Signs of Complicated Grief & Ways to Cope

by Janel Ruby, LBSW, & Janna Kontz, MDiv

We will all experience grief at some point in our lives. At its best, grieving is complicated. We may feel a variety of emotions when something in our lives has changed, been lost or has come to an end. 

It may be the death of someone important to us, but it could also be another type of loss, including:

  • Loss of independence because of aging or health concerns
  • A relationship ends
  • A job is done—whether by choice or not
  • A child moves on to college or to an even more adult venture
  • A beloved pet dies
  • We move to another community

All of these events can, and usually do, cause grief. When other emotions, life events or other people enter into our grief, it can become even more complicated. We can end up feeling stuck.

The Merriam-Webster dictionary defines “complicated” as:

  1. Consisting of parts intricately combined.
  2. Difficult to analyze, understand or explain.

Grief, by nature, can be both of these things.

When does grief become complicated grief?

Grief affects many aspects of a person’s life. It affects how a person feels, thinks, behaves—even what they believe. Grieving people can feel a range of emotions while also experiencing cognitive effects like being unable to remember simple things, and physical changes, such as fatigue and sleeplessness. These types of reactions are common and completely normal.

Most people who are experiencing normal grief will go through a period of sorrow, numbness and even guilt or anger. With time and personal growth, these feelings will gradually ease, allowing the individual to accept the loss and move forward.

However, some people experience grief that is more complicated. This is grief that sets in and does not fade over time, hindering the person’s ability to come to terms with a new normal. It is unknown what exactly causes complicated grief. But women can be 10 to 20 percent more prone to this type of grief if they are also dealing with other factors, such as multiple losses, high stress levels, pre-existing mental health conditions and/or substance use.

A list of signs and symptoms of complicated grief follow. Many of the same symptoms can be applied to “normal” grief, as well. If you are experiencing any of the following, please reach for help.

Signs & Symptoms of Complicated Grief

  • Focusing on little else but your loved one’s death
  • Feeling that life holds no meaning
  • Wishing you had died along with your loved one
  • Isolating yourself from others and/or withdrawing from activities
  • Having trouble carrying out normal routines

4 Strategies to Manage Your Grief

  1. Express your feelings – Talking about your grief and allowing yourself to feel and work through your grief can help prevent you from getting stuck in your sadness.
  2. Identify your support system – Ask for help and lean on others to help support you in your grief. Support from family, friends and your faith community are all good options. In addition, support groups can be a helpful place to connect with others who may have experienced a similar type of loss. Hospice of the Red River Valley offers monthly ongoing support groups for men, widows, pregnancy and infant loss, and more.
  3. Seek grief counseling – One-on-one grief counseling after a loss can offer you a safe place to explore your emotions surrounding your loss and learn healthy coping skills.
  4. Know when to contact a medical professional – Your doctor or a mental health professional can assist you. If you have thoughts of suicide, talk to someone you trust. If you think you may act on suicidal feelings, call 911 or the National Suicide Prevention Lifeline at 800-273-TALK.

Grief is a process that needs to be carefully worked through, and you are not alone. If you are feeling “stuck” in your grief for any reason, please call a trusted friend, a counselor, a clergy person or our grief specialists at Hospice of the Red River Valley. Call (800) 237-4629 and ask to speak to someone in the grief support department.

There is help. There is hope.

Janel Ruby and Janna Kontz are grief specialists with Hospice of the Red River Valley.

About Hospice of the Red River Valley
In 1981, Hospice of the Red River Valley was founded on the belief that everyone deserves access to high-quality end-of-life care. We fulfill our nonprofit mission by providing medical, emotional, personal and spiritual care, as well as grief support to our patients, their families and caregivers during a tender time in life. Our staff helps those we serve experience more meaningful moments through exceptional hospice care, 24 hours a day, 365 days a year, wherever a patient calls home. The organization serves more than 40,000 square miles in North Dakota and Minnesota, including in and around Bismarck, Detroit Lakes, Devils Lake, Fargo, Fergus Falls, Grand Forks, Lisbon, Thief River Falls, Valley City and many more communities. Hospice of the Red River Valley offers round-the-clock availability via phone, prompt response times and same-day admissions, including evenings, weekends and holidays. Contact us anytime at 800-237-4629 or


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