Sometimes grief lasts for longer than you expect. You might have difficult thoughts and feelings with it. Complicated grief is when strong feelings have a significant impact on your daily life for more than 12 months. It can help to understand your feelings and find out what support is available.
You may be reading this page because you’re worried about yourself or someone you know. If it would help to talk, you can contact our free Support Line on 0800 090 2309 or email support@mariecurie.org.uk.
What is grief?
When someone dies, many people have strong feelings. These might include sadness, shock, anger, guilt or relief.
Adjusting to life without the person takes a different amount of time for everyone. Many people have intense feelings that come and go for months or years.
Over time, these feelings usually become less intense or less frequent. You might feel worse around the time of important anniversaries or life events. And you might sometimes have a few difficult days or times when things seem overwhelming. But gradually most people will be able to take part in daily life again. This might include work, socialising, hobbies, home life and responsibilities.
Everyone needs support when they are grieving. You may need support from family or friends, a support group, or a professional, like a counsellor.
What is complicated grief?
Complicated grief is when strong feelings have a significant impact on your daily life for more than 12 months. These feelings stay intense or get worse over time. For example, day after day you may not be able to get out of bed, wash your hair, watch TV or go to the shops. See What are the signs of complicated grief? below for how you might feel.
You are not alone – around 1 in 10 (10%) of people experience complicated grief. It can be difficult to deal with. But, with the right support, you can find ways to cope better.
Complicated grief is sometimes called prolonged grief disorder, persistent complex bereavement disorder or traumatic grief.
What are the signs of complicated grief?
Complicated grief is different for everyone. You may relate to some things in this section, but not others. These feelings and experiences are a part of grief for many people. They could be signs of complicated grief when they do not go away and continue to affect your daily life.
These things can be signs of complicated grief:
- Strong feelings of pain, anger, loneliness, guilt, blame, relief, sadness, resentment or emptiness.
- An intense yearning for the person who died. You might think about them a lot or find it difficult to imagine life without them.
- Difficulty thinking about the person who died without feeling strong and negative emotions.
- Flashbacks or if you’re not able to stop thinking about difficult moments. For example, something that happened soon before the person died.
- Avoiding places, people or things that remind you of the person or their death. Or the opposite, thinking about the person all the time.
- Thinking negative things about yourself. For example, that you did not do enough or are not good enough.
- Not being able to take part in life. This might include work, socialising, hobbies, or home life and responsibilities.
- Not being able to look after yourself. For example, not caring for your own health, wellbeing or relationships.
- Feeling that you do not want to live without the person or want to die so you can be with them.
- Having suicidal thoughts or making plans for suicide.
If you feel you cannot cope with grief
You might find your feelings overwhelming. You may feel that you do not want to live without the person and have suicidal thoughts.
It’s not your fault you feel this way and help is available. At any point after your bereavement, it’s important to get support. You can contact the Samaritans on 116 123. You can also book an appointment with your GP or call 111 (or, in Northern Ireland, your out of hours GP service).
If you feel like you might harm yourself, call 999 or go to your nearest accident and emergency department.
Who is at risk of complicated grief?
Anyone can experience complicated grief. It's about the impact that your loss has on your life. You might find that other people with the same experience do not have the same reaction. We are all different.
The following things make it more likely that you'll experience complicated grief:
- You were very close to the person who died or if one of you was a carer for the other one.
- You had a difficult or strained relationship with the person who died. You might find you have complicated feelings including anger or resentment.
- Your mental health – if you’ve had depression, bipolar disorder, anxiety or post-traumatic stress disorder (PTSD). Many people experience complicated grief at the same time as these conditions.
- Your experiences – if you’ve had other losses or difficult experiences in your life.
- Your relationships – if you do not feel supported by or connected to family or friends.
- The person’s death – if you or they found it difficult to accept their illness. Or if their death was traumatic or sudden.
- Coronavirus – some people found dealing with grief hard during and after the pandemic. For example, if coronavirus affected the person’s care or visiting restrictions. Or if you had less support from other people.
Can children have complicated grief?
Yes, children and young people can experience complicated or prolonged grief. It can help to listen to how they are feeling and their understanding of what has happened. It’s important to get help from their GP or another professional. There are also organisations and charities who can help.
How is complicated grief diagnosed?
Complicated grief or prolonged grief is not always diagnosed.
A specialist (such as a counsellor or psychotherapist) may assess you. They may have a questionnaire or ask you more general questions. They might ask questions about the feelings and thoughts you have and how they affect your life. They may say that you have a complicated grief reaction or prolonged grief disorder.
