Can children and adolescents experience complicated grief?

Yes, children and adolescents can experience what is clinically known as Prolonged Grief Disorder or complicated grief. Although grieving is a natural process following a loss, for some children and adolescents, it may take a more intense and persistent course that hinders their daily emotional and social development [4]. For more general information on this topic, you can read our article on Complicated Grief (Arabic).

How does the experience of grief differ in children and adolescents?

The response of children and adolescents to loss differs significantly from that of adults. Their experience of grief often appears in intermittent, short bursts; a child might display deep sadness one moment and then suddenly switch to playing or engaging in daily activities. This fluctuation does not mean the child has "gotten over" it or that they do not realize the magnitude of the loss; rather, it is a natural defense mechanism for the child's mind to protect itself from emotional pressures that may be greater than their ability to process all at once [1].

In cases of complicated grief, these symptoms become persistent and severe enough to disrupt the child's life. An adolescent or child may become excessively preoccupied with details surrounding the death of a loved one, or demonstrate a persistent sense of shock and disbelief, which causes them to feel detached from their surroundings or lose meaning in their daily life [4].

Diagnostic criteria for young people

There is a fundamental difference in the time-based criteria for diagnosing complicated grief between adults and children. To diagnose Prolonged Grief Disorder in children and adolescents, the loss of a close person must have occurred at least 6 months prior, whereas this duration extends to a full year for adults [4]. Additionally, the individual must suffer from persistent daily symptoms, such as constant emotional pain (anger, bitterness, sadness), identity disturbance (feeling that a part of the self has been lost), or avoidance of reminders of the deceased person in a way that affects their performance at school or with friends [4].

Steps for management and treatment

When there is a suspicion that a child is suffering from complicated grief, it is essential to have their condition evaluated by a mental health professional. Research indicates that Cognitive Behavioral Therapy (CBT) has proven effective in helping children and adolescents going through this experience, as it assists them in developing skills to manage negative thoughts and behaviors associated with the loss [4].

It is also important to provide a supportive environment at home. This includes speaking honestly about the death, answering the child's questions in age-appropriate language, and involving them in family rituals related to remembrance if it is comfortable for them [1]. Peer support groups that include others who have gone through similar experiences may also provide a sense of connection and reduce the intensity of isolation [4].

When to seek immediate help?

In some cases, grief may overlap with symptoms of clinical depression or develop into suicidal ideation. If you notice that the child or adolescent is suffering from prolonged hopelessness, talks seriously about wanting to join the deceased, or shows tendencies toward self-harm, this must be treated as an emergency [3]. Do not leave the child alone in these moments, and contact the nearest emergency department or call local mental health crisis hotlines immediately to obtain urgent professional intervention [3].

Medical references

• Grief, Bereavement, and Loss (PDQ®)–Patient Version
• Grief
• Psychiatry.org - Prolonged Grief Disorder