When Grief Becomes Complicated: What Happens?


By Larry M Barber, LPC-S, CT

“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.