Table of ContentsView AllTable of ContentsWhat Is It?SymptomsDiagnosisTreatment

Table of ContentsView All

View All

Table of Contents

What Is It?

Symptoms

Diagnosis

Treatment

While grief is a natural and normal response to painful or traumatic events or losses, prolonged grief makes it challenging for a person to accept the reality of a loss and begin to move forward.

This article discusses prolonged grief disorder, as well as its symptoms, diagnosis, and treatment.

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Grieving older woman with face in her hands

What Is Prolonged Grief Disorder?

As a society, our experiences with grief are becoming more prevalent—so much so that the mental health community is adding prolonged grief disorder to the text revision of the “Diagnostic and Statistical Manual of Mental Disorders”(DSM-5), the American Psychiatric Association’s handbook for mental health disorders.

Prolonged grief can be incapacitating. A person may:

Grief becomes complicated when we lose someone and continue to experience extreme longing or yearning for them, and it causes significant impairment in important areas of functioning.When a person’s experience of grief extends beyond what is appropriate for their culture, religion, age, or social norms, prolonged grief disorder may be the reason.

Complicated grief can impact a person’s life in a variety of ways. It can feel all-consuming and come to the surface many times a day. A person may start to notice issues at home, work, school, in their relationships, and their mental and physical well-being.

What Causes Prolonged Grief Disorder?

When thinking about how we navigate grief, it’s important to remember that every person handles loss in their own way. Some factors that may influence the grief process include culture, religion, age, or gender.

Symptoms of Prolonged Grief Disorder

Though a person may continue to think about and miss someone they’ve lost, grief responses generally begin to improve within six months.However, others may become preoccupied with the loss of their loved one, and these thoughts and feelings can disrupt their daily lives. This is when grief becomes complicated or prolonged. In these cases, a person may struggle to accept that the loss has occurred, be focused on their death, and have intense feelings of longing for the individual.

Prolonged grief disorder can be diagnosed when symptoms persist for more than 12 months after the passing of a loved one in adults and at least six months in children.

Symptoms associated with complicated grief include, but are not limited to:

Grief may look different in children and adults. For example, adolescents and children may experience mood changes, sadness and fear, concern about losing others, and separation anxiety.

Adults may experience social issues, feeling unable to accept the loss, drug or alcohol use, orsuicidal thoughts.

Learning to take care of yourself as you grieve is essential. Prolonged grief has been linked to problems with sleep, cardiovascular disease, accidents, professional and interpersonal issues, and depression.

Help Is AvailableIf you or someone you love is struggling with complicated grief, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.If you are havingsuicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call911.

Help Is Available

If you or someone you love is struggling with complicated grief, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.If you are havingsuicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call911.

If you or someone you love is struggling with complicated grief, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.

If you are havingsuicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call911.

Diagnosing Prolonged Grief Disorder

Your healthcare provider may consider prolonged grief disorder if your symptoms don’t align with the criteria for other conditions. Prolonged grief disorder is diagnosed when a person reports intense longing and preoccupation with their loved one, and when significant disruptions in their daily functioning are present.

Anyone can experience prolonged grief. If you are struggling, getting professional support can be helpful. Your healthcare provider may share information or referrals to connect you with a mental health professional who can treat prolonged grief disorder.

An estimated 10% of adults who have lost someone will experience prolonged grief disorder.

Treating Prolonged Grief Disorder

Seeking help from a mental health professional can provide an accurate diagnosis and symptom management. A therapist can help you process your loss in a compassionate, safe, and non-judgmental environment and talk about how to improve your emotional well-being and functioning.

Therapy for prolonged grief may include:

Before getting started with a therapist, you can take steps to make sure they are a good fit for you and your concerns. As you consider therapists, you can ask about their background, education, training, and experience with treating grief.

Cognitive Behavioral Therapy

Cognitive behavioral therapy(CBT) is an effective treatment for many mental health conditions, and it involves exploring negative thought patterns to change unwanted thoughts and behavior. A study that examined the use of CBT and exposure techniques (repeated exposure to something that causes negative emotions) with grieving people found that these interventions helped reduce symptoms of grief and depression. Additionally, the participants noted an increase in their psychological well-being and social functioning.

