What is meant by chronic grief?

This morning I entered the phrase ‘Types of Grief’ into Google and my search returned a surprising number of results. On the first page of results alone I found 10 different types of grief with 3 subheadings under ‘Complicated Grief’ and I thought to myself, “what the?!?” Who knew there were so many different classifications and titles?

I’m sure most people operate under the assumption that grief is just plain old grief! So with this in mind I have created a ‘Types of Grief Glossary’. Kind of like a wiki but less comprehensive and slightly more random. It’s just a reference tool so you can understand the different terms you may encounter as a griever.

You’re welcome!

Normal Grief

Hahahahaha…oh wait, you’re serious. Okay fine let’s talk about ‘Normal Grief’ by first clarifying there is no ‘typical’ or ‘average’. There are no timelines and grief experiences generally vary from one individual to another. ‘Normal Grief’ simply refers to a grief response that falls under an extremely broad umbrella of predictability.

Reactions to a loss can be physical and psychological. It is not uncommon to experience periods of intense distress and feeling such as (but not limited to) the following: longing, crying, dreaming of your loved one, anger, denial, sadness, despair, insomnia, fatigue, guilt, loss of interest, confusion and disorganization, disbelief, inability to concentrate, preoccupation with thoughts of your loved one, fleeting hallucinatory experiences, meaninglessness, withdrawl, avoidance, over-reacting, numbness, relief, sadness, yearning, fear, shame, loneliness, helplessness, hopelessness, emptiness, loss of appetite, weight gain. Right, I just listed every symptom to every disorder that’s ever existed. I’m sorry but grief makes you crazy.

However, ‘Normal Grief’ is marked by movement towards acceptance of the loss and a gradual alleviation of the symptoms, as well as the ability to continue to engage in basic daily activities.

Anticipatory Grief: (See our post on Anticipatory Grief) 

As its name suggests, ‘Anticipatory Grief’ is the reaction to a death you were able to anticipate such as when an individual dies from a long term illness. As soon as you accept and understand someone you love is going to die, you begin grieving.

Grief that occurs preceeding a loss can be confusing, as you may feel conflicted or guilty for experiencing grief reactions about someone who is still here. You may experience anger, loss of emotional control, and helplessness. You may also feel grief over the loss of things other than the individual, such as loss of hopes and dreams for the future and the loss associated with a changing roles and family structures.

‘Anticipatory Grief’ is different than the grief response felt after a death and does not necessarily make the later any easier. However, it can allow those who love the individual to slowly and gradually prepare for and absorb the reality of the loss. Also, for some but not all, it allows for meaningful time spent with the individual lending to a sense of closure and peace.

Complicated Grief

Refers to grief reactions and feelings of loss that are debilitating, long lasting, and/or impair your ability to engage in daily activities. Other types of grief such as ‘Chronic Grief’, ‘Delayed Grief’, and ‘Distorted Grief’ all fall under the blanket of ‘Complicated Grief’.

Although the concept of ‘Complicated Grief’ is well known and generally accepted, it’s not without its detractors. There are some who believe ‘Complicated Grief’ is simply the manifestation of grief reactions combined with other mental disorders such as Depression and Anxiety.

Chronic Grief

Strong grief reactions that do not subside and last over a long period of time. Continually experiencing extreme distress over the loss with no progress towards feeling better or improving functioning.

Delayed Grief

When grief symptoms and reactions aren’t experienced until long after a persons death or a much later time than is typical. The griever, who consciously or subconsciously avoids the reality and pain of the loss, suppresses these reactions.

Distorted Grief

Extreme, intense, or atypical reactions to a loss – odd changes in behavior and self-destructive actions. Anger and hostility towards oneself or others are common.

Cumulative Grief: (See our post on Cumulative Grief) 

When one experiences a second loss while still grieving a first loss.  This is also referred to as “bereavement overload” or “grief overload”.

Prolonged Grief 

(Similar to ‘Chronic Grief’) Grief reactions that are prolonged and intense. The griever is incapacitated by grief and daily function is impaired on a long-term basis. The griever spends much time contemplating the death, longing for reunion, and is unable to adjust to life without the individual.

Exaggerated Grief

An overwhelming intensification of normal grief reactions that may worsen over time. Characterized by extreme and excessive grief reactions possibly to include nightmares, self-destructive behaviors, drug abuse, thoughts of suicide, abnormal fears, and the development or emergence of psychiatric disorders.

Secondary Loss: (Check out our post on Secondary Loss) 

When a loss impacts many areas of one’s life, creating multiple losses stemming from the “primary loss”.  Though it is easy to think our grief is solely the grief of losing the person who died, our grief is also the pain of the other losses caused as a result of this death.

Masked Grief

Grief reactions that impair normal functioning however the individual is unable to recognize these symptoms and behaviors are related to the loss. Symptoms are often masked as either physical symptoms or other maladaptive behaviors.

Disenfranchised Grief: (Check out our blog post here.)

One’s grief is ‘disenfranchised’ when their culture, society, or support group, make them feel their loss and/or grief is invalidated and insignificant. This can occur when the death is stigmatized (suicide, overdose, HIV/AIDS, drunk driving), the relationship is seen as insignificant (ex-spouse, co-worker, miscarriage, pet), the relationship is stigmatized by society (same-sex partner, gang member, partner from an extramarital affair), the loss is not a death (Dementia, Traumatic Brain Injury, Mental Illness, Substance Abuse).

Traumatic Grief 

Normal grief responses experienced in combination with traumatic distress suffered as a result of a loved one dying in a way perceived to be frightening, horrifying, unexpected, violent and/or traumatic. Distress is extreme enough to impair daily functioning.

Collective Grief

Grief felt by a collective group such as a community, society, village, or nation as a result of an event such as a war, natural disaster, terrorist attack, death of a public figure, or any other event leading to mass casualties or national tragedy.

Ambiguous Loss: (See ‘Disenfranchised Grief’)

Losses that lack clarity and can lead to different views of who or what has been lost. Individuals and those around them may question whether a loss has occurred or if this is a loss that should validate deep emotional responses (such as with disenfranchised deaths).

Inhibited Grief 

Occurs when an individual shows no outward signs of grief for an extended period of time. The individual inhibits their grief, eventually leading to physical manifestations and somatic complaints.

Abbreviated Grief 

A short-lived grief response. The grieving process often seems shorter because the role of the deceased is immediately filled by someone/something else*, because there was little attachment to the deceased, and/or the individual is able to accept and integrate the loss quickly due to ‘Anticipatory Grief’.

*So, I was surprised to find the most common explanation for abbreviated grief was due to “replacement of the deceased such as with a remarriage”. What the what? I see what they are getting at and I suppose for a small faction of widows/widowers this could be true, but as a generalization this just seems ridiculous. Getting remarried after the death of a spouse is neither a ‘replacement’ nor the fast track to end your grief.

Absent Grief

This is when the bereaved shows absolutely no signs of grief and acts as though nothing has happened. Characterized by complete shock or denial, especially in the face of a sudden loss. This becomes concerning when it goes on for an extended period of time. This does not account for differences in how we grieve and it’s important to note that just because you can’t tell someone is grieving doesn’t mean they aren’t.

What is the meaning of chronic grief?

What is an example of chronic grief?

Is grief a chronic condition?

What are the 3 types of grief?