This vulnerability places the grieving individual at increased risk for physical and mental illness for approximately two years after the loss, with men more at risk than women. However, in cases where grief is unresolved or complicated, physical and mental vulnerabilities continue. According to the authors, should grief remain unresolved, this vulnerability becomes part of the individual's nervous system, hardwired, so to speak, in the neurochemical substrate. The stage has been set for the development of recurring major depression. What is important, then, is differentiating between normal and complicated grief.
Normal grief requires no treatment.
Untreated complicated grief may lay the groundwork for lifelong depression. Neurovegetative symptoms were especially notable in this group. Treatment with tricyclic antidepressants is often effective. Elders with pathological bereavement, however, do not respond to tricyclic antidepressants alone. Treatment, most likely, will require both psychotherapy and psychopharmacology over a fairly extensive period.