The indicators of complicated grief (as identified below) are also natural responses to loss and typical manifestations of grief. The term ‘complicated’ refers to factors that interfere with the natural healing process. These factors might be related to:

• Characteristics of the bereaved person
• The nature of the relationship with the deceased person or what has been lost
• The circumstances of the death or loss
• Things that occurred after the death or loss

Complicated grief often disrupts relationships with friends and family and makes the bereaved person feel cut off and alone. Complicated grief can mean that young people and families can find it difficult to function effectively or even to care about functioning.

The indicators that grief has become complicated are as follows:

• Strong feelings of yearning or longing for the person who died or for what has been lost
• Feeling intensely lonely, even when other people are around
• Strong feelings of anger or bitterness related to the death or loss
• Feeling like life is empty or meaningless without the person who died or what has been lost
• Thinking so much about the person who died or the loss so that it interferes with participating in valued activities or with relationships with other people
• Strong feelings of disbelief about the death or loss
• Finding it very difficult to accept the death or loss
• Feeling shocked, stunned, dazed or emotionally numb
• Finding it hard to care about or to trust other people
• Feeling very emotionally or physically activated when confronted with reminders of the loss
• Avoiding people, places, or things that are reminders of the loss
• Strong urges to see, touch, hear, or smell things to feel close to the person who died

Youth AOD practitioners should avoid diagnosing or labeling the grief of their clients as complicated but can help young people and families to recognise the signs and arrange for further assistance to be provided should it be required.

Grief that is profound and complicated might also be associated with traumatic experiences and the development of mental health problems such as depression and anxiety.

While the experience of grief following loss is natural and to be expected, practitioners concerned that young people have lost interest in their future or their own self care should conduct a risk assessment and follow organisational policies and procedures in making an appropriate response.