SIDS Program Manual SIDS & Infant Death Program Manual and Trainer's Guide Trainer's Guide

Bereavement Support Services

Complicated Grief

Complicated Grief

Before grieving can be labeled normal, disturbed or distorted, there must be an understanding of what the loss means to the bereaved and how their thoughts, feelings and actions attempt to cope with or avoid that loss.10

The distinction between the normal range of grief reactions and extreme reactions should always be made by a health care professional. Sometimes, family members may experience extreme reactions to their grief, called complicated grief. Screening and treatment for Post-Traumatic Stress Disorder (PTSD) may be needed for parents and children who have experienced a sudden death because they are at higher risk of traumatic stress and complicated grief.11

Referrals for mental health services might be necessary if a family member:

  • Indicates that he/she wants to kill himself/herself. Although many family members feel this way at times, someone who describes how, when or where he/she would commit suicide should be referred to a suicide prevention hotline or crisis intervention service immediately.
  • Fears that he/she will hurt, or confesses that she has hurt, their spouse or a surviving child. This situation also calls for immediate attention.
  • Seems continually anxious or depressed, especially if he/she tells or hints that he/she is unable to care for her home or family.
  • Continually uses alcohol or drugs—prescription, over-the-counter or illegal—to alter his/her mood, induce sleep or numb pain.
  • Says that he/she has, or appears to have, gained or lost over 25 pounds.
  • Frequently expresses relief or indifference over the infant’s death.
  • Continually blames him/herself or another person for the child’s death. Persistent relationship difficulties with spouses, surviving children or extended family members may also indicate the need for referral to professional assistance.

A single or occasional occurrence of most of these situations is usually not a cause for great concern. However, if repeated over a period of weeks or months, these reactions may indicate that a family member is experiencing complicated grief and might best be served by a medical or counseling professional.