For those stuck in debilitating grief after a loved one’s death, their condition can often be mistaken as depression. However, complicated grief is just as debilitating but otherwise exists as a different condition altogether. Those who suffer from complicated grief have intense yearning for the deceased that persists over time.

“They have difficulty comprehending the reality of the death,” said lead author M. Katherine Shear, professor of psychiatry at Columbia University School of Social Work.

These individuals may actually blame themselves for the deaths and shun places and activities that they once enjoyed together, according to Shear, who is also the director of the Center for Complicated Grief in New York City.

“They are caught up in thinking about the person who died, sometimes daydreaming about them,” said Shear.

Roughly nine percent of bereaved elderly women will suffer complicated grief. While some cases resolve spontaneously, others left untreated can cause major health problems.

Shear and colleagues report this week in JAMA Psychiatry that people who suffer from complicated grief respond better to a specially designed treatment approach that is different than standard approaches for treating depression. They looked at over 150 older adults suffering from the condition who either received the special treatment or received treatment for depression called interpersonal psychotherapy.

While 70 percent of the subjects that received the special treatment showed improvement, only a third of those on interpersonal psychotherapy showed improvement.

One key difference between complicated grief and depression is that those who are depressed lack the ability to have positive feelings.

“Grief is the form love takes after someone dies,” Shear said. “It has a lot of positive emotions.”

The specialized treatment for complicated grief involves asking the patients to visualize the loved ones’ deaths and explain what happened. The recount is recorded, and the patients are instructed to listen to the stories again at home. The highly emotional activity “jump-starts” the patients’ processes of coming to terms with the deaths.

People are also asked to identify the activities, things, and places they avoid because of their connection to the deceased. They are then asked to re-engage with the identified items.

“The goal of the therapy is to get grief back on track,” Shear said. “We are not trying to achieve a remission of grief. We are trying to free grief to find its rightful place in our lives.”