Thomas Ramey Watson

When Grief Becomes a Disorder

As M. Katherine Shear, MD, professor of psychiatry at the Columbia University School of Social Work, puts it: “Grief is not one thing. It is a shorthand word for a complex, time-varying experience that is unique for each person and each loss.”

There is no timetable for the healing process. “In general, grief usually evolves over time from an acute form that tends to dominate a person’s mind to an integrated form in which the core features of sadness and yearning are much more subdued,” Dr. Shear says. When those feelings persist or intensify, the result may be a condition known as complicated grief or prolonged grief disorder (PGD). As much as 10 percent of all bereaved people experience complicated grief.

Complicated grief is marked by “broad changes to all personal relationships, a sense of meaninglessness, a prolonged yearning or searching for the deceased, and a sense of rupture in personal beliefs,” according to the American Psychological Association.

People with complicated grief often experience chronic sleep disturbances and disruptions in their daily routine. Studies have found that they are at increased risk for hypertension, heart disease, substance abuse, and suicidal thoughts. They may “try to avoid confronting the intense pain associated with the loss and this, paradoxically, ends up increasing the pain and interfering with the natural adaptive process,” says Shear, who is director of Columbia’s Center for Complicated Grief.

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