Sometimes a specialist will diagnose complicated grief when grief is affecting your daily life longer than 12 months after the person died. But other times they will diagnose it from 6 months. It depends on how your feelings are affecting your life.
What is important, is that you are getting the right support.
What can help with complicated grief?
If you think you may have complicated grief, it’s important to get support. Everyone has different needs – what works for one person, might not help someone else. If you’re ready, here are some ways to get support:
- Contact your GP if your grief is affecting your mood and ability to cope with your daily life. See Your GP below.
- Contact the free Marie Curie Support Line on 0800 090 2309 to speak to someone about how you're feeling.
- Speak to a staff member or trained volunteer who can listen to what you're going through. See Bereavement support below.
- Contact a counsellor or psychotherapist if you need more help. See Counsellors or Psychotherapists below.
- You might not feel ready to talk to someone yet. You could look at online support groups or have a web chat with the free Marie Curie Support Line.
Your GP
Tell your GP why you think you might have complicated grief or prolonged grief disorder. They may be able to:
- assess your symptoms
- refer you to a specialist, such as a counsellor or psychotherapist, for support
- see if you have symptoms of depression or other conditions
- check any physical symptoms you are having
- tell you about support that is available in your area.
They may ask you questions about your thoughts and feelings, and the impact they have on your life.
Bereavement support
Some organisations and charities offer bereavement support:
- Marie Curie’s Support Line offers a free information and listening service on 0800 090 2309 or email support@mariecurie.org.uk.
- Marie Curie’s Bereavement Support Service provides a free telephone listening service from trained volunteers.
- Cruse UK and Cruse Scotland offer free bereavement support from a counsellor or trained volunteer.
- Your local hospice may have a free bereavement service you can access if they cared for the person who died.
The support these services can offer varies. If you need a higher level of support, they may not be able to help. But they can tell you about where else you can get the right support for you.
Counsellors or psychotherapists
Counsellors or psychotherapists can help you to process your feelings. They can help you find ways of coping. You can ask about their experience supporting people with bereavement and complicated grief.
To find a therapist:
- refer yourself through NHS talking therapies (see Self-referral for mental health support below)
- ask your GP to refer you
- access Sue Ryder’s online bereavement counselling service
- find a private counsellor or psychotherapist – search on the British Association for Counselling and Psychotherapy website
- ask your local hospice if they have a bereavement service that includes counselling
- see if your workplace offers free counselling.
These services are usually free, except for getting a private therapist.
Hospice bereavement services are sometimes only for people whose family member or friend had care from the hospice.
If you’re already seeing a therapist, tell them you might have complicated grief.
Self-referral for mental health support
If you live in England, Scotland or Wales, you can refer yourself for NHS mental health support:
In Northern Ireland, ask your GP to refer you.
These services may or may not have experience in supporting people with complicated grief. You can ask them what their experience is and how they can help you.
Support groups
It can help to talk to people you do not know but who have had similar experiences to you. This might be in person or online.
You can find a group by searching online or asking your GP surgery.
Talking with family and friends
It can help to think about who you can trust to share how you feel and who will listen without judging you.
You may feel like your family and friends do not understand what you’re going through. They may not be grieving in the same way as you. Everyone’s relationship with the person who died is different.
Sometimes people assume how you feel. For example, they might think you feel sad when actually you feel angry or relieved. If you had a challenging relationship with the person who died, this can be difficult for other people to understand. You may not feel like you can talk about how you really feel.
You might find yourself withdrawing from the people around you. They might remind you of the person who died. Or you might feel angry or frustrated towards them.
Many people experience these feelings. Try to find someone to talk to, whether it’s someone you know or a support line (see Bereavement support above).
Looking after yourself while grieving
It can be hard to look after yourself when you have complicated grief. It’s important to get support from any family or friends you have, or from a professional.
To look after yourself, you can:
- focus on giving yourself time to rest and sleep
- eat healthily when you can and ask other people to cook for you when you need it
- keep active when you can, even if it’s a short walk outside
- have a daily routine and set small goals like getting up, washing and having something to eat
- meet up with or speak to any family or friends who can support you.
Spiritual support
Spiritual support can help if:
- you're struggling to find meaning and purpose in life
- it's harder for you to find hope, peace, and comfort
- you're lacking a sense of belonging or connection
- you're questioning the things you used to believe were true.
You do not have to be religious to get support. You can speak to a hospital or hospice chaplain, a spiritual adviser, or a religious leader. They have experience helping people make sense of their thoughts.