8 signs of prolonged grief taking hold when sorrow refuses to fade and life feels heavy

Prolonged grief disorder, newly included in the DSM by the APA, occurs when someone close passes away.

It describes a situation where grief after a loss becomes so severe and long-lasting that it significantly interferes with a person’s daily life. Grief is a natural response to losing a loved one, but for some, it becomes prolonged and deeply disruptive.

It typically manifests within 6 months for children and teens and 12 months for adults.

What is grief?

Grief is a natural response to losing a loved one, often improving within a year, according to NIH.

However, some people experience prolonged grief disorder, where they feel stuck and unable to move on.

Symptoms such as sadness and sleep issues are normal in acute grief and often resolve on their own.

Yet, intense grief can contribute to health issues like sudden heart problems, particularly in those with existing cardiovascular conditions.

Prolonged grief disorder (PGD)

In prolonged grief disorder, those who have lost someone may constantly think about or miss the person who passed away.

This can occur daily for at least a month, causing significant distress and making it difficult to handle daily activities and relationships.

“The circumstances in which we are living, with more than 675,000 deaths due to COVID, may make prolonged grief disorder more prevalent,” said APA President Vivian B. Pender, M.D.

Symptoms of prolonged grief disorder

After losing someone you love, monitor your mental health closely.

While feeling sad is normal, it’s concerning if it becomes very intense and lasts all day for many months, says Web MD.

Signs of PGD may include:

1. Feeling like a part of you has died
2. Having trouble believing the person has passed away
3. Avoiding things that remind you of their death
4. Feeling strong emotional pain such as anger, bitterness, or sorrow
5. Finding it hard to move forward in life, like seeing friends, pursuing hobbies, or making plans
6. Feeling emotionally numb
7. Feeling like life doesn’t have meaning
8. Feeling extremely lonely

Someone experiencing PGD might:

1. Keep the belongings of the deceased unchanged
2. Struggle to recall positive memories of their loved one
3. Find it difficult to trust others
4. Increase their use of tobacco, alcohol, or other substances
5. Have thoughts of suicide or engage in suicidal behavior

PGD can affect anyone, but its symptoms may vary based on age, gender, or culture. Generally, PGD is more common among women.

Children and teenagers can experience PGD after losing a primary caregiver or parent who is very important to them.

Since it’s normal for kids to grieve deeply for someone significant, doctors should diagnose PGD in children carefully.

1. Wait for the deceased person to return
2. Return to places where they last saw their loved one
3. Fear that others might also die
4. Have magical thoughts or worry about being separated
5. Express intense sadness or emotional pain through mood swings

Anger over losing a loved one can show as irritability, tantrums, or behavior problems, especially in young children.

PGD varies by culture, with different groups having unique emotional expressions of grief, rituals for coping, beliefs about the afterlife, and certain types of death, like suicide or the death of a child.

How is PGD diagnosed?

A doctor may diagnose PGD if your symptoms don’t match another mental disorder.

The DSM-5 defines PGD as ongoing grief with constant longing for the deceased or fixation on their death, along with at least three of the eight listed symptoms.

In 2018, the WHO added that PGD symptoms must cause significant personal, educational, or work issues, requiring intense effort to function in these areas.

Prolonged grief disorder treatment

Prolonged grief disorder therapy (PGDT) is a short-term treatment that helps you cope with grief.

It adapts to your needs and involves working with an expert to discuss your attachment to the deceased, independence, emotional management, thought processes, relationships, and other psychological and social aspects.

This focused approach can help you feel better and move forward.

How is PGD different from other conditions?

PGF is different from other grief-related conditions.

Unlike depression, which involves feeling detached and losing interest in things, PGD is marked by a constant longing for someone who has died.

Moreover, studies show that PGDT is more effective than depression treatments for this condition.

Here’s a video about prolonged grief disorder from CBC News: