Traumatic grief is a term that describes when an individual is experiencing both grief and trauma at the same time. Grief is the experience of reacting to the loss of a loved one, while trauma is an emotional response to a terrible event that often includes a threat to someone’s life.1,2
What Is Traumatic Grief?
Grieving, while painful, is normal after a death. While distressing and overwhelming, one often experiences different stages of grief, and it begins to lessen in intensity and frequency over time. There’s no exact time frame to cope with a loss, but many experience decreased symptoms after 6-12 months, which continues to lessen over the next few years.7 In trauma grief, a traumatic event is often connected to the loss, making it more difficult to cope.
Some characteristics about a death can heighten the risk for a traumatic reaction, but all deaths have the capacity to terrify and overwhelm. Just because a death is understood as being traumatic doesn’t necessarily mean that it will traumatize a person, and vice versa.
A death may be considered traumatic if:3
- It occurs without warning
- It is untimely
- It involves violence
- There is damage to the loved one’s body
- It was caused by a perpetrator with intent to harm
- The survivor/griever regards the death as preventable
- The survivor/griever believes that the loved one suffered
- The survivor/griever regards the death, or manner of death, as unfair and unjust
- The survivor/griever witnessed the death
- The survivor/griever is confronted with multiple deaths
- The survivor/griever’s own life is threatened
Childhood Traumatic Grief
Just like adults, children grieve the death of a loved one in their own way and can experience traumatic grief after any type of loss. Childhood grief will differ depending on the age and cognitive development of the child, previous life experience, emotional health prior to the loss, and their support system.4
Traumatic grief symptoms in children can include:4
- Changes in sleeping and eating patterns
- Feelings of sadness, anger, anxiety, guilt, and self-blame
- Thoughts about the death
- Nightmares
- Bedwetting
- Regressive behaviors (acting in a younger or needier way)
- Avoidance of reminders of the loved one who died or the death experience
- Irritability
- Decreased concentration
- Difficulty in school
- Stomachaches
- Headaches
- Fears about their own safety and the safety of other loved ones
Common Symptoms of Trauma Grief
Symptoms of traumatic grief often include a combination of what’s typically seen with grief and trauma respectively. Everyone is unique and as such, no two experiences will be the same, but there are common or typical ways you may experience both grief and trauma.
Traumatic grief symptoms include:5
- Yearning or longing for the loved one
- Sadness or loneliness
- Disbelief, shock, and confusion
- Anxiety
- Anger
- Depression, despair, hopelessness or numbness
- Guilt or relief
- Thoughts or images of the loved one (grief hallucinations)
- Difficulty concentrating and forgetfulness
- Loss of identity, sense of self, meaning or purpose
- Feeling disconnected from others
- Changes in sleep or appetite
- Fatigue, muscle tension, headaches or aches
- Abdominal/digestive distress
- Palpitations
- Preoccupation with thinking about the deceased or intrusive images of the death
Symptoms of trauma include:6
- Anxiety
- Sadness
- Fear
- Anger
- Difficulty concentrating or thinking clearly
- Difficulty sleeping
- Continually thinking about what happened
- Flashbacks – reliving the experience through frightening throughs
- Nightmares
- Avoidance of places, people, or things that trigger traumatic memories and responses
- Isolating oneself from others
- Headaches
- Digestive issues
- Fatigue
- Feeling jumpy/easily startled
How to Cope with Traumatic Grief
When thinking of the ways to strengthen and build on your coping strategies, the first step is to start with compassion and empathy for yourself. After compassion, it can help to understand specific self-care and coping strategies. Take a moment and think about the ways you take care of your body, mind, and soul.
Here are areas to take stock of when coping with trauma grief:
- Physical health: nutrition, exercise, rest/sleep
- Mind-body: breathing, meditation, mindfulness
- Spiritual or faith-related traditions: finding or engaging in things that create meaning or purpose
- Social support:solace and connection from friends, family, or support groups
Traumatic Grief & Depression
Traumatic grief can turn into depression, or more specifically, major depressive disorder (MDD). This can include the following symptoms: depressed mood most of the time; loss of interest or pleasure in activities or sleep; appetite changes; feelings of worthlessness; difficulty concentrating; and recurrent suicidal ideation.9
In depression, the strongest feelings are an overwhelming sadness and an inability to feel happiness or pleasure. Depressive feelings often focus on yourself and others (not just the deceased loved one).
Traumatic Loss & PTSD
PTSD can include the following symptoms: recurrent, involuntary, and intrusive distressing memories; recurrent distressing dreams; flashbacks; avoidance of triggers or reminders; feelings of fear, horror, anger, guilt, or shame; hypervigilance, irritability, problems with concentration; and sleep disturbances.9
In PTSD, the experience is a reaction to witnessing or experiencing a traumatic event. Thoughts and behaviors are often focused on the trauma or distressing circumstances; you may avoid thoughts or situations that trigger or remind you of the traumatic situation.
Treatment for Trauma & Grief
Treatment for trauma grief should integrate elements of treatment for trauma and grief, starting by creating a sense of physical and mental safety.
Therapies to treat PTSD and traumatic responses include:8
- Cognitive behavioral therapy (CBT)
- Cognitive processing therapy (CPT)
- Cognitive therapy
- Prolonged exposure
- Brief eclectic psychotherapy
- Eye movement desensitization and reprocessing therapy (EMDR)
- Narrative exposure therapy
There’s less research on effective treatments for grief, partly due to the fact that grief isn’t a mental-health disorder.
For individuals who aren’t diagnosed with prolonged grief disorder (PGD) or another mental health disorder, here are ways to support the grieving process:
- Psychoeducation (education on the typical experience of grief)
- Commemorative services
- Peer or professional led support groups
- Strong social support network (friends, family, clergy, counselors)
- Implementing self-care practices
For those who meet the criteria for PGD, adaptations of cognitive-behavioral therapy that incorporate strategies from exposure therapy, cognitive restructuring, interpretive therapy, and interpersonal therapy have been found to be helpful.1
When to Get Professional Help For Traumatic Grief
Due to the fact that the term traumatic grief is not a recognized mental-health disorder, clinicians look more closely at the diagnosable conditions that individuals may be at higher risk for, including major depressive disorder (MDD), post-traumatic stress disorder (PTSD), PGD, and suicidal ideation.7,1
Wondering whether it’s time to seek professional help for complex bereavement, complicated grief or trauma grief? Ask yourself two questions:
- Does the intensity of my emotional pain overwhelm my ability to cope?
- Have there been any shifts in my experience since the death, or do I feel stuck even after months or years?
If the answer to either is ‘yes’ then a therapist trained in grief and trauma can probably help.
Start your search to find a grief counselor using an online therapist director. If you are having thoughts of harming yourself or others, it is imperative to get help immediately. Call 1-800-273-8255 (National Suicide Prevention Lifeline) 24/7 for free, confidential support.
Final Thoughts
What you are struggling with is unique to you, but you are not alone. Talking with a therapist, trusted friend or family member, or spiritual advisor can make a positive difference in how you feel. Don’t be afraid to reach out for more support.
For Further Reading
Traumatic Grief Infographics
