Dysfunctional grieving is a maladaptive emotional and behavioral response to loss. This is in contrast to the adaptive, normal or uncomplicated grief process, which progressively moves the bereaved towards healing and resolution. In dysfunctional grieving, excessive or prolonged dysfunctions in the grief response can lead to behavioral, psychosocial and physical problems.
Differences Between Normal and Dysfunctional Grief
According to the Journal of Psychosocial Nursing and Mental Health Services, dysfunctional grieving deviates from what is considered to be the normal process, intensity and duration of grieving. Because the severity, frequency and duration of symptoms in normal grieving vary widely between people depending on personal circumstances and culture, it might be sometimes difficult to decide when a person is suffering dysfunctional grief, according to an article that appeared in World Psychiatry (June 2009).
Symptoms of Abnormal Grief
The following can be present in dysfunctional grieving:
- Changes in your emotions, behaviors and thoughts are more exaggerated than expected. These changes may include sleeplessness, poor appetite, anger, rage, despair, depression, anxiety, self-blame, guilt and feelings of loneliness.
- You have difficulty moving out of your state of grief, your distress gets worse each day, and you are stuck, crying or pining over your loss.
- You experience emotional numbness for a prolonged period rather than the typical emotions and behaviors of normal grieving.
- Your grief response is out of proportion to your loss.
You withdraw from family and friends, work, school and other activities.
You engage in inappropriate or risky behavior.
You begin to drink alcohol in excess or misuse prescription or illegal drugs.
If the severity or duration of your symptoms begins to disturb your life and normal functioning, your grieving process is likely dysfunctional.
When Does Normal Grief Become Dysfunctional?
In general, experts say that normal grieving generally resolves in six months to a year. A 2007 Yale research study followed a group of mourners over one to two years. The researchers found that grief symptoms peaked by six months after a loss and then progressively decreased over the first year. Some symptoms such as depression tended to persist longer than others.
The six months to a year duration before grief is thought to be dysfunctional grief is only a guideline. According to an early grief expert's review in the American Journal of Psychoanalysis, defining a timeline for grieving is a simple matter. Some people may develop psychological or physical dysfunctions early. Likewise, many normally functioning people continue to have some symptoms of grief, such as yearning for a deceased for years or forever.
The Effects of Dysfunctional Grief
A delay in healing and resolution from the emotional and behavioral symptoms of normal grief can lead to health impairments. Based on a study in the American Journal of Psychiatry the following impairments can occur:
- Psychological disorders such as major depression or anxiety, suicidal thoughts and, less commonly, post-traumatic stress disorder (PTSD)
- Distorted thoughts and senses which might cause visual and auditory hallucinations (seeing and hearing things, including the deceased)
- Increased chance of chronic pain, headaches and weight loss or gain, as well as an increased risk for chronic illnesses such as high blood pressure, cancer, heart disease or stroke
These impairments may, in turn, lead to greater difficulty dealing with the grief.
World Psychiatry notes that there several risk factors that either influence or increase the risk for dysfunctional grieving and the degree and duration of the dysfunction:
- Circumstances of the loss, such as a violent or unexpected death with no time to say goodbye
- Nature of the relationship the person grieving had with the deceased
- Degree of attachment and dependency on the deceased
Underlying vulnerabilities such as stress, a behavioral or psychological disorder, or previous losses
Poor coping skills and poor resilience
- Lack of adequate family and social support
- Living alone
Treatment of Dysfunctional Grief
According to the American Psychological Association (APA), the goal of grieving is not about "letting go," as much as it is about creating a different, healthy connection that allows you to function well. The APA notes that intervening in the grief process too early can do more harm than good. However, if a person is struggling through a dysfunctional grieving process, therapy that helps build a griever's resourcefulness, coping skills and other strengths is more helpful than focusing on the negative symptoms.
Depending on the types and severity of symptoms the following therapies can help:
- Grief counseling - Grief counseling is supportive psychotherapy that helps someone to examine her feelings, thoughts and reactions and can help the person move towards resolution.
- Cognitive-behavioral grief therapy - This is a type of behavioral therapy that helps a person understand the reasons for her problems and how to cope with them.
- Pastoral or spiritual counseling - Counseling from your pastor or spiritual leader can be helpful to those who find comfort in religion, according to Harvard Health Publications.
A doctor may also prescribe antidepressants for symptoms of depression and anti-anxiety medicines as needed. Treatment should address the underlying reasons why you have difficulty resolving your grief and what you can expect from the therapy.
When to Seek Professional Help
Chances are, it is time to seek professional help if:
- Your grief reaction is making you feel unwell or unsafe.
- It is difficult to cope and function effectively.
- Your symptoms cause you to suffer for more than a year.
- You have thoughts of suicide.
- You have other symptoms of depression such as anorexia, insomnia, loneliness, despair, anger, or anxiety feel overwhelming.
- Symptoms that started soon after your loss are not progressively improving or are getting worse.
- You are drinking too much alcohol or abusing drugs.
Don't hesitate to ask for help if you recognize that your grief is not resolving, you are moderately to severely depressed and find it hard to function, you have thoughts of suicide, or you are abusing drugs or alcohol. Encourage a family member, friend or acquaintance to do the same if you believe their grieving is dysfunctional.