Grieving is a healthy, but often painful emotional reaction to a loss. Abnormal grieving occurs when this reaction is prolonged, delayed, or otherwise unresolved over a long period of time. Grief is considered abnormal when it is accompanied by thoughts of suicide, or if there are psychotic symptoms, such as a loss of contact with reality.
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 behavioral reactions to an irrevocable loss. Grief usually lessens over time.
To adapt to loss, a person must complete four tasks:
Unresolved grief may contribute to higher rates of depression, anxiety, and other psychological disorders. Abnormal grieving is more likely to occur in difficult circumstances. It is more common, for example, when there are multiple losses within a short period of time.
A person with abnormal grieving may show many of the healthy signs of grieving. He or she may also show unusual behaviors. For example, a person who is grieving in a healthy manner may "hear" the voice of the dead person, but the episodes are brief and fleeting. Someone with abnormal grieving may continually "hear" the dead person's voice.
Abnormal grieving may last for an excessively long period of time. The person may show intense identification with the lost loved one. There may be a belief that he or she will soon die of the same cause as the loved one. The grieving person may insist that the loved one is still alive and show overly intense reactions in different situations.
Abnormal grieving is diagnosed when a person shows the symptoms listed above following a loss.
A person can help prevent abnormal grieving by seeking help from a healthcare professional. Family and friends can help by being supportive of the grieving person.
A person will often mourn the death of a child or spouse longer than other losses. It is not unusual for survivors to grieve over this kind of loss for the rest of their lives. Some people are not able to get on with their lives following a loss.
A person who is not able to complete the grieving process 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.
The goal of treatment 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 pleasure, take on new roles, and look forward to new events. Occasional feelings of sadness may remain. However, 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. Medicine such as antidepressants may be helpful. There are many support groups for people who have lost a loved one.
Side effects are specific to the medicine used, if any.
With treatment, the person usually will be able to work through the grieving process and find happiness in life again.
A person may need to continue with psychotherapy for awhile. Any new or worsening symptoms should be reported to the doctor.
Author:Ann Reyes, Ph.D.
Editor:Crist, Gayle P., MS, BA
Reviewer:Gail Hendrickson, RN, BS
Woman and Grief, www.estronaut.com/a/women_grief_mourning.htm
Principles and Practice of Psychiatric Nursing, 4th edition, Stuart and Sundeen, 1991