What Is Prolonged Grief Disorder?

Wondering about prolonged grief disorder? Here’s everything you need to know.

It’s normal to grieve when you lose someone close to you, suffer a major setback in your life or go through a challenging, traumatic experience. 

Grief is natural, and for many people, it’s a reaction that slowly gets better as time passes from the triggering event and your life starts to change. But for some, the symptoms of grief can be persistent and severe enough to get in the way and impact your quality of life for an extended period.

When grief doesn’t fade away over time or is so severe that it prevents you from maintaining a normal life, it’s often referred to as prolonged grief disorder (or PGD).

Prolonged grief disorder can have a severe impact on your mental well-being, especially when it causes you to feel empty or face emotional numbness. In certain cases, it could also affect your physical health.

The good news is that, as with many other mental health disorders, prolonged grief disorder can be treated, allowing you to move on from periods of intense grief and gain control over how you feel, think and behave. 

Is prolonged grief disorder a natural process? Should you be worried, and if so, what can you do to get past it?

Below, we’ll talk about what prolonged grief disorder is, as well as the symptoms you might develop if you’re affected by this form of severe, complicated grief.

We’ll also discuss the potential causes of prolonged grief disorder, as well as risk factors that may make you more susceptible to severe or persistent grief after a life setback. 

Finally, we’ll cover effective treatment options for prolonged and/or intense grief, from forms of talk therapy such as cognitive behavioral therapy (CBT) to support groups, friends and family, lifestyle changes and more.

Prolonged grief disorder is a condition involving severe, pathological grief that can develop after a personal loss or setback. If you have PGD, you might feel intense longing, numbness or traumatic grief after the loss of a person you care about or another negative event.

It’s normal to experience grief after someone you care about dies, whether it’s a family member, partner or friend. It’s also normal to develop grief in response to a sudden, severe change to your life, particularly when the change affects your happiness and well-being.

Common reactions to grief include feelings of distress, depressive symptoms, difficulty sleeping, loss of appetite, a sense of shock or disbelief and anger. For some people, it may also involve denial related to the event that triggered the grieving.

Grief can affect anyone, from older adults with significant life experiences to young children going through a tough situation for the first time.

For most people, grief occurs in stages. As a bereaved person recovers from a personal loss or another event that causes severe grief, they may slowly move from feelings of denial and anger to bargaining to sadness and, eventually, acceptance of the loss. 

These feelings can occur at different times for different people — and sometimes in different orders. For example, research suggests that some folks experience low, moderate or high levels of grief immediately after a loss, while others experience grief several months after a death or another traumatic loss.

Many people experiencing grief benefit from grief therapy — a mix of counseling techniques and behavioral therapy that can make dealing with these feelings easier.

Unlike normal grief, prolonged grief can remain intense and severe for a long period and may not improve on its own.

If you have prolonged grief disorder, you may constantly think about a deceased person, even a long time after their passing. A while after the loss occurred, you may worry about the circumstances that occurred prior to their death, develop intense emotional pain or feel extremely lonely now that they’re gone.

Other symptoms of prolonged grief disorder may also include:

• Feeling as though part of yourself has also died with the loss of a specific person

• Persistent disbelief about a person’s death, personal setback or another negative event

• Intense emotions, including feelings of pain, bitterness, anger, frustration and sorrow

• Severe, persistent numbness and an inability to process emotions in a healthy way

• A sense that your life is hopeless or meaningless and that you can’t be helped

• Avoidance of reminders that the person you miss is no longer alive

• Feelings of severe, prolonged loneliness and isolation from others

• Difficulty falling or staying asleep, including long-term poor sleep quality

• Increased suicidal ideation (suicidal thoughts) and risk of suicide

• Difficulty reconnecting with friends and “restarting” your life.

We should note that many of these symptoms also occur with the normal grieving process — the main difference is how long they last.

As well as these emotional and behavioral symptoms, data from studies and systematic reviews suggests that severe and/or prolonged grief may also affect your physical health.

Grief is linked to high blood pressure, increased levels of stress hormones, such as cortisol, an elevated risk of heart issues, such as tachycardia (fast heart rate), and clogged arteries.

These changes may increase your risk of serious health issues if you’re experiencing severe or prolonged grief, including cardiovascular events such as a heart attack.

It’s crucial to understand that grief reactions can vary from person to person. And a number of factors, including your cultural and religious norms, could affect how you react in a situation that causes you to feel grief.

As such, you may only develop some of the symptoms listed above following a loss, even if you have prolonged grief disorder.

Prolonged grief disorder has historically been referred to under a number of names. Terms such as “complicated grief disorder” and “persistent complex bereavement disorder” are also used in research when referring to similar conditions that can occur after the loss of a loved one.

Prolonged grief disorder occurs more often than you may think. For example, studies suggest an estimated seven to 10 percent of bereaved adults experience prolonged grief disorder symptoms after suffering a personal loss.

Similarly, between 5 to 10 percent of children and adolescents develop symptoms of mental disorders, such as major depressive disorder (MDD), post-traumatic stress disorder (PTSD) or prolonged grief following a person’s death.

