Persistent Complex Bereavement Disorder

If you have lost something or someone that meant something to you, you will grieve the loss. It’s ingrained in our DNA as living beings. It is the price we pay for love.

There is no getting around it. It’s a door you have to walk through in order to get to the other side. Some people claim that they never stop grieving, it just morphs into something softer like an old sweater that you know is unravelling but still feels familiar and is strangely comforting.

You fear that if you pull it out into the open too many times it may just fall apart and you’ll forget what it feels like, so you fold it up and test placing it on a shelf for a while until the feelings are so unbearable you walk around wearing an old sweater in the heat and people begin to stare. Family and friends stop calling because they don’t know how to help you and they feel embarrased and ashamed to admit it and this makes them feel powerless. This would be tragically sad if it werent so… ironic.

After about a year, if you still feel as if your head is in the clouds, and you’ve made robotic attempts at living, all the while still yearning for the deceased as though the loss were yesterday, you may be experiencing Persistent Complex Bereavement Disorder. It is defined in the Diagnostic and Statistical Manual of Mental Disorders fifth edition as continuing to experience sorrow and intense emotional pain; preoccupation with the deceased and the circumstances of their death on more days than not. It has been descibed as being emotionally numb, having difficluty with positive reminiscing about the loss with escessive avoidance of people, places and situations that may be a reminder and bring pain to you. Sometimes there may also be a desire to die in order to be with the deceased and feeling utterly alone in that process. Life may have no meaning any longer and trusting others to confide in is nonexistent. And if the breavement was due to tragic circumstances, such as murder or death by suicide, there may also be a preoccupation with the factors surrounding the loss.

Children also can suffer from the disorder. Unlike adults, children are usually more resilient when it comes to loss. After about six months (versus twelve in adults), they have usually accepted their life as it is as their new normal. Grieving in children will resurface at each holiday, birthday and anniversary, but will return to baseline and this should be expected into young adulthood. On the other hand, if after six months the child continues to express yearning in their play behavior and has marked difficulty accepting the finality of death, then they may also be experiencing the disorder. Younger children will avoid talking about their feelings regarding the deceased and older children may be preoccupied with them. The less the caregiving routine of children is disrupted, the better.

Increased and misdirected anger when someone speaks about the deceased, acting as if the deceased individual will be coming home, cooking meals for them or saving presents for them at holidays or auditory or visual hallucinations in adults may be present. This can occur at any age after 12 months of life. Grief responses are different, and usually occur at once after a loss. PCBD may be delayed months or in some cases years. Although this is rare, anyone experiencing these symptoms should get medical help immediately.

Pathologizing grief to some is unnecesary, however there are those that walk around in many, many shades of pain and are afraid to ask for help. Please don’t be. Death remains a mystery but to those of us left behind, it can be a great teacher if we learn to share in our grief. As much pain as you may be in right now while you are reading this, please know that there is someone else following right behind you and it may help them to know that you survived in spite of it.

PEACE.

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