Unresolved Grief: What Causes It & How to Process

What Is Unresolved Grief?

Unresolved grief is a form of grief that remains severe well after a loss. It involves persistent longing for the lost one and difficulty accepting the loss. It causes significant emotional and physical symptoms that can become debilitating, often resulting in self-harm behaviors like self-isolation, poor self-care, and increased use of alcohol or drugs.

The closest psychiatric diagnosis to unresolved grief is prolonged grief. The American Psychiatric Association defines the diagnosis of prolonged grief disorder as someone who “experiences intense longing for the person who has died or preoccupation with thoughts of that person.”¹ It occurs most frequently in people who are experiencing guilt surrounding their grief or traumatic grief.

How Is Unresolved Grief Different From Regular Grief?

In a normal grief reaction, people experience a variety of overwhelming emotions, but over time, they can discuss their emotions and seek out the support they need. However, with unresolved grief, symptom severity incapacitates them, and they cannot come to terms with the loss and remain unable to cope. The yearning for the person who is gone persists or can grow even stronger.

Unresolved Grief Vs. Complicated Grief

The difference between unresolved grief and complicated grief is that complicated grief symptoms are more severe and often get worse, with an inability to accept the loss of a loved one.  In some instances of complicated grief, the bereaved may begin to experience suicidal ideation because the pain of losing a loved one is unyielding and overwhelming. People feel stuck with unresolved grief, and the symptoms are intense but eventually will begin to understand the reality of the loss and what it means. The bereaved eventually are able to re-engage in relationships and resume their normal daily activities.²

Symptoms of Unresolved Grief

Symptoms of unresolved grief include a persistent longing for the deceased, denial about the loss, bitterness over the death, and withdrawal from social activities. These symptoms significantly impair functioning and emotional well-being. The closer an individual was to the individual who passed, the more intense and persistent the grief symptoms will be.

There are also physical symptoms associated with unresolved grief. Extreme grief exhaustion occurs with the emotional flooding that co-exists with unresolved grief. People often struggle to sleep while grieving. Grief can cause headaches, body aches, muscle tension, and digestive issues.

Common symptoms of unresolved grief include:

• Denial: You are unable to emotionally accept the reality that the person has died.
• Self-harm: Self-harm behaviors increase as a way to stop grief symptoms. For example, you use alcohol or drugs to cope with the loss of your loved one.
• Self-isolation: You find it difficult to be around other people because you don’t want to discuss your loss or don’t want to hear what others have to say about it. You become emotionally unavailable.
• Lack of self-care: Negative changes in self-care behavior persist. For example, you sleep too much or are unable to sleep. You eat too much or forget to eat.
• Irritation: You remain bitter or angry about the loss of a loved one. You may feel angry at them for dying and leaving you alone.
• Inability to focus: You may find it difficult to concentrate or focus on anything for very long because your thoughts keep moving toward feelings and memories related to your deceased loved one.
• Self-anger and guilt: You may experience self-anger or guilt related to the loss because you erroneously believe that “you could have done something to prevent it.”
• Dissociation: For self-preservation purposes, you unconsciously become dissociated and emotionally numb from your feelings to help stop the pain related to the death of a loved one.

Who Is at Risk for Unresolved Grief?

Individuals who experience a loss that is unexpected are at the highest risk of developing unresolved grief because they have not had time to prepare themselves emotionally. Additionally, people who have never experienced a death in the past and children or young adults who do not have coping skills are at higher risk.

Risk factors for developing unresolved grief include:

• Age: Children and adolescents process grief differently than adults do.
• Social support: The amount of social support available to the bereaved can make a big difference. Those without social, family, spiritual, or religious support have a harder time coping with the challenges of unresolved grief.
• Mental health history: A pre-existing history of mental health conditions, such as depression or substance abuse, can increase the likelihood of being unable to grieve effectively.
• Attachment style: Individuals who struggle with attachment disorders are less likely to be able to cope with the loss.³
• Traumatic loss: Individuals are less likely to grieve effectively If the loss was particularly traumatic for the person, such as discovering the body or being told about the death in an unhealthy manner.⁴

Unresolved Grief From Childhood

When a child experiences trauma at a young age, they feel it more deeply because they are so vulnerable. Memories of this trauma can remain with them for a lifetime. This creates a greater risk factor for developing unresolved grief compared to adults.

How Can Unresolved Grief Impact a Person?

Unresolved grief can deeply impact a person’s life, leading to prolonged emotional pain and depression. Individuals experiencing unresolved grief often feel a strong sense of vulnerability, which can result in them self-isolating. Additionally, it can be hard to establish new relationships while struggling with the loss of a significant relationship. It is challenging to find new meaning in life, and it’s also hard to focus, which impacts work and school.

Over time, this can contribute to physical health problems, such as sleep disturbances and weakened immunity. Additionally, unresolved grief can trigger anxiety and exacerbate existing mental health conditions. If left untreated, it can develop into major depression, potentially trigger suicidal ideation, or create substance abuse issues.

How to Overcome Unresolved Grief

In order to overcome grief, an individual needs to stop denying the grief, learn how to identify their emotions, and develop coping skills to manage them. Coping skills can range from maintaining self-care to participating in activities that redefine oneself without their loved one. It is also important to address unhealthy coping mechanisms the person may have developed in order to heal entirely.

Here are eight ways to overcome unresolved grief:

1. Explore the Grief in Therapy

Many people find it difficult to overcome grief on their own. Working with a therapist who specializes in grief therapy offers many benefits. A major goal of grief therapy is to help understand and process the emotions you are feeling. There are universal feelings associated with grief, but people experience it in their own unique ways.

