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Co-Occurring Disorders:
Grief & Addiction

Grief is a very human tragedy, and most of us will face it in our lifetimes. While grieving is common life experience, that doesn’t make it easy to handle, especially for people in recovery from addiction.

What is grief?

Grief is the emotional response to the loss of someone with whom you felt a bond, such as family members, romantic partners, and cherished animals. Typically, (but not always) the severity of the grief will be impacted by how significant the person and relationship were in your life. When experiencing grief you may feel a range of overwhelming emotions from deep sorrow, sadness, anger, and even depression. Each person who grieves may experience the process differently.

People with a terminal medical diagnosis may also experience grief about their future loss of life and not being able to fulfill their dreams. Some may grieve the loss of a job, or of their mobility.

The process of grieving or mourning the loss of a loved one can take months to years. While it does get easier as time passes, for many the feelings of sadness and loss never really go away.

The symptoms of grief

Grief can manifest in a number of ways and will be different from person to person. There is no “right” or “wrong” way to experience grief. Generally speaking, the most common symptoms of the grieving process include:

  • Depression
  • Headaches
  • Insomnia
  • Feeling emotional
  • Appetite changes
  • Feeling numb or devoid of emotion
  • Irritability
  • Social withdrawal
  • Guilt
  • Fatigue
  • Digestive problems
  • Loss of pleasure
  • Feeling like you are not coping and/or overwhelmed by life
  • Substance misuse (sometimes referred to as substance abuse)

Those grieving may experience these symptoms together, or at different times, and they can recur after ceasing for a while. For example, you might struggle with getting to sleep and staying asleep for the first month after a loss, but then your sleep returns to normal. Six months later, you may experience insomnia again. Bottom line: there is no defined time period for the symptoms of grief.

The process of grieving

You may have heard of the “stages of grief,” which come up often in conversation and pop culture. These stages were proposed by Elisabeth Kübler-Ross in 1969 to describe what she saw patients going through as they were dying from cancer, and many have adopted them to describe all types of bereavement. In her grieving model, Kübler-Ross outlines the following phases of grief:

  • Denial
  • Anger
  • Bargaining
  • Depression
  • Acceptance

This is not a linear process. You may find yourself starting at depression and cycling back to denial. You may also experience some stages at the same time. It’s also important to note that these stages are descriptive, not prescriptive. There is nothing wrong with you if you don’t experience these stages. Grief is a very individual process.

Complicated grief disorder

In some cases, unresolved grief can lead to complicated grief disorder. According to the American Psychological Association, prolonged grief is described as a “pervasive yearning for the deceased” and is most common among those who have lost a child or romantic partner. It can also occur after sudden or violent deaths like a suicide, homicide, or accident. Around 1 in 10 people grieving will develop complicated grief disorder, which can have a detrimental effect on a person’s mental health. This type of persistent grief may require psychological intervention and treatment, and it carries the risk of prolonged substance misuse. If grief is impacting your ability to take part in life or is leading you to substance use, please seek help.

Grief and addiction

Those experiencing grief often turn to drinking and/or substance use to blunt their feelings and cope with their loss. However, continued substance use can lead to addiction. Additionally, long-term grief (complicated grief disorder), is a risk factor for developing substance use disorder, or for relapsing if a person is in recovery.

Research shows that people with complicated grief reported higher frequency of anxiety, depression, and PTSD, and those who already experience depression are at a higher risk of developing complicated grief compared to bereaved individuals who were not formerly depressed. There is also some promising research that shows a dual treatment for addiction and complicated grief lowered depression scores and symptoms of complicated grief, highlighting the need for co-occurring disorders treatment.

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