For some, the grief response may reach the level of clinical depression or generate a sense of uncertainty that borders on anxiety or panic. Here are the symptoms that indicate a need for professional help.

A sadness so intense that it begins to interfere with your life. You don’t go out. You avoid people. Nothing lifts your feelings of gloom.

A debilitating sense of guilt, because you can’t shake the feeling that you should have been able to prevent the loss.

Increased anger at or irritation by others who don’t appear to understand your feelings or who, you believe, haven’t experienced the same kind of loss.

Reliance on alcohol or drugs to alleviate the sadness.

Sleep disruptions, especially beyond six months.

Severe depression and hopelessness about the future. Thoughts of suicide.

Symptoms of post-traumatic stress disorder: reexperiencing the loss event through flashbacks or nightmares, memory and concentration problems, anxiety, a tendency to be easily startled.