One example of exposure therapy for prolonged tried disorder would be repeated exposure to the story of the death that occurred.

In addition to helping with grief, CBT can help with symptoms that might occur with prolonged grief disorder, such asinsomnia. CBT for insomnia focuses on sleep hygiene, reframing thoughts about sleep, and controlling stimulating inputs before sleep.

Support Groups

Support groups can also be useful to those experiencing grief. This is especially true because bereaved people often experience a lack of social support, which these groups can help address.

Psychodynamic Psychotherapy

Other psychotherapeutic approaches, such as psychodynamic psychotherapy, can also be effective. Psychodynamic psychotherapy is a form of talk therapy in which people explore patterns of thoughts and behaviors in their past as well as present.

Summary

Prolonged grief is a new DSM-5 diagnosis that refers to the preoccupation with a deceased person. This can lead to significant emotional distress and make it difficult to get through the day and function in important ways.

Seeking support from a healthcare provider and support system can help a grieving person develop coping skills and examine thoughts and feelings about their loss.

8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Yi X, Gao J, Wu C, et al.Prevalence and risk factors of prolonged grief disorder among bereaved survivors seven years after the Wenchuan earthquake in China: a cross-sectional study.Int J Nurs Sci. 2018;5(2):157-161. doi:10.1016/j.ijnss.2018.04.001American Psychiatric Association, ed.Trauma- and stressor-related disorders. In:Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision. American Psychiatric Association; 2022:322-328. doi:10.1176/appi.books.9780890425787.x07_Trauma_and_Stressor_Related_DisordersKillikelly C, Maercker A.Prolonged grief disorder for ICD-11: the primacy of clinical utility and international applicability.Eur J Psychotraumatol. 2018;8(Suppl 6):1476441. doi:10.1080/20008198.2018.1476441American Psychiatric Association.APA offers tips for understanding prolonged grief disorder.Thimm JC, Kristoffersen AE, Ringberg U.The prevalence of severe grief reactions after bereavement and their associations with mental health, physical health, and health service utilization: a population-based study.Eur J Psychotraumatol. 2020;11(1):1844440. doi:10.1080/20008198.2020.1844440Szuhany KL, Malgaroli M, Miron CD, Simon NM.Prolonged grief disorder: course, diagnosis, assessment, and treatment.FOC. 2021;19(2):161-172. doi:10.1176/appi.focus.20200052Szuhany KL, Malgaroli M, Miron CD, Simon NM.Prolonged grief disorder: course, diagnosis, assessment, and treatment.Focus (Am Psychiatr Publ). 2021;19(2):161-172. doi:10.1176/appi.focus.20200052Leichsenring F, Abbass A, Heim N, et al.The status of psychodynamic psychotherapy as an empirically supported treatment for common mental disorders – an umbrella review based on updated criteria.World Psychiatry. 2023;22(2):286-304. doi:10.1002/wps.21104

8 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Yi X, Gao J, Wu C, et al.Prevalence and risk factors of prolonged grief disorder among bereaved survivors seven years after the Wenchuan earthquake in China: a cross-sectional study.Int J Nurs Sci. 2018;5(2):157-161. doi:10.1016/j.ijnss.2018.04.001American Psychiatric Association, ed.Trauma- and stressor-related disorders. In:Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision. American Psychiatric Association; 2022:322-328. doi:10.1176/appi.books.9780890425787.x07_Trauma_and_Stressor_Related_DisordersKillikelly C, Maercker A.Prolonged grief disorder for ICD-11: the primacy of clinical utility and international applicability.Eur J Psychotraumatol. 2018;8(Suppl 6):1476441. doi:10.1080/20008198.2018.1476441American Psychiatric Association.APA offers tips for understanding prolonged grief disorder.Thimm JC, Kristoffersen AE, Ringberg U.The prevalence of severe grief reactions after bereavement and their associations with mental health, physical health, and health service utilization: a population-based study.Eur J Psychotraumatol. 2020;11(1):1844440. doi:10.1080/20008198.2020.1844440Szuhany KL, Malgaroli M, Miron CD, Simon NM.Prolonged grief disorder: course, diagnosis, assessment, and treatment.FOC. 2021;19(2):161-172. doi:10.1176/appi.focus.20200052Szuhany KL, Malgaroli M, Miron CD, Simon NM.Prolonged grief disorder: course, diagnosis, assessment, and treatment.Focus (Am Psychiatr Publ). 2021;19(2):161-172. doi:10.1176/appi.focus.20200052Leichsenring F, Abbass A, Heim N, et al.The status of psychodynamic psychotherapy as an empirically supported treatment for common mental disorders – an umbrella review based on updated criteria.World Psychiatry. 2023;22(2):286-304. doi:10.1002/wps.21104

