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Lindemann (1944), Lazare (1979) and Worden (2005) have identified numerous symptoms and behaviours that indicate unresolved / complicated grief. While many of the symptoms identified can be considered ordinary during the more acute earlier phase of grief, they are considered major signs of unresolved / complicated grief if they remain for unusually prolonged periods of time. 

Also, the more symptoms an individual exhibits, the more likely they are experiencing unresolved grief (Worden, 2005; Freeman, 2005). Some of the symptoms are listed below:
 
Lindemann’s symptoms

  • Over activity without a sense of purpose
  • Acquisition of symptoms belonging to the last illness of the deceased
  • Alteration in relationships with friends and relatives
  • Lasting loss of patterns of social interaction
  • Agitated depression with tension, insomnia, feelings of worthlessness, self accusation, obvious need for punishment and even suicidal tendencies
  • Furious hostility towards someone connected to the death.

Lazare’s symptoms

  • Unwillingness to move the possessions of the deceased even after a reasonable amount of time has passed.
  • A depressive syndrome to varying degrees of severity
  • Symptoms of guilt and self reproach, panic attacks and somatic symptoms
  • Somatic symptoms representing identification with the deceased, often symptoms of the terminal illness
  • A feeling that the death has occurred yesterday even though the loss took place a long while back
  • Inability to discuss the deceased without crying
  • Changes in current relationships following death
  • A history of delayed or prolonged grief

Worden’s symptoms

  • Inability to speak of the deceased without experiencing intense grief emotions
  • Unaccountable sadness during various times of the year
  • Self destructive themes
  • Radical changes in lifestyle
  • Phobias about illness or death
  • Over identification with the deceased leading to compulsion to imitate the dead person
  • A relatively minor event triggering a major grief reaction.
  • Exclusion of friends, family members or activities associated with the deceased.

References:

  1. Freeman, S (2005). Grief and Loss: Understanding the Journey. Belmont, CA: Thompson Brooks/ Cole.
  2. Williamson. J.B. & Shneidman, E. (1995). Death: Current Perspectives. (4th ed.). California: Mayfield Publishing Company
  3. Worden, J.W. (2005). Grief Couselling and Grief Therapy: Handbook for Mental Practitioners (3rd ed.). New York, NY: Springer Publishing Company.

This article is an extract of Mental Health Academy’s Complicated Grief professional development course.

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