Complicated grief reactions require more complex therapies than uncomplicated grief reactions. Complicated grief is identified by the extended length of time of the symptoms, the interference caused by the symptoms, or by the intensity of the symptoms (for example, intense suicidal thoughts or acts). Some of the common problems of complicated bereavement are adjustment disorders (especially depressed and anxious mood or disturbed emotions and behaviour), major depression, substance abuse, and even post-traumatic stress disorder.
The American Psychological Association (APA), (1994) refers to abnormal grief reactions as “complicated bereavement”. It is complicated because of the intensification of the grief to such a level that the person is overwhelmed. They may therefore resort to maladaptive behaviour or remain in a state of grieving without progressing through the mourning process.
Normal and complicated mourning are on a continuum, with differences in intensity, time scale and effect. It is the extremes of these rather than their presence that indicate complicated grief. It is important that any grief counsellor is aware of this when supporting clients who are grieving.
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