Grief is a universal human experience following significant loss, most commonly the death of a loved one. For most people, the journey of grief is intense at first but gradually eases as they adapt to life without the person who died. However, for some individuals, that process stalls or becomes deeply disruptive, resulting in what clinicians call complicated grief or prolonged grief disorder (PGD).
What’s Complicated Grief?
This condition is a severe and persistent form of despair that extends far beyond the typical mourning period and significantly impairs daily functioning. Most people experiencing a loss will have intense feelings of sadness, longing, or yearning early on, but over time these emotions lessen and individuals begin to reorganize their lives.
In contrast, complicated grief is defined by symptoms that don’t diminish over time and, for many adults, often persist for a year or more. This includes relentless yearning for the deceased, persistent disbelief about the death, emotional numbness, difficulty engaging in life, and preoccupation with the loss.
The American Psychiatric Association now recognizes PGD in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) as distinct from normal grief and other psychiatric conditions. PGD reflects intense emotional distress that remains maladaptive and interferes with daily functioning long after the expected period of adjustment has passed.
How Does Complicated Grief Differ From Other Types of Grief?
The grieving process isn’t a single, uniform experience. And while no one can really tell you how long it takes, some differences point to when someone is truly struggling with loss. For example:
- Normal grief involves sadness and adjustment challenges after loss, but over weeks to months, people gradually regain a sense of purpose and routine.
- Anticipatory grief occurs before an expected loss, such as during a prolonged illness.
- Disenfranchised grief refers to grief that isn’t socially acknowledged (for instance, loss of a pet).
However, as the Substance Abuse and Mental Health Administration explains, with PGD, the core issue isn’t the type of loss itself but the duration and intensity of someone’s emotional distress and dysfunction.
Unlike acute but short-term grief reactions that tend to evolve into integrated or resolved bereavement, complicated grief involves persistent, intense longing, avoidance of reminders, and rumination that prevents adaptation to the new reality of loss. For some people, these symptoms might resemble major depression or post-traumatic stress disorder (PTSD), but are conceptually distinct in that the focus remains primarily on the unrelieved grief response.
Why Might Complicated Grief Lead to Addiction?
For some people, the psychological pain of persistent loss feels unbearable. Intense emotions such as sadness, guilt, and emptiness may overwhelm one’s ability to cope, particularly when there are few supportive resources or strong coping mechanisms available. In these cases, alcohol or drugs can appear to offer a temporary escape or numbing of emotional distress.
But here’s an important note: addiction isn’t a choice. Many people who have never struggled with substance use before may turn to substances as a way to manage feelings they don’t know how to process. When grief is all-consuming and doesn’t diminish with time, the urge to self-medicate with alcohol or drugs to reduce emotional pain can increase—especially if warning signs like social withdrawal, anxiety, or depression are present.
There are several reasons why this happens:
- Emotional regulation challenges. Complex grief disrupts normal emotional regulation, making substances seem like a faster way to quiet distress.
- Avoidance coping. Drugs or alcohol can be used to avoid confronting painful thoughts or reminders of the loss.
- Biological stress responses. Chronic stress from unresolved grief activates brain systems associated with addiction, increasing vulnerability to substance dependence.
Why Dual and Focused Treatment Matters
When complicated grief and substance misuse co-occur, dealing with only one issue is often insufficient. Traditional addiction treatment that ignores unresolved grief usually doesn’t fully address the emotional drivers that contribute to substance use behaviors. Likewise, grief counseling that doesn’t consider addiction might miss the ways substances interfere with the grieving process and maintain maladaptive coping patterns.
Fortunately, integrated care models that focus on both PGD and substance use simultaneously can improve outcomes. Research suggests that grief-informed interventions reduce symptoms of the disorder and substance misuse, slowing the cycle of distress that fuels both conditions.
For example, clinical approaches that combine grief therapy with addiction counseling and motivational interviewing help individuals:
- Recognize and tolerate emotional pain safely.
- Develop adaptive coping strategies.
- Improve communication and social support.
- Reduce reliance on substances as a coping mechanism.
Discover Whole-Person Care at Willingway
Persistent, intense grief can drive people—even those without prior substance use issues—to seek relief through alcohol or drugs. However, compassionate, evidence-based care supports deeper healing, reduces harmful coping strategies, and improves overall mental health and quality of life. That’s what you’ll find at Willingway’s Georgia and Florida addiction rehabilitation locations. Our board-certified professionals help you find success in recovery not by erasing your past but by learning from it. Contact our admissions team today.