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Hope for People Stuck in Grief

Program That Targets Long-Term Mourning Works Well, Study Shows

Setting Goals

Shear says her program merges some of the most effective treatments for depression and post-traumatic stress disorderpost-traumatic stress disorder but targets issues associated with death and separation.

In one exercise, patients carry on imagined conversations with their dead loved one, exploring unresolved issues. In another, patients talk in detail about their loved one's actual death and later listen to taped recordings of their musings.

"Once they hear themselves talking about it, the death does not stay so intrusive in their thoughts," she says.

In another exercise, patients were asked to think about specific personal goals that they would have if their grief was not so strong and to take steps to accomplish them.

"Standard bereavement counseling encourages patients to move forward with their lives after they start to feel better," she says. "The treatment we developed encourages people to move forward with their lives at the same time as they are dealing with the loss."

Medicalizing Grief

Over the course of the three-year study, 51% of the participants who got the targeted complicated grief treatment showed significant improvements, compared with 28% of those treated with more traditional psychotherapy. Patients who got the targeted treatment also responded much faster.

"Our treatment findings suggest that complicated grief is a specific condition in need of a specific treatment," Shear and colleagues write.

Virginia Eskridge is a believer. Although she was highly skeptical when she entered the program, she says the treatment has helped change her life.

"I still have occasional downtimes, but they don't seem to be centered around my husband like they used to be," she says. "They are more about just dealing with the day-to-day realities of life."

In an editorial accompanying the study, University of Chicago psychiatrist Richard M. Glass, MD, addresses concerns that the concept of complicated grief is simply "another example of the medicalization of various aspects of the human condition." In this case, mourning loss.

"The answer to the question 'Is grief a disease?' is 'sometimes,'" he writes. "The painful process of normal grief following bereavement certainly warrants sympathy and concern, along with the support of family and friends. Complicated grief warrants more research about effective ways to prevent and treat it."

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