Coronavirus has taken the lives of more than 130,000 Americans and it continues devastating communities across the nation. It has also drastically changed the way families and friends can grieve their losses—those lost to COVID-19 and deaths from other causes that are also continuing during the pandemic.

Physical distancing restrictions have meant that family and friends may have had only limited visits or no visits at all to their loved ones in the hospital. The pandemic has disrupted the traditional social and cultural rituals that help people navigate the process of grieving. Many funerals are being conducted remotely or with only a few people in attendance. The comfort normally provided by hugging or just being together is not available. Travel restrictions may also disrupt what would have been plans to visit with family members or honor a loved one.

The Center for Complicated Grief identifies other ways the COVID-19 pandemic may disrupt and make the process of grieving more difficult. The seemingly random nature of the illness and sudden unexpected death from COVID-19 can make it more likely that family members get caught up in the unfairness of it or have feelings of survivor guilt. Ongoing concerns about the spread of COVID-19 and ongoing limits on typical everyday activities and interactions may make it difficult to start to plan ahead and move forward with one’s life.

In a commentary in the American Journal of Geriatric Psychiatry, Joseph Goveas, M. D., of the Medical College of Wisconsin, and Katherine Shear, M.D., of Columbia University, write: “Though we are often heartened by human resilience in response to death and other hardships, for some, the burden of this pandemic will be too much.” They suggest that this will lead to an increase in people with more intense, longer lasting grief, or prolonged grief disorder. “The circumstances, context, and consequences of deaths during the COVID-19 pandemic comprise risk factors that will likely elevate rates of prolonged grief disorder,” they note.

Prolonged grief is different from the typical process of grieving and distinct from depression. It involves pervasive yearning or preoccupying thoughts of the deceased and grief-related emotional pain that cause significant distress or problems functioning lasting at least 6 months (or more than the timeframe expected by societal, cultural or religious norms). Among people grieving the loss of a loved one, an estimated one in 10 people will develop prolonged grief. 

Increased awareness of the risks of prolonged grief can help with more attention to prevention and better treatment. Goveas and Shear suggest mental health professionals can help individuals cope with the unique challenges faced during the COVID-19 pandemic and that effective treatments can be delivered via telehealth.

One type of therapy, complicated grief therapy, has been developed to help people coping with an extended and intense period of grief. This evidence-based therapy can help the person to understand and accept the grief, to live with reminders and to begin to plan for a meaningful future.(Read more.)

If you know someone who is struggling with the loss of a loved one, offer your support or just be there to listen. If you or a loved one is experiencing prolonged, intense grief, consider talking with a mental health professional.