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abnormal grieving

Alternative Names 
pathological grieving, unresolved grief

Abnormal grieving occurs when the normally painful emotional reaction is prolonged, delayed, or otherwise unresolved. It is considered abnormal for a person not to grieve at all after a major loss. Grief is also considered abnormal when it is accompanied by thoughts of suicide or psychotic symptoms like a loss of contact with reality.

What is going on in the body? 
Grief is the subjective state that follows loss. It is one of the most powerful emotional states. Grief affects all aspects of one's life. Most often, it is the response to loss of a loved one through death or separation. It may also follow the loss of something that is highly valued, such as a job, an object, or status. People often have emotional, physical, and behavioural reactions to an irrevocable loss. Unlike some cases of depression, grief usually lessens over time.

To adapt to loss, a person must complete four tasks:
  • accept the reality of the loss
  • work through the pain of the loss
  • adjust to an environment following the loss
  • move on with life
What are the signs and symptoms of the condition? 
In addition to the expected symptoms of grief, abnormal grieving may include:
  • overly intense reactions
  • an excessively long period of grieving
  • identification with the lost person. The person may believe that he or she is also dying, or will soon die of the same cause as the loved one.
  • continually hearing the voice of the dead person. In normal grieving, a person often hears the dead person's voice, but the episodes are brief and fleeting.
  • insistence that the person is still alive. It is normal, however, to deny certain aspects of death.
What are the causes and risks of the condition? 
Unresolved grief may contribute to higher rates of depression, anxiety, and other psychological disorders. Abnormal grieving is more likely to occur in difficult circumstances, such as multiple losses within a short period of time.

What can be done to prevent the condition? 
A person can help prevent abnormal grieving by seeking help from a health care professional if the grieving process continues. Family and friends can help by being supportive of the grieving person, and listening to him or her.

How is the condition diagnosed? 
Abnormal grieving is diagnosed when a person shows the above symptoms following a loss.

What are the long-term effects of the condition? 
The death of a child or spouse normally involves a longer grieving time. It is not unusual for survivours to grieve over this kind of loss for the rest of their lives. Some people are not able to get on with their life following a loss.

What are the risks to others? 
There are no risks to others. However when a person is not able to complete the grieving process, he or she may not be capable of showing love to others. An example would be a parent who has lost a child, and still has other children. The other children may be neglected.

What are the treatments for the condition? 
The goal of treatment for abnormal grieving is to identify and help resolve any difficulties that prevent the person from completing the tasks of mourning. Grieving is considered to be complete when the person is able to experience pleasures, take on new roles, and look forward to new events. Occasional feeling of sadness may remain, but memories of the deceased no longer cause physical responses of sorrow or pain.

Psychotherapy may be needed if a person is not able to complete the grieving process. Medication such as antidepressants may be helpful. There are many support groups available for people who have lost a loved one.

What are the side effects of the treatments? 
Side effects are specific to the medication used, if any.

What happens after treatment for the condition? 
Hopefully, with treatment, the person will be able to work through the grieving process. The person should be able to find happiness in life again.

How is the condition monitored? 
A person may need to continue with psychotherapy for a period of time. Family and friends can help monitor abnormal grieving by checking on the person frequently, and being there to listen as needed.

Author: Ann Reyes, Ph.D.
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 25/04/2005
Potential conflict of interest information for reviewers available on request

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