What is Prolonged Grief Disorder?
When an individual loses someone close to them, it’s obviously normal for them to feel grief for a long time afterward. The grief could last even years following the death: Different people deal with it differently. But, it’s an important distinction between grief, and what mental health experts are calling “prolonged grief disorder” (PGD). For a select group of individuals, the feeling of intense grief persists, and the symptoms are severe enough to get in the way of continuing their lives as normal.
Prolonged Grief Disorder is a mental health condition characterized by intense, prolonged grief lasting for an extended period following the loss of a loved one. The diagnosis and treatment of PGD are not yet standardized in the way more established mental health conditions are. However, mental health professionals may provide support.
Symptoms of Prolonged Grief Disorder
PGD may cause a person to be constantly preoccupied with persistent thoughts about their lost loved one. They may experience difficulty in performing daily activities at home and at work/school. Persistent grief affects everyday function in a disabling way that the typical grieving process does not. It’s important to note that grief is a natural response to loss, and that it affects everyone differently. Not everyone who grieves for a prolonged period necessarily has PGD. It is diagnosed when the grief symptoms are significant enough to impair the individual’s ability to function in their daily life.
For a diagnosis of PGD, the loss in question must have occurred over a year ago (a year for adults, over 6 months for children or adolescents). Furthermore, the person must have experienced at least three of the following symptoms:
- The individual’s bereavement lasts longer than expected based on social and cultural norms
- Intense emotional pain related to the death
- Avoidance of reminders that the lost person is deceased
- Marked disbelief about the death
- Difficulty engaging with others, pursuing interests, and planning for the future
- Intense loneliness (feeling alone or detached from others)
- Emotional numbness
…Almost every day for one month prior to the diagnosis. An estimated 7% to 10% of adults will experience the 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. PGD is also at risk of occurring if the death of a loved one happens suddenly/under traumatic circumstances. Furthermore, it often occurs alongside other mental disorders, such as PTSD, depression, and anxiety. Insomnia is also common.
For most people, the feelings of grief following the death of a loved one decrease over time, and do not impact their everyday ability to function. Even though feelings and symptoms of grief may increase at different points in time, they don’t usually require mental health treatment. But for people who develop the more intense, ongoing symptoms of Prolonged Grief Disorder, there are some methods of treatment for it. The use of cognitive behavioral therapy (CBT) has been found to be effective.
“Complicated grief treatment” incorporates elements of CBT as well as other approaches to help the person grapple with the loss. This treatment focuses on both helping them to accept the reality of the loss, and working toward goals for the future, now living in a world without their 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 CBT is an effective treatment for insomnia.
Additionally, bereavement support groups may provide a useful source of social connection and support. They may be able to help the bereaved feel less isolated, stopping the feelings of loneliness that could increase the risk of PGD. There are, however, currently no medications to treat the specific symptoms of grief.
Despite the existence of effective treatments, many people experiencing PGD 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 in order to mitigate it. If you or someone you know is experiencing intense prolonged 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.