What is Prolonged Grief Disorder?
When we lose someone close to us, it’s obviously normal to feel grief for a long time afterward, even years following the death. But, it’s an important distinction between this and what mental health experts call “prolonged grief disorder” (PGD).
For a select group of people, the feeling of intense grief persists. The symptoms are severe enough to get in the way of them continuing their lives as normal.
Prolonged Grief Disorder (PGD) is a mental health condition characterized by intense and prolonged grief lasting for an extended period after the loss of a loved one. It is also known as Persistent Complex Bereavement Disorder. The diagnosis and treatment of PGD are not yet standardized in the same way as more established mental health conditions. However, mental health professionals may provide support and interventions to help individuals cope with prolonged grief.
Symptoms of PGD
Prolonged grief disorder may cause an individual to constantly be preoccupied with persistent thoughts about their lost loved one. The individual may experience difficulty performing daily activities at home or work. Persistent grief is disabling and affects everyday function in a way that typical 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. It is diagnosed when the grief symptoms are significantly distressing and impairing the person’s ability to function in their daily life.
For a diagnosis of PGD, the loss must’ve occurred at least a year ago (for adults, only 6 months for children or adolescents). Furthermore, the individual must have experienced at least three of the following symptoms.:
- 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)
…Almost daily for the past month prior to the diagnosis. An estimated 7 to 10 percent of adults will experience the persistent symptoms of prolonged grief disorder.*
Some individuals may be at greater risk of developing PGD, including older adults and people with a history of depression or bipolar disorder. Caregivers, especially if they were caring for a partner, are also at greater risk.
Prolonged grief disorder is also a risk if the death of a loved one happens suddenly or under traumatic circumstances. Additionally, it often occurs along with other mental disorders, such as PTSD, anxiety, and depression. Sleep problems are also common.
For most people, grief-related symptoms following the death of a loved one decrease over time and do not impact their everyday function. Although feelings and symptoms of grief may increase at different points in time, as it affects everyone differently, they don’t usually require mental health treatment.
For people who develop the more intense, ongoing symptoms of Prolonged Grief Disorder, there are (thankfully) some methods of treatment. The use of cognitive behavioral therapy (CBT) has been found to be effective in reducing symptoms.
Complicated grief treatment incorporates elements of CBT as well as other approaches to help an individual adapt to the loss. This treatment focuses on both accepting the reality of the loss, and working. toward goals for the future, in a world without the lost loved one.
Cognitive Behavioral Therapy can also be helpful in addressing symptoms that occur along with prolonged grief disorder, including sleep problems. Research* has shown that cognitive behavioral therapy as a treatment for insomnia is effective at improving sleep.
Bereavement support groups can also provide a useful source of social connection and support. They may be able to help the bereaved feel less alone, stopping the feelings of isolation that could increase the risk of prolonged grief disorder. There are currently no medications to treat the specific symptoms of grief.
Despite the existence of effective treatments, people 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 access mental health services.
If you or someone you know is experiencing intense grief or difficulty coping with the loss of a loved one, seeking support from a mental health professional, counselor, or support group can be beneficial in addressing the challenges of grief and finding healthy ways to cope with loss.