Our guide to the types of grief goes into more detail about the various ways a person might respond to a loss, including prolonged grief.

Like many other psychiatric disorders, experts aren’t yet completely aware of what causes prolonged grief disorder in some people and normative grief in others.

However, researchers have identified certain factors that may give you an elevated risk of grief that’s severe, prolonged and difficult to overcome.

Potential risk factors for prolonged grief disorder include:

• Having a history of depression or depressive symptoms

• Suffering from bipolar disorder or other psychiatric disorders

• Being the partner or caregiver of the deceased person (known as bereaved caregivers)

• Traumatic circumstances surrounding the person’s death (also known as traumatic grief)

• Having alcohol use disorder or substance use disorder (SUD)

• Death of a loved one that occurs suddenly and/or unexpectedly

Prolonged grief disorder is also common in people with anxiety disorders, such as generalized anxiety disorder (GAD).

If you have persistent and/or severe symptoms of grief and think you may have prolonged grief disorder, it’s important to connect with a mental health provider. Further, if you’re experiencing suicidal ideations, be sure to talk to someone as soon as possible.

You can connect with a mental health provider by talking to your primary care provider about a mental health referral or using our online psychiatry service.

In order to diagnose you with prolonged grief disorder, your mental health provider will talk with you about your symptoms, how long they’ve occurred and the impact they may currently have on your daily life and ability to function.

Therapy for Prolonged Grief Disorder

Prolonged grief disorder is treatable, usually with talk therapy customized to address your specific needs and concerns.

This type of treatment, called complicated grief treatment (CGT), involves cognitive behavioral therapy (CBT) — a form of therapy that involves identifying and modifying thoughts, emotions and ways of behaving that contribute to your symptoms — among other approaches.

By taking part in CBT, you can learn new ways to address the challenges you face after losing a loved one, including acceptance of your loss. This can help you to move on from loss and make progress toward a more fulfilling, satisfying life.

Medication isn’t always used as part of treatment for prolonged grief disorder. However, one study found that some medications for depression might help to improve results from therapy in people with complicated grief.

Your mental health provider will work with you to choose an approach that best suits your unique symptoms, needs and preferences.

We offer online therapy as part of our range of mental health treatments, allowing you to access help for prolonged grief disorder and other problems that have a mental health impact from your home.

Support Groups for Dealing With Grief

Another form of treatment that’s often effective for people with prolonged grief disorder is taking part in a support group. Participating in a support group can help you to connect with like-minded people and learn new methods for coping with grief.

For example, you might be able to talk with bereaved caregivers or other bereaved adults recovering from personal losses. Connecting in a private, anonymous environment will give you the opportunity to freely express yourself and feel less alone.

We offer anonymous online support groups, allowing you to take part in a private, judgment-free discussion from the privacy and comfort of your living space.

Other Ways to Cope With Prolonged Grief

In addition to taking part in therapy and joining a support group, making changes to your habits and daily life can potentially make the symptoms of prolonged grief disorder easier to deal with, allowing you to focus on making progress and recovering.

The following tips and techniques may help you cope with grief and feel better: 

• Confide in trusted friends, family and authority figures. Talking to a close friend, a trusted family member or clergy may help you to let your emotions out and get support during a challenging situation.

• Avoid drinking alcohol or using illicit drugs. These substances may reduce feelings of grief in the short term, but they can also lead to larger problems, including substance use disorders.

• Take good care of yourself. When you’re feeling down, it’s easy to let good habits fall by the wayside. Our guide to self-care tips for women lists effective techniques you can use to care for yourself when you’re dealing with a tough situation in life.

• Keep yourself physically and socially active. Regular exercise and socializing both have benefits for your well-being. Try to exercise on a daily basis and spend your time with friends, even if you may not feel like it in the short term.

• Don’t be afraid to ask for help. Grief can be very difficult to deal with, and there’s no shame in asking for help. Don’t ever be afraid to call your healthcare provider or meet with a psychiatrist, as it’s highly likely they can help you to get through this. 

Though it can be chronic, most grief is temporary (even when it’s severe), and your life will eventually begin to get better as your current feelings pass.

Focus on treatment, practice healthy daily habits and don’t hesitate to reach out for help. In a few months, you’ll likely be able to look back on your life and see exactly how much progress you’ve made on your journey toward recovery from grief.

Grief is a normal, natural and universal part of life. It affects all of us, but it may affect some of us more than others. When grief is prolonged and severe, it can have a serious impact on just about every aspect of your life, including your mental and physical well-being. 

If you think you’re affected by prolonged grief disorder, it’s critical to get help. You can talk to a mental health specialist by asking your primary care provider for a referral or scheduling an appointment with a psychiatrist in your area.

You can also take part in a mental health consultation online using our telehealth platform and connect with a provider from your home.

With time, therapy and changes to your habits, it’s often possible to overcome prolonged grief, improve your mental health and enjoy a higher-quality, more fulfilling life.

Interested in learning more before getting help? Our complete guide to seeking help for mental health shares common signs that you may be suffering and explains what you can do to talk to an expert and make progress toward thinking, feeling and behaving like your best self.