The relationship between Post-Traumatic Stress Disorder (PTSD) and grief is intricate and complex. These two emotional states are often experienced in tandem, especially following significant traumatic events or losses. Together, they form a powerful duo that can profoundly affect an individual’s psychological health and daily functioning. Yet, despite their frequency and impact, the connection between PTSD and grief remains poorly understood by many.

Understanding the relationship between PTSD and grief can significantly influence treatment and recovery approaches. When left unidentified or misunderstood, these interconnected conditions can amplify each other’s effects, complicating the healing process.

Understanding grief

Grief is an intense, complex emotional response that follows the loss of a loved one, a relationship, a job, or any significant aspect of one’s life. It is a universal experience, yet unique to each individual, with no set timeline or one-size-fits-all process. The intensity of grief can vary depending on personal circumstances, cultural practices, and individual belief systems. One widely accepted model to understand grief is Elisabeth Kübler-Ross’s five stages of grief. The stages, which often overlap and recur in no particular order, are denial, anger, bargaining, depression, and acceptance.

Denial is the initial shock and disbelief at the loss. Anger sets in as the reality of the loss sinks in and can be directed at oneself or others. Bargaining is a stage where individuals might make promises or deals in the hope of reversing the loss. Depression is a period of intense sadness, while acceptance does not mean happiness but a form of coming to terms with the new reality. It’s essential to remember that these stages are not linear, and individuals may not go through all the stages or in this particular order.

Grief’s impact on mental health can be profound. It can lead to conditions like depression, anxiety, and even Post-Traumatic Stress Disorder (PTSD). This occurs when the intense feelings associated with grief persist for an extended period and begin interfering with daily life. While grief is a natural response to loss, when it extends into complicated grief or persistent complex bereavement disorder, it may result in significant emotional pain, intrusive thoughts, extreme focus on the loss, and difficulty engaging in daily activities.

Grief can also have a physiological impact, such as changes in appetite and sleep patterns, which can, in turn, affect mental health. In severe cases, grief can lead to suicidal thoughts or actions.

A traumatic event, such as the sudden death of a loved one, a natural disaster, war, or violence, can trigger both grief and Post-Traumatic Stress Disorder (PTSD). Grief arises from the loss associated with the event – the death of a person, the loss of a home, or a sense of safety, for instance. It is a natural response to losing someone or something that is important to us. PTSD, on the other hand, is a psychiatric disorder that can occur following the experience or witnessing of life-threatening events.

The triggering of both grief and PTSD can happen simultaneously because the traumatic event is both a source of immense loss (leading to grief) and intense fear or helplessness (leading to PTSD). While grief focuses on the pain of loss, PTSD centers around the terror of the traumatic event, often characterized by symptoms like flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event.

The interaction between PTSD and grief can complicate the grief process significantly. For example, one of the primary tasks of grieving is to remember and make sense of the loss. However, for someone with PTSD, the memories associated with the trauma might be too distressing, leading to avoidance behaviors. This avoidance can interfere with the natural grieving process, as the individual might suppress memories or emotions related to the loss to avoid the traumatic aspects tied to it.

Additionally, the intrusive symptoms of PTSD, such as flashbacks and nightmares, can cause a person to repeatedly relive the traumatic event, which can intensify feelings of grief and make it difficult to reach a place of acceptance or find any sense of closure. In other words, PTSD can keep an individual stuck in a cycle of grief and distress, making it harder to progress through the stages of grief.

Moreover, the hyperarousal symptoms of PTSD (like feeling ‘on edge’ or experiencing sleep difficulties) can exacerbate the physical and emotional exhaustion that often comes with grief, making it even more challenging to cope with the loss.

While grief and PTSD can have overlapping symptoms, several unique signs may indicate the presence of PTSD in a grieving individual. Here are some key indicators to look for:

• Having frequent intrusive memories.
• Avoiding people, places, activities, or thoughts that remind you of the traumatic event, including those related to the loss.
• Feeling alone, feelings of hopelessness, and negative thoughts about the world.
• Memory issues, especially related to the traumatic event, or feelings of detachment or estrangement from others.
• Being easily startled or frightened, always on guard for danger.
• Sleeping issues like insomnia or nightmares.
• Irritability, angry outbursts, or aggressive behavior.
• Feelings of guilt, shame, or self-blame, especially if the traumatic event involved a loss of life and you feel responsible.
• Feeling detached or disconnected from your surroundings.

It’s important to note that these symptoms could be a normal part of grief for some people, but when these symptoms persist for more than a month, significantly impair functioning, and are not due to medication, substance use, or other illnesses, then it might indicate the presence of PTSD. If you or someone you love is experiencing these signs, seeking professional help is essential, as early intervention can greatly improve the prognosis for PTSD.

The risk of complicated or unresolved grief due to untreated PTSD can be debilitating. Therefore, it is important to address PTSD and grief in tandem; this can help in processing the traumatic event and finding healing from the loss that has occurred. Serene Health offers a wide range of behavioral health and mental health services to help those who are struggling with grief and trauma, including individual therapy, family therapy, and PrTMS. We also have online therapy through our Telehealth platform, so you can speak to a therapist online from wherever you choose.

Serene Health’s supportive team of mental health professionals can create personalized treatment plans that address the complexities of both grief and PTSD, providing the care needed to promote healing and growth. If you or a loved one are struggling with unresolved grief due to trauma, please get in touch with us for more information about our services. Call us at 844-737-3638 or visit www.serenehealth.com to book an appointment.