The general public lines up to say good bye to the late Tim Russert.

The general public lines up to pay tribute to the late television newsman Tim Russert in June 2008. Russert's unexpected death of a heart attack is the kind of traumatic death that may bring on complicated grief.

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Complicated Grief

In most cases, mourners pass through grief successfully, although the timetable varies significantly. In some cases, however, normal side effects associated with grief (the physical and emotional manifestations) can spiral out of control. Anyone experiencing or witnessing someone else experience the following symptoms for more than a couple of months should contact a professional for help: anxiety, sleeping problems, eating problems, abnormal social withdrawal, aggressive behavior, self-destructive attitudes, feelings of guilt or blame, or an inability to mention the deceased.

In recent years psychologists have begun to pay extra attention to the more severe manifestations of grief in an effort to tailor treatment plans specifically to the bereaved. In fact, the American Psychological Association (APA) estimates that 15 percent of bereaved people are at risk for developing "complicated grief." According to the APA, this form of grief is more severe than typical grief and is characterized by feelings of meaninglessness, changes in personal beliefs, exaggerated searching or yearning for the deceased, and marked shifts in personal relationships [source: APA].

Although little research has been published in this area, psychologists do believe that this type of extreme grief is more commonly associated with sudden and traumatic death situations or the death or loss of a child. Also, people who lose someone to whom they are extremely close and had a dependent relationship with are more likely to experience complicated grief. If left untreated, complicated grief can become a serious health threat to the individual. Some psychologists advocate a different type of counseling to help these patients through their grief. Rather than encouraging them to "let go" of their beloved, they should create and continue a lasting emotional bond with the deceased.

Similarly, psychologists also emphasize that normal grief is not considered a psychological disorder, as is depression. Professional help to treat possible depression should be sought if the bereaved experiences thoughts of suicide, preoccupation with death, severe feelings of guilt, decreased enjoyment in activities, inability to function or persisting feelings of worthlessness.

In some cases, traumatic situations can inhibit or block the grieving process altogether. This is most common when a person has lost a loved one suddenly, such as in cases of murder, heart attack or an accident. According to the National Institute for Trauma and Loss in Children, trauma and grief can be distinguished from each other by considering the following: Trauma feels unreal and terror is the most common resulting emotion, whereas grief feels real and is trademarked by sadness. Feelings of pain are common in grief, but trauma yields feelings of pain, helplessness and a fear of danger. Also, when grieving it's common to have dreams about the lost loved one; however, those suffering from trauma often have dreams where they themselves are in danger. If left untreated, trauma can become worse, whereas grief tends to run its course over time.

We'll look at some ways to work through grief on the next page.