The other important aspect of grief therapy is it gives you a safe place to discuss your feelings. Many people don’t have people they can turn to and speak candidly about their bereavement. Once these emotions are revealed and identified, the therapist will begin to offer techniques to help you learn how to cope with your grief.

2. Acknowledge the Pain

Before you can begin to heal from unresolved grief, you must be able to allow yourself to feel and acknowledge the pain it has created. This is one of the most challenging aspects of coping with unresolved grief. The longer you internalize the feelings and symptoms associated with grief, the longer it will extend your bereavement period.

3. Journal About the Loss

Journaling about your loss and your feelings of grief can be a powerful tool to help you cope with the loss of a loved one. Putting your thoughts and feelings to paper is a safe way to process and understand grief. There are journaling apps like Bearable that can help with the process and give you tips about how to begin journaling.

Journaling can also have surprising physical benefits. Researchers have discovered that writing about emotions can help regulate mood. The act of writing about feelings and thoughts is a healthy way to release them, potentially causing lower blood pressure and relaxing the body.

4. Join a Support Group

Grief support groups can be a wonderful source of support, especially for people who are feeling isolated and alone with their grief. They offer a space where you can share feelings relating to your grief with people who have been through a similar experience. It helps to understand that what you are feeling with your grief is similar to what others have been through. Support group participants can offer compassion and understanding. They can also share insights and resources that may be very helpful to use as you try to move forward and build a “new normal.” You can participate in a support group online or in person.

5. Read Books Written by Others Who Have Experienced Loss

For many people, putting their experiences, feelings, and thoughts on paper can promote self-understanding and personal growth when trying to heal from a major loss. There are a variety of books on grief and loss. Readers can find inspiration in knowing there are ways to survive an experience that feels overwhelming and immobilizing. They may read experiences of others that can stimulate compassion and empathy as well. It helps give a person who is grieving hope that they can also overcome a devastating loss.

6. Talk to Trusted Friends & Family

If you are lucky enough to have family and/or friends in your life that you can turn to for support as you grieve the loss of a loved one, reach out to them. Identify people in your life who you know will listen to what you have to say without judgment. Just knowing that people will listen to you and care for you when you are in pain can be very comforting. Talking about the person who has died with people who knew that person can also be helpful. They may share stories, information, or insights you were not aware of.  This can help with your healing process. Not discussing your grief will keep it unresolved for a longer period of time.

7. Develop Grief Rituals

Grief rituals help to mourn and express grief. It is a way to remember the loved one who is gone. It honors their memory and your relationship with them. Examples include lighting candles or planting a tree or a garden. By engaging in these activities, the bereaved can externalize their grief, helping to move the intense emotions from the inside to the outside.

8. Find New Meaning and Purpose in Your Life

When a significant other has died, people often feel a loss of self and identity. This is especially true for caregivers, where that role becomes a prominent and all-consuming aspect of their lives. One way to release unresolved grief is to find something else to focus on that brings new meaning and new goals to attain.

People frequently find it helpful to devote themselves to a cause that is closely associated with the person who has died. For example, if a significant other has died from suicide, working on a suicide hotline. Another example is if the person who has died loved nature and the outdoors, working on projects to preserve the wilderness or planting and tending to a garden.

Treatment Options for Unresolved Grief

It can be difficult for the bereaved to overcome unresolved grief without outside help from a therapist. The goals of grief counseling are to help the person who is grieving understand, articulate, and process feelings related to their loss. The therapist will also provide coping skills to manage grief and help the bereaved identify new ways to connect with the person who has died.⁶

There are times when unresolved grief becomes debilitating and worsens. It can elevate to major depression and sometimes suicidal ideation when a person can’t imagine life without their loved one. In those scenarios, SSRIs like Bupropion and Escitalopram may be used within the treatment.

Treatment options for unresolved grief include:

• Narrative therapy: Narrative therapy gives people the opportunity to tell their own life stories to help define their experiences, beliefs, and values. This helps people feel more in control and shapes their self-narrative to be more positive and self-affirming.
• Psychodrama therapy: Psychodrama therapy has people act out past traumas and conflicts by assuming the parts of all the people involved. If you had conflicts with your mother, you might speak to yourself in ways you remember she would. You assume her persona. This process gives patients insights into the perspective of others and helps alleviate emotional pain.
• Cognitive behavioral therapy (CBT): CBT is a short-term therapy. It is based on the idea that negative behavior patterns are created by negative thinking. In therapy, thoughts are reframed into a more positive perspective, altering behaviors into a more desirable outcome.
• Group therapy: Participants in group therapy learn about grief and its symptoms and explore ways to cope. Group members share and learn from their personal experiences and challenges with grief.
• Mindfulness techniques: Mindfulness techniques like meditation and yoga can be very useful in terms of managing the physical and emotional pain that can be triggered by unresolved grief. Self-care in the form of mindfulness is often ignored while in the midst of grieving.

When to Seek Professional Support

Sometimes, grief does not subside, and the yearning for the person who has died continues or becomes stronger. It is not uncommon for people to struggle to imagine life without their loved ones. Unresolved grief may even grow into ideas about self-harm. In all of these scenarios, it is important to seek help from a mental health professional who specializes in grief therapy.

Therapy can be done in person or online. Consider which might be a good option for you and discuss it with the therapist you choose. You can find a therapist specializing in grief therapy in your area using an online therapist directory. There are also many available options in terms of online therapy services. If medication management is needed, an online psychiatrist service can offer assistance.