What is Prolonged Grief Disorder?

When you lose a loved one, it’s (obviously) normal to grapple with feelings of grief for a long time afterward. You may even feel this way years following the loss: Grief affects different people in different ways. But, it’s important to distinguish between this feeling, and what mental health experts have dubbed “prolonged grief disorder,” or PGD. You see, for a select group of people, feelings of intense grief persist. And, the symptoms are severe enough to get in the way of continuing their lives as normal.

Prolonged grief disorder is characterized by intense, prolonged grief lasting for an extended period following the loss of a loved one. It’s also known as Persistent Complex Bereavement Disorder. The diagnosis and treatment of PGD have not yet been standardized in the same way more established mental health conditions have. However, mental health professionals can provide some support to individuals suffering from prolonged grief.

Symptoms of Prolonged Grief Disorder

Prolonged grief disorder may cause the afflicted individual to be preoccupied constantly with thoughts about their deceased loved one. They may experience difficulty performing daily activities at home or work. Persistent grief is disabling, and affects everyday function, in a way that expected grieving doesn’t. It’s important to note that grief is a natural response to loss, and not everyone who grieves for a prolonged period has PGD.

PGD is diagnosed when the grief symptoms are significantly distressing, and impact the individual’s ability to function in their daily life. For a diagnosis of Prolonged Grief Disorder, the loss must’ve occurred over a year ago for an adult (6 months for a child or adolescent). Additionally, the afflicted must experience at least three of the following symptoms almost daily for a month prior to their diagnosis:

• The individual’s bereavement lasts longer than expected based on social and cultural norms
• A marked sense of disbelief about the death
• Avoidance of reminders that the person is dead
• Intense emotional pain related to the death
• Emotional numbness
• Difficulty engaging with others, pursuing interests, and planning for the future
• Intense loneliness (feeling alone or detached from others)

An estimated 7% – 10% of adults will experience the persistent symptoms of prolonged grief disorder.* Some people may be more at risk of developing PGD. For example, older adults, and people with a history of depression or bipolar disorder. Caregivers, especially if they were caring for a partner, are also at a greater risk. PGD is also a risk if the loss happens suddenly or under traumatic circumstances. Furthermore, it often occurs alongside other mental disorders, including PTSD, anxiety, and/or depression. Sleep problems are also common.

Treatment for PGD

For most people, grief following the death of a loved one decreases over time, and does not continue to impact their everyday function. Although feelings of grief may increase at different points in time, as it does affect everyone differently, they don’t usually require mental health treatment. But for people who develop the more intense, ongoing symptoms of Prolonged Grief Disorder, there are (thankfully) some methods of treatment available. The use of cognitive behavioral therapy (CBT) has been found to be adequate in reducing symptoms. Cognitive Behavioral Therapy can also be helpful in addressing symptoms that often occur alongside prolonged grief disorder, including sleep problems. Research* has shown that cognitive behavioral therapy is an effective treatment for insomnia.

“Complicated grief treatment” incorporates elements of CBT, as well as other approaches to help individuals adapt to loss. This treatment focuses both on accepting the reality of the loss and working toward goals for the future, living in a world without the deceased loved one.

Bereavement support groups can also provide a useful source of support and social connection. This may be a way to help the bereaved feel less alone, mitigating the feelings of isolation that could increase the risk of PGD. There are currently no medications specifically to treat the symptoms of PGD.

Get Help

Despite effective treatments being available, many individuals experiencing ongoing intense grief may not seek professional help. One study found that, among caregivers with prolonged grief disorder, the majority didn’t choose to seek mental health services. If you or someone you know is experiencing intense grief or difficulty coping with the death of a loved one, seek support from a mental health professional, counselor, or support group. This process can be beneficial in addressing the challenges of grief, and finding healthy ways to cope with it. Seek professional help today.

*Source: Psychiatry.org