It's complicated

photo by Katharina Jung

I was told grief would come in waves; remain messy and untamed, and I should welcome it. It wouldn’t always feel this dark and heavy, but there wasn’t a timeline, and it wasn't a linear process. Mental health professionals didn’t give validation to the infamous “five steps of grief” anymore, so there was no pressure to evaluate myself. I should just feel it, talk about it, and know that it was normal.  

I am a people-pleaser by nature, but I was encouraged to let that go. Guilt-free, I released certain relationships, lay in bed when I wanted to, said no to social events, and sensed others tiptoe around my unpredictable, difficult self without a whole lot of apology.

I was grieving, and it was not pretty, but that was okay.

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Last year, (18 months after Agnes died), I sat in a new doctor’s office for a physical. My heart was racing for the very fact I was in a medical building for the first time since her death, but the doctor was also very pregnant, and the combination of those two things began to cause some panic. I started to cry, and told her I’d had a baby, and how old she would be had she been born with a functioning body.

After discussing what happened, our conversation took a turn for which I was not prepared for. She began to question whether or not my daughter’s death was interfering with my daily life.

I stared at her blankly, and then replied, “Of course.”

She took out her prescription pad, and suggested starting anti-depressants. The doctor, this woman with the round, pregnant belly told me it was okay I was still sad my baby died, but it was not okay I was affected by it every day.

Confused and offended, I went home and began to research. I came across the topic of 'complicated grief', which may have explained her response. In essence, complicated grief encompasses the exact feelings expected of normal grief. The difference between the two is that complicated grief is considered prolonged beyond 6 months to a year post-loss. In addition, it can involve some serious thoughts about harming oneself (I realize self-harm and suicidal thoughts require immediate attention, neither of which I have experienced). However, those thoughts aren't required for a diagnosis of complicated grief.

It turns out I’m a prime candidate. Most likely, so are you. The complicated griever tends to be young, female, and the death of their loved one was unexpected.

Rhonda O’Neill—pediatric nurse, grieving mother, and author of the book The Other Side of Complicated Grief—notes the increased risk for complicated grief as including:

• Death of a child or spouse
• Lack of family or social support
• Issues around how they found out about the death
• History of anxiety or depression before the loss
• The death was violent or traumatic

In addition, the following are some of the symptoms that can indicate your grief has shifted into complicated grief if you are still experiencing them six months to a year after the death of your loved one:

• Persistent and invasive thoughts of your loss that disrupt daily activities
• Avoiding or feeling consumed by reminders/memories of your loved one
• Unable to accept the finality of the death
• Intense yearning for your lost loved one
• Feeling angry about the death
• Feeling numb or confused, developing a loss of trust in others
• Isolating from others
• Suffering physical symptoms similar to that experienced in the deceased’s final illness
• Feeling that life is meaningless and hopeless without your loved one

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I was thankful to discover the issue and 'disorder' of complicated grief is a controversial one. Not all mental health professionals were in favor of categorizing grief as a medical condition. Grieving, they argue, is normal, healthy, expected, and there are too many variables at play to draw these lines in the sand. They argued we already exist in a get-over-it culture, where grieving is expected to be short, private, and tidy, and that cultural expressions of grief change throughout time, so our ideas of normal vary.

Nonetheless, complicated grief became a recognized, valid condition in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM). Now it's a thing, apparently.

For what it's worth, I didn’t take the anti-depressant. Eight months later, I did. I cannot say that it helped or hurt, or that it was right or wrong. I am sure I am many things alongside my grief; sometimes anxious, depressed, socially uncomfortable, angry, and difficult. I am positive these things have lasted well beyond six months to a year, and then lightened again, only to return. I have times where my relationships work, and I feel love and light, and times I feel dark and angry. In that respect, grief does come in waves, sometimes as fiercely as it did early on. Eventually, we just go on living with a sort of resilience about us; one that we find in our own way and time—at least, I hope. I think I have. 

I’m not sure if I am a normal griever or complicated griever, or what I think about it existing as a medical disorder. Maybe some will benefit from hearing about it. Maybe some will feel indifferent or angry, like I did.

But does my daughter’s death interfere with my daily life?

Absolutely. And it always will.

What do you think? Is there such a thing as 'normal' grief that 'doesn't interfere with daily life'? What, to you, is healthy grieving? How do you define your own boundary from healthy to not-healthy, from what you know of yourself? Most important: how do you protect your grieving space in a get-over-it world?