Understanding Prolonged Grief Disorder & Treatment Options
Grief is a natural part of life, but what happens when grief lingers far longer than “expected” and becomes an overwhelming, life-altering burden? While there is some controversy to the diagnosis, The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) officially recognized Prolonged Grief Disorder (PGD) as a mental health diagnosis in 2021.
What Is Prolonged Grief Disorder?
When feelings of grief don’t subside over time but intensify, this can turn into a diagnosis known as Prolonged Grief Disorder (PGD). PGD is a mental health condition when someone experiences intense, excessive, and persistent grief for an extended period, typically exceeding 12 months in adults or 6 months in children. Unlike grief that lasts longer than might be expected based on social, cultural, or religious norms, PGD interferes significantly with a person’s ability to function in their daily life. Most bereaved parents who have to terminate their pregnancies for medical reasons grieve- its a natural response to such a significant loss. Yet PGD persists in what some researchers suggest is a more typical length and severity of grief.
How Is Prolonged Grief Disorder Different From Normal Grief?
Grief is a deeply personal process, and everyone grieves at their own pace. However, PGD is unique because the symptoms remain extreme and unrelenting, preventing a person from getting back to their daily routines or even finding meaning in life after a loss.
Key differences include:
Duration⎯While normal grief typically subsides gradually, individuals with PGD remain "stuck," with symptoms persisting for years.
Severity⎯The emotional pain and yearning in PGD often feel unbearable, overshadowing all other aspects of a person’s life.
Impact⎯PGD interferes significantly with personal, social, and ability to work as these things may take a back seat to the overpowering focus on loss.
Signs & Symptoms Of Prolonged Grief Disorder
Recognizing PGD early is crucial to get your feelings under control so it doesn’t affect your whole life. Some common symptoms include:
Emotional Symptoms
Intense longing or yearning for the deceased.
Persistent sadness, emotional numbness, or bitterness.
Difficulty accepting the death, accompanied by feelings of disbelief.
Strong, recurring thoughts or memories of the loss, including intrusive daydreams.
Behavioral Symptoms
Avoiding situations or places that remind you of your loved one.
Difficulty moving personal belongings of the deceased.
Neglecting self-care, responsibilities, or relationships.
Withdrawal from social interactions and isolating oneself.
Physical Symptoms
Fatigue or physical exhaustion
Disruption in sleep patterns, including insomnia or oversleeping.
Changes in appetite or significant weight fluctuations.
Increased susceptibility to illness due to weakened immunity.
What Causes Prolonged Grief Disorder?
Not everyone grieving a loss develops PGD. It is typically associated with specific circumstances or the state of an individual's mental health.
Nature of loss⎯Sudden, unexpected, or traumatic deaths like those due to accidents or violence, increase the likelihood of PGD.
Relationship with the deceased⎯Losing a spouse, child, or other close loved one often intensifies grief.
Pre-existing mental health conditions⎯People with a history of anxiety, depression, or post-traumatic stress disorder (PTSD) are often more vulnerable.
Lack of a support system⎯A limited support network can leave individuals feeling isolated in their grief.
Cultural expectations⎯Cultural or societal pressures to "move on" quickly may stifle emotional expression or healing.
The Impact Of Untreated Prolonged Grief Disorder
Without treatment PGD can seriously affect mental, emotional, and physical wellbeing, leading to clinical depression, anxiety, or substance abuse as individuals look for ways to "numb" their pain. Isolation and emotional withdrawal commonly strain or sever relationships with family and friends. As well as the lack of motivation to work or hold down a job.
Treatment & Support For Prolonged Grief Disorder after TFMR
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Techniques like mindfulness meditation, yoga, and breathing exercises can help alleviate the emotional and physical symptoms of PGD, so people can regain control over their mental state. Regular exercise, journaling, and establishing a routine can help ground individuals struggling with loss. Eating well and maintaining good sleep hygiene also contribute to emotional regulation because a study by Columbia University Department of Psychiatry found that “sleep disturbances were linked to higher levels of psychological distress.”
