When Grief Becomes Complicated: What Happens?


“Complicated grief” refers to grief, which doesn’t follow the usual or expected grief pattern due to complicating factors.  When grief is complicated, the grieving individual may not heal in a healthy manner without outside assistance or intervention.  The following signs may indicate that the grieving individual needs professional intervention:

Children and Adolescents

  • Chronic or severe somatic symptoms (headaches, stomach aches, etc.)

  • Pronounced self-blame

  • Chronic school problems

  • Nightmares/sleep disturbances

  • Extreme regression (return to bedwetting, clinging, thumb-sucking, etc.)

  • Poor self-care

  • Excessive hopelessness

  • Extreme anger/hostility/violence or other extreme acting out/defiance

  • Social isolation/extreme withdrawal

  • Sudden change in friends/peer group

  • Intense separation anxieties or phobias

  • Apparent absence of grief or unwillingness to discuss the loss

  • Skipping school

  • Intense involvement in dating relationship to the exclusion of other friends or activities

  • Extreme negativity/gloom

  • Intense attraction to the topic of death, or fixation on the subject of death

  • Illegal activity/violating the rights of others

  • Substance abuse

  • Suicidal thoughts or plans


  • Persistent somatic complaints, physical problems, or chronic illness

  • Acute anxiety or panic

  • Excessive hostility and anger

  • Inability to work

  • Poor self-care or inability to meet daily needs of self, dependents

  • Social Isolation

  • Increased or new alcohol/drug/nicotine use

  • Sleep disturbances

  • Eating disturbances, appetite changes, or major weight loss or gain

  • Lasting or agitated depression

  • Excessive and unrealistic guilt

  • Suicidal thoughts or plans

Written by Larry M. Barber, LPC-S, CT author of the grief survival guide “Love Never Dies: Embracing Grief with Hope and Promise”  available online at Amazon, Barnes & Noble or Christianbook.com.

The grief survival guide is also available in Spanish as “El Amor Nunca Muere: Aceptando el Dolor con Esperanza y Promesa” on Amazon.com.