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Yi X, Gao J, Wu C, et al.Prevalence and risk factors of prolonged grief disorder among bereaved survivors seven years after the Wenchuan earthquake in China: a cross-sectional study.Int J Nurs Sci. 2018;5(2):157-161. doi:10.1016/j.ijnss.2018.04.001American Psychiatric Association, ed.Trauma- and stressor-related disorders. In:Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision. American Psychiatric Association; 2022:322-328. doi:10.1176/appi.books.9780890425787.x07_Trauma_and_Stressor_Related_DisordersKillikelly C, Maercker A.Prolonged grief disorder for ICD-11: the primacy of clinical utility and international applicability.Eur J Psychotraumatol. 2018;8(Suppl 6):1476441. doi:10.1080/20008198.2018.1476441American Psychiatric Association.APA offers tips for understanding prolonged grief disorder.Thimm JC, Kristoffersen AE, Ringberg U.The prevalence of severe grief reactions after bereavement and their associations with mental health, physical health, and health service utilization: a population-based study.Eur J Psychotraumatol. 2020;11(1):1844440. doi:10.1080/20008198.2020.1844440Szuhany KL, Malgaroli M, Miron CD, Simon NM.Prolonged grief disorder: course, diagnosis, assessment, and treatment.FOC. 2021;19(2):161-172. doi:10.1176/appi.focus.20200052Szuhany KL, Malgaroli M, Miron CD, Simon NM.Prolonged grief disorder: course, diagnosis, assessment, and treatment.Focus (Am Psychiatr Publ). 2021;19(2):161-172. doi:10.1176/appi.focus.20200052Leichsenring F, Abbass A, Heim N, et al.The status of psychodynamic psychotherapy as an empirically supported treatment for common mental disorders – an umbrella review based on updated criteria.World Psychiatry. 2023;22(2):286-304. doi:10.1002/wps.21104

Yi X, Gao J, Wu C, et al.Prevalence and risk factors of prolonged grief disorder among bereaved survivors seven years after the Wenchuan earthquake in China: a cross-sectional study.Int J Nurs Sci. 2018;5(2):157-161. doi:10.1016/j.ijnss.2018.04.001

American Psychiatric Association, ed.Trauma- and stressor-related disorders. In:Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision. American Psychiatric Association; 2022:322-328. doi:10.1176/appi.books.9780890425787.x07_Trauma_and_Stressor_Related_Disorders

Killikelly C, Maercker A.Prolonged grief disorder for ICD-11: the primacy of clinical utility and international applicability.Eur J Psychotraumatol. 2018;8(Suppl 6):1476441. doi:10.1080/20008198.2018.1476441

American Psychiatric Association.APA offers tips for understanding prolonged grief disorder.

Thimm JC, Kristoffersen AE, Ringberg U.The prevalence of severe grief reactions after bereavement and their associations with mental health, physical health, and health service utilization: a population-based study.Eur J Psychotraumatol. 2020;11(1):1844440. doi:10.1080/20008198.2020.1844440

Szuhany KL, Malgaroli M, Miron CD, Simon NM.Prolonged grief disorder: course, diagnosis, assessment, and treatment.FOC. 2021;19(2):161-172. doi:10.1176/appi.focus.20200052

Szuhany KL, Malgaroli M, Miron CD, Simon NM.Prolonged grief disorder: course, diagnosis, assessment, and treatment.Focus (Am Psychiatr Publ). 2021;19(2):161-172. doi:10.1176/appi.focus.20200052

Leichsenring F, Abbass A, Heim N, et al.The status of psychodynamic psychotherapy as an empirically supported treatment for common mental disorders – an umbrella review based on updated criteria.World Psychiatry. 2023;22(2):286-304. doi:10.1002/wps.21104

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