Prolonged grief disorder (PGD), or complicated grief, can happen after a person close to you has died within at least 6 months (12 months for children and teens). You may feel a deep longing for the person who died and become fixated on thoughts of them. This can make it hard to function at home, work, and other important settings.
Experts recently added this disorder to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. It defines and organizes mental disorders.
What Causes Prolonged Grief Disorder?
After a loved one dies, painful thoughts and feelings tend to get better within 6 months. But for some people, they linger and become hard to control.
PGD is common in those who’ve lost a child or romantic partner. It’s more likely to happen after a violent or abrupt death, such as murder, suicide, or an accident.
Loss from ongoing disasters, like the COVID-19 pandemic, can also lead to PGD.
What Are the Symptoms of Prolonged Grief Disorder?
If you’ve recently lost a loved one, it’s crucial to pay attention to your mental health. Grief is normal in these situations. But it can be unhealthy if it becomes too intense and lasts all day for many months. Some warning signs of PGD include:
- Feeling as though part of you has died
- A sense of disbelief about the death
- Avoidance of reminders that the person is dead
- Strong emotional pain related to the death (anger, bitterness, or sorrow)
- Difficulty moving on with your life (socializing with friends, pursuing interests, planning for the future)
- Emotional numbness
- Feeling that life is meaningless
- Extreme loneliness (feeling alone or separate from others)
Someone with PGD might also:
- Leave the deceased person’s belongings exactly how they were before their death
- Have trouble remembering positive memories about their loved one
- Have a hard time trusting other people
- Use more tobacco, alcohol, or other substances
- Have suicidal thoughts or behavior
PGD can happen to anyone. But the symptoms may be different based on one’s age, gender, or culture. Overall, PGD is more common in women.
Kids and teenagers may have PGD after the loss of a primary caregiver or parent due to the large role that person played in their life. But since it’s normal for children to have severe emotional responses after the loss an important figure, doctors should carefully diagnose children with PGD.
Symptoms in children with PGD might show up differently. They may:
- Wait for the deceased person to come back
- Go back to places where they last saw their loved one
- Become fearful others may die
- Have “magical” thinking or separation anxiety
- Show intense sadness or emotional pain through different moods
Anger related to the death of a loved one might show up as irritability, tantrums, or other behavior problems. (This is common in young children.)
PGD also differs based on one’s culture. For example, distinct groups of people share:
- Different emotional expressions of grief
- Rituals to manage the grieving process
- Ideas of the afterlife and stigma linked to certain types of death (such as suicide or especially traumatic events, like the death of a child).
How Do Doctors Diagnose Prolonged Grief Disorder?
A doctor will likely consider you to have PGD when your symptoms don’t fit more with the description of another mental disorder.
The DSM-5 criteria for PGD are a persistent grief response, including constant yearning for a person who died and/or fixation with the death of a loved one. And at least three of eight symptoms listed above.
In 2018, the World Health Organization (WHO) approved another trait. They state that PGD symptoms also cause significant trouble in important areas, such as one’s personal, educational, or work life. If the person is still able to function in these areas, it’s only through intense additional effort.
What’s the Treatment for Prolonged Grief Disorder?
Prolonged grief disorder therapy (PGDT) can help you feel better with this condition. This form of therapy is based on research in psychological and social functioning after loss. It’s a short-term treatment that focuses on and adapts to your specific needs. In PGDT, you’ll work with an expert to discuss your:
- Attachment relationships
- Self-determination processes
- Emotion regulation processes
- Cognitive processes
- Relational and social self
- And several other psychosocial processes
Prolonged Grief Disorder vs. Other Conditions
This disorder is different from others related to grief.
It may be confused with depression. But prolonged grief disorder involves persistent longing for someone who has passed away, while symptoms of depression involve more detached sadness and loss of interest. Studies show treatment for depression is less helpful than PGDT for those with the condition.