasts longer than most people think. But sometimes grief becomes something more than sadness about loss. Sometimes it shifts into territory where you might need professional support to find your way through.

The line between normal grief and complicated grief is not always clear. Grief is different for everyone. There is no universal timeline. But there are some signs that suggest you might benefit from talking to someone trained to help. This is not shameful. This is not weakness. Sometimes grief is too big to carry alone, and reaching out for help is exactly what you need to do.

Normal grief versus complicated grief

Normal grief hurts. It's waves of sadness and waves of other emotions. You miss the person. You have hard days and easier days. You cry sometimes. You think about them. You have moments where you forget they're gone and then remember and it hits you again. You feel relieved that their suffering ended and guilty that you're relieved. You feel angry. You feel grateful for the time you had. All of this is normal.

Over time, normal grief becomes less acute. It doesn't disappear, but you have longer periods of time between waves. You have more days where you're functioning and fewer days where grief is incapacitating. You still miss them, but you're also building a life that has room for other things besides missing them.

Complicated grief is different. Complicated grief is being stuck in the acute phase of grief. It's more than a year or two after the death and you're still unable to function. You can't work. You can't take care of yourself. You can't engage with other people. You're not just sad. You're unable to exist in the world in a functional way. The grief has become so heavy that it's suffocating you.

Complicated grief is also called prolonged grief disorder or persistent complex bereavement disorder. It's not something you're doing wrong. It's not that you're grieving too much. It's that something about the grief has shifted into something more difficult to work through alone.

Signs that you might need help

If you're constantly unable to function, that might be a sign. If you can't get out of bed. If you can't shower or take care of yourself. If you've lost interest in everything, not just in activities that involve the person who died, but in life generally. If you're unable to work or maintain basic routines. These are signs that you might need support.

If you're having thoughts about harming yourself, that's a sign. You need help immediately. If you're drinking heavily or using drugs to cope, if you're unable to stop despite wanting to, that's a sign. If you're having panic attacks or severe anxiety that doesn't seem to get better, that's a sign.

If everyone around you is expressing concern about your well-being, that might be a sign. You might not be able to see it clearly yourself because you're in it, but other people noticing that something is wrong might be worth taking seriously.

If it's been a year or more since the person died and you're still in as much acute pain as you were in the first weeks, that might be a sign. Most people don't completely get over grief, but the intensity usually decreases over time. If it's not decreasing at all, if it feels like the death just happened, that might mean you need help.

If you're having intrusive thoughts about the person, especially about the death itself, if you're replaying it over and over, if you can't stop thinking about the moment they died, that's a sign. Grief includes thinking about them, but being unable to stop intrusive thoughts about the death, about what happened, about details you can't unsee, that's different.

Where to get help

A therapist trained in grief counseling can help. Grief is a specific type of pain and some therapists specialize in it. Look for someone who has experience with grief, especially if the death was traumatic or complicated.

Your primary care doctor can help direct you to mental health services. They can also help rule out depression or other medical conditions that might be making grief harder to bear.

Grief support groups can help. Even if you're not sure you need therapy, talking to other people who are grieving can be powerful. These groups exist specifically for people grieving. You're not alone. You're not doing this wrong. Other people understand.

If you're having thoughts of suicide or self-harm, call the 988 Suicide and Crisis Lifeline. This is a free, confidential service available 24/7. You can call or text 988. If you're in immediate danger, call 911.

Some hospice organizations offer grief support services to anyone, not just to people whose loved ones died under their care. If your loved one was under hospice, ask if they offer continued grief support. Many do.

There's no shame

Reaching out for help is not a sign that you're broken. It's a sign that you're taking care of yourself. It's a sign that you recognize you need support and you're brave enough to ask for it.

Many people benefit from grief counseling. Many people find that talking to someone trained to listen helps them work through the complicated terrain of loss. This is not weakness. This is wisdom.

You don't have to feel this way forever. You don't have to suffer through it alone. Help exists. You can access it.

How To Help Your Elders is an informational resource for families working through aging and elder care. We are not medical professionals, attorneys, or financial advisors. The information provided here is for educational purposes and should not replace professional consultation. Every family's situation is unique, and rules, costs, and availability vary by location and circumstance.