Loss, Grief, and Bereavement (cont.)

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What are the causes and risk factors of prolonged grief?

The risk factors for experiencing more serious symptoms of grief for a longer period of time can be related to the survivor's own physical and emotional health before the loss, the relationship between the bereaved and their family member or other loved one, as well as related to the nature of the death. For example, it is not uncommon for surviving loved ones who had a contentious or strained relationship, or otherwise unresolved issues with the deceased to suffer severe feelings of grief. Parents who have lost their child are at a significantly higher risk of divorce compared to couples who have not. They are also at increased risk for a decline in emotional health, including being psychiatrically hospitalized following the loss. This is a particular risk for mothers who have lost a child.

Bereaved individuals who either feel the death of their loved one is unexpected or violent may be at greater risk for suffering from major depression, posttraumatic stress disorder (PTSD), or complicated grief. Major depression is a psychiatric disorder characterized by depression and/or irritability that lasts at least two weeks in a row and is accompanied by a number of other symptoms, like problems with sleep, appetite, weight, concentration, or energy level and may also lead to the sufferer experiencing unjustified guilt, losing interest in activities he or she used to enjoy, or thoughts of wanting to kill themselves or someone else. PTSD refers to a condition that involves the sufferer enduring an experience that significantly threatened their sense of safety or well-being (for example, the suicide or homicide of a loved one), then re-experiencing the event through nightmares or flashbacks (feeling as if the trauma is happening again at times when the sufferer is awake), developing a hypersensitivity to events that are normal (for example, being quite irritable, getting startled very easily, having trouble sleeping, or difficulty trusting others), and avoiding things that remind the person of the traumatic event (for example, people, places, or things that the sufferer may associate with the death of their loved one). Being able to care for a dying loved one tends to promote the healing process for those who are left behind. That care can either be provided at home, in the hospital, or in hospice care. Hospice is a program or facility that provides special care for people whose health has declined to the point that they are near the end of their life. Such programs or facilities also provide special care for their families.

Medically Reviewed by a Doctor on 8/23/2012

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