Persistent Complex Bereavement Disorder – I Hate February

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I Hate February

I hate February. I didn’t always hate it, but I do now. In technical terms, the reason I hate February is because grief suck. Yes, very technical. My mom died a while ago, when I was younger, in February, which just happens to be the month she was actually born in. Ironic, right? I have been struggling with her departure for a long time. In the stages of grief, I am still in between the stages of Depression and Acceptance. And because I haven’t actually ‘moved on’ from her death, every death after hers is also stalled.

In order to help myself, and maybe help someone else, I want to talk about the mental and emotional toll that prolonged grief can bring. Not so much for the person going through the grief but for the people who are trying to understand why someone can grieve for so long, and what they can (and can’t do) to help.

I lost my mom, my best friend, both of the only grandparents I knew, and most recently, my brother, all in February. Three of those deaths happened in the same year. One being a suicide. And, my brother died on the same day that we had had my mother’s funeral. It’s an emotional month. The song, “Wake Me UP When September Ends” runs through my mind when February starts; I just wait out the tumultuous storm called February until it is over.

Introduction

Persistent complex bereavement disorder is a diagnosis given to those who have an unusually prolonged response to grief. It causes an extreme longing for the deceased loved one that is debilitating to the sufferer’s daily living.

The main difference between grief and bereavement is that bereavement is considered to be the literal term for the period of time in which grief is experienced. In this time, someone goes through the different stages of grief, sometimes bouncing back and forth between the stages. Emotions run high and low with shock, sadness, and numbness which can cause depression, anxiety, bad dreams, guilt and exhaustion, among so many other feelings. With people who have persistent complex bereavement disorder, these symptoms are severe, intense, distressful, and lasts far longer than anyone could anticipate.

Prolonged Grief

There is an unshakeable grief that does not improve over time but rather becomes persistent and constant. This grief can impair different areas of functioning. Mostly, it’s the obsession of the deceased person or people. It’s the inability to accept the death, finding it difficult to continue living, numbness and refusal to feel anything. For me, I become defensive and I turn away from being comforted. If I become sad or angry regarding any memory or thought of someone I lost, I do not want to be held or shown sympathy. The numbness helps me to move past the memory that entered my mind thereby not actually dealing with the death (in my case, deaths).

I also avoid places and things that remind me of my loss, as well as ruminate over how I could have saved any one of them; how their deaths could have been avoided had I done something differently. I also still blame others as well as myself in their deaths. This is very typical for people with persistent complex bereavement disorder.

Who is Susceptible

Persistent complex bereavement disorder can affect people who have lost someone through a sudden and violent death. This would be like getting shot during a robbery or getting killed by a drunk driver. This is not just sudden and violent but, without any preparation, the living has to go back to the home where everything is just as it was left. When my best friend died suddenly, he was living with me and I couldn’t go back to the house. I literally had to move.

Sudden and violent deaths also include suicide. Although the person who takes their own life had been thinking about it for a long time. They had time to put their affairs in order, or at least prepare themselves. However, if there are no real signs of serious depression or persistent sadness, other people are struck with the suicide as a sudden or impetuous act. When my best friend took his life, it was sudden for all of us and even though I had not had a degree in psychology yet, I still feel that there was something I could have done which I did not.

People who have lost a child are also susceptible. You should never bury your child. This is probably the worst, absolute worst thing that someone can live through. Literally, a piece of you is gone and it’s the hardest to live through. Most deaths linger, even if just a tiny bit, in everyone who has lost someone. However, a parent who loses a child never regains a full life again.

There are also people who lose more than one person at a time, like a home invasion that kills your brother, your sister-in-law and your nieces and nephews. It’s hard enough to mourn the loss of one person that you love; image losing several at one time. Bereavement, I think, should last longer in this case. You need that extra time to grieve for each person, individually.

Then there’s survivor’s guilt. This is when you are in a car crash that kills everyone except you. Or surviving a school shooting when most of your friends were killed. This kind of guilt also will take more time because not only are you dealing with your own traumatic experience, but you also need to grieve at the same time.

In my case, it is the loss of someone I love followed closely in time with someone else that I love. Then, followed again by yet another and then another. Grieving for someone who meant so much to you breaks your heart and tears apart your life; you can’t sleep, can’t eat, and can’t stop crying. Once I got through the first stage of grief, I had to start over with the next death. I basically stayed stuck in the grieving process. Psychologically speaking, I am in prolonged and complicated grief.

I know that I am ‘stuck’ because I ignore and numb the memories of those that have left me. Even in writing this post, I notice that I write ‘love’ and not ‘loved’ as in I still love them as if they were still here, not loved them (past tense) as if they are actually gone. The only real time that I feel great sadness and grief is during this month and on Mother’s Day.

Symptoms

Watching someone grieve is difficult especially if you do not or did not know the person that had died. However, generally speaking, most people go through what is called simple grief (although I hate this term because no grief is simple). Through time, sometimes counseling, and support, the painful and debilitation symptoms of grief are short-lived and mostly get resolved in a matter of time so that the griever can get on with their life.

Persistent complex bereavement disorder is described and characterized by grief that causes severe and intense distress along with symptoms that impair judgement and major areas of daily functioning.

Those suffering from persistent complex bereavement disorder become so debilitated with grief that the symptoms become chronic and either never get better or they get worse. The following list are symptoms that are in extreme and for a long period of time. You can see these symptoms in simple grief; however, again, if they are in extreme or for a long period of time, the sufferer may have persistent complex bereavement disorder:

  • Intense and indefinitely longing for the deceased
  • Detachment, numbness, isolation
  • Inability to accept the passing
  • Extreme focus on the deceased; shrines or continual reminding
  • Anger, bitterness, irritability
  • Unable to enjoy any aspect of living
  • Inability to believe they will be loved again
  • Deep sadness, depression, sorrow
  • Withdrawal from social/occupational living
  • Trouble with daily functioning
  • Constant and consistent crying/loneliness and emptiness
  • Life no longer has a purpose or meaning
  • Suicidal tendencies
  • Severe and constant preoccupation of circumstances surrounding the death

Living with persistent complex bereavement disorder

People suffering from this disorder have a lot of adverse effects on behaviors, moods, relationships and overall functioning. Prolonged grief can manifest differently depending on the individual person. Some people get so obsessed and preoccupied with the deceased that they create feelings, emotions and even the ailments that the deceased had. Others surround themselves with the loved ones’ possessions and lose sight of the living.

Others could have a completely different response, avoiding any and all reminders of the deceased. Foregoing social activities or places that would remind them of their loved one. This would include the avoidance of going to the gravesite, the place where the person died, and even people and mutual friends. There can also be an avoidance of any foods, smells, textures, etc. that would remind the senses of the deceased. This is my way of living with my grief. I spend eleven months doing just this. Only in February do I expose myself to my grief. Thankfully, it’s a short month.

Then there are those who are in a continual state of missing; so much so that they have a growing desire to be with their deceased loved one. They become preoccupied with the thoughts of suicide and with the thoughts of seeing their loved one again. This, of course, is the most traumatic and dangerous way to live with this disorder.

What to do

There are many types of therapies that can help someone with persistent complex bereavement disorder. Worse thing to do is to tell someone to get over it, or that it’s been long enough. When my mom died, the person closest to me tried to get me past the grief when it had only been a few weeks. Needless to say, that person is no longer in my life.

The grieving process is different for everyone and it needs to be worked out by the griever, in their own time. However, it can become a problem and there are ways in which to help. Finding hope and meaning and trying to get someone re-engaged in life sometimes takes professional skill to accomplish. Also, if you push too hard or are not supportive in the way that the griever needs you to be, then they can feel even less important, less worthy, and can take their own life.

Treatment and therapies

Unfortunately, there is no surefire way to cure persistent complex bereavement disorder. There are ways that work for some people and there are ways to manage the symptoms in others. This would include medication, therapy, or a combination of the two.

Medication that could help would be antidepressants and/or anti-anxiety drugs. These can help to manage the wide range of depressive symptoms, anxiety that can trigger suicidal tendencies, and can moderate mood swings. However, medication will not work alone.

Cognitive behavioral therapy is used a lot in order to help modify the way a person thinks and behaves. For persistent complex bereavement, this type of therapy works through irrational thoughts about a person’s loss. “Death is the absolute end of anything and it’s an intolerable experience.” Cognitive behavioral therapy can help a griever find significance and meaning in the life of the person who died, making their death not an absolute but rather a purposeful stamp on someone else’s life. The mourner doesn’t need to let go of the person who has passed away but rather learn to celebrate their life by continually living theirs.

Death is looked upon as not just the end of the deceased life but also the end of the person who meant the most in yours. This therapy helps to open up the close-ended thoughts about life and death, giving the griever thoughts and ideas of what life was for the deceased and what kind of life the deceased would want for the griever.

Exposure therapy for persistent complex bereavement disorder can help the sufferer become ‘unstuck’ in the grieving process. This is by not concentrating on the person that died but rather exposing the people and things that are actually still around. Exposing family, friends, hobbies, work, and the future to the griever can help to re-engage them to life. In this process, there is a slow removal of the things that bring upon the sadness of the death.

Meaning therapy is a way to help the griever make sense of the loved one’s death. Finding meaning in a person’s death can be difficult to do, especially if it was sudden or violent. However, this type of therapy can help a griever who lost someone who was suffering from cancer or had heart disease. Giving meaning to a death can help the griever learn to accept the death and help bring meaning to those surrounding them.

Complicated grief therapy is a relatively new therapy that is being used but is still also being studied. This is where the grief is the forefront of the treatment process. The therapist and the griever focus on the deceased and the grief, concentrating on the emotion of loss. While doing this, the therapist also strives to help the griever find their own personal strengths in order to use them to balance out the weaknesses felt through grief. There is a reevaluation of personal and professional relationships as well as finding the joy in life surrounding the sufferer.

Journal and poetry therapy is used in a wide variety of ways. This is generally used in conjunction with other therapies. In writing, we are able to sort of escape the life we are actually sitting in and be in a world that we create. Journaling is a way for us to scream, yell, fight, and cry in a fulfilling way. Although people who are grieving want to scream and yell and hit something, we can’t in actuality. We can, however, write about it and be as descriptive as we actually feel. Poetry works the same way just more so for people who have difficulty just talking about screaming; poetry is our screams and our blood and tears.

Conclusion

As with any disorder, a sufferer can become more functional with the right treatment and support. Through understanding what is it that can truly matter in a person’s life, someone suffering from persistent complex bereavement disorder can find their condition improved, with the reduction of the severity of symptoms over time.

What does this mean for me? I am going to make a category of Poetry Therapy where I will post poetry that I write that can help me with my grief. I also think sometime this month I will visit the grave sites of those that I lost. And as I type this, I am getting a lump in my throat and a tightness in my chest. I have never been to any of the grave sites; maybe it’s time. Or, maybe I’ll just continue to hate February.

 

 

 

 

2 comments

  1. I’m saving this post. The information is invaluable. I’m so sorry you’ve had so much loss in your life so far. I lost two close family members in the last three months and the pain is agonising. I know over time I’ll come back to your post to read more where I am at and keep an eye that my grief doesn’t turn into prolonged grief!

    Like

    • Although I have had experience in grief, I still find it difficult to express how my heart aches for you. I wish that there was something more that I could say to make this easier or better. Although there is no guaranteed way in which to successfully grieve in the shortest amount of time, there are some safeguards I would like to extend to you. First and foremost, make sure that you have support. Reach out to anyone who has offered their help. Also, talk about the people you have lost and let the tears fall as you remember the times you shared. Let yourself feel the whole gamut of emotions that accompany grief so that you don’t become stuck in the grieving progress. My thoughts are with you.

      Like

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