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Grief is a normal reaction to the loss or death of a loved one and is something that virtually everyone experiences during their life.

In most cases, the symptoms of grief will lessen over time as the grieving person begins to accept the situation and move on. However, for some people, these symptoms persist for much longer, and this is considered a prolonged grief disorder. Approximately 10% of people will experience prolonged grief at some point.

If a person cannot overcome the grief they feel following the death of someone close to them, treatment might be necessary to help them move forward. Understanding the signs of this disorder helps recognize the condition. This article discusses the disorder in further detail, including who can be affected by it and how to treat it.

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What is prolonged grief disorder?

Prolonged grief disorder is sometimes also referred to as complicated grief. The condition can occur if someone close to you has died within the last twelve months. For children and teenagers, the condition can arise if a death has occurred within the previous 6 months. It’s essential to recognize that cultural expectation for responding to grief vary. If someone’s response to death falls outside what’s seen as usual in their culture, this can also indicate prolonged grief.

Someone affected by this disorder may become fixated on the person who died and experiences intense longing for them. These feelings might make it more challenging to function in everyday life or make plans for the future. This persistent grief is debilitating and disruptive in a way that normal grief is not and lasts much longer. Because of the prevalence of this condition, in 2021, it was added to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This document defines and characterizes mental disorders.

Differences between regular and prolonged grief

When someone dies, feelings of grief are normal and healthy. It’s possible to experience grief for people you don’t know personally, for example, when a famous person dies. It’s usual to feel grief after losing someone you have an emotional connection with. It’s also possible to experience grief in some circumstances that don’t involve death, for example, following the end of a romantic relationship or friendship. Although grief is universal, the experience can vary between people, and some people can cope more quickly than others. One person’s grief reactions can also vary between different losses, and they might find some more straightforward to cope with than others.

Grief can last for months or years, and many reports that sometimes grief never entirely goes away. This is especially true if they lose someone they were very close to. While grief is often very intense, over time, these feelings subside, and the grieving person can accept their loss. Over time they can return to normal activities and continue their lives, even if they still feel pain because of the death.

When experiencing prolonged grief, intense feelings last for much longer than is usually expected. Even after time has passed since the death, the grieving person may experience the grief reaction just as intensely as they did when it first happened and find it harder to go back to their everyday life.

Who does prolonged grief disorder affect?

Anyone can be affected by prolonged grief disorder. Adults can develop this condition, as well as children and teens who might have less experience responding to death. A pre-existing mental health condition might increase the chances of developing prolonged grief. Additionally, prolonged grief can be accompanied by other mental health conditions like depression or PTSD that are also a response to bereavement. Women are considered at greater risk of the condition than men. Although anyone can be affected by this condition, it’s more likely to affect someone who has lost someone very close to them, who was a caregiver for the deceased person or following the death of a young person.

Why do people develop this disorder?

People can develop prolonged grief conditions for several different reasons. It can often be challenging to predict who will develop the disorder. Often the condition is more likely to develop following the death of someone very close, like a romantic partner, child, or parent. The condition might also be more likely to arise if the death was violent, traumatic, or unexpected, for example, because of a murder, suicide, or accident. A loss caused by a disaster, such as a Covid-19 death or death because of a natural occurrence like a hurricane or tsunami, can also cause this disorder.

Symptoms of prolonged grief disorder

Eight symptoms have been identified as part of prolonged grief disorder. Many of these symptoms are a normal part of grief immediately following a death and may not be a cause for concern if the death was very recent. If these symptoms continue to show over an extended period, this can indicate prolonged grief. The symptoms are:

  • Identity disruption and feeling that part of the self has also died
  • Continued disbelief or denial of the death
  • Avoiding reminders that the person has died
  • Intense emotional pain relating to the death, such as anger, sadness, or bitterness
  • Difficulty reintegrating, for example, making plans or engaging with others
  • Absence or reduction of emotions
  • Intense loneliness or detachment from others
  • Feeling that life is meaningless

Diagnosis

To get a diagnosis of prolonged grief disorder, the grieving person must have at least three of the eight identified symptoms of the condition. They should also have experienced these symptoms almost daily for at least a month before the diagnosis. The timing of the death is also essential in identifying prolonger grief – for adults to get a diagnosis, the death should have occurred at least 12 months earlier and at least six months earlier for children and teenagers.

Treatment for prolonged grief

Cognitive Behavioral Therapy (CBT) is recognized as one of the most effective ways of treating prolonged grief disorder. Studies have shown that combining CBT with exposure therapy may be an even more effective way of treating the condition.

CBT is a talking therapy that changes how someone thinks and behaves. It’s a therapy that can be useful for treating a range of mental health conditions. This therapy can help to grieve people who look at their grief differently and therefore start to move forward. It’s about helping the patient to accept the loss and work towards achieving goals and feeling satisfied with the world following the loss of their loved one. Exposure therapy involves confronting fears and pain. With prolonged grief, this might involve looking at photos of the deceased person or talking about memories of them. This can be effective if the grieving person avoids reminders of the person or their death.

Another helpful treatment method can be attending bereavement support groups. This can help the grieving person to feel less isolated and discuss their experiences with others. While these treatments are helpful, there are no specific remedies for grief and the feelings associated with it. Whatever treatment method is used, improvement may take some time. How quickly someone will respond to treatment varies between different individuals.

Seeking help for prolonged grief

Although prolonged grief disorders can be highly disruptive and debilitating, many people who experience them are unlikely to seek help for the condition. It’s essential to recognize that support is available. With the right help and treatment, people experiencing prolonged grief can usually make progress and get back to leading a fulfilling life. Knowing the signs of the condition and how to seek help can make it easier to identify prolonged grief and